Document Detail

Metabolic syndrome score and ambulatory blood pressure in untreated essential hypertension.
MedLine Citation:
PMID:  16077262     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The relationship between metabolic syndrome components, as defined by the Adult Treatment Panel III report, and ambulatory blood pressure in hypertensive patients has not been investigated to date. OBJECTIVE: To explore the relation between metabolic syndrome components ambulatory blood pressure levels and blood pressure day/night variations in a large population of never-treated essential hypertensive patients. METHODS: This investigation included 519 patients with uncomplicated grade 1 and 2 hypertension (mean age 45+11 years) who were attending a hypertension hospital outpatient clinic. They underwent the following procedures: (1) repeated clinic blood pressure measurements; (2) blood sampling for routine chemistry examinations; and (3) ambulatory blood pressure monitoring over two 24-h periods within 4 weeks. Because, by selection, all participants fulfilled one of the Adult Treatment Panel III criteria, the additional four criteria, abdominal obesity, hypertriglyceridemia, low HDL cholesterol and high blood fasting glucose, were specifically searched for. Patients were stratified according to the absence (group I) or the presence of one (group II), two (group III), three or four (group IV) components of the metabolic syndrome. Nocturnal dipping was defined as a night-time reduction in average systolic and diastolic blood pressure >10% compared to average daytime values. Each participant was classified according to the consistency of the dipping or nondipping status in the first and second ambulatory blood pressure measurement periods as follows: reproducible dipper (DD: decrease in blood pressure >10% in both ambulatory blood pressure measurement periods), reproducible nondipper (ND-ND: decrease in blood pressure <10% in both ambulatory blood pressure measurement periods) and variable dipper (VD: i.e dipper in one and nondipper in the other ambulatory blood pressure measurement period). RESULTS: In the whole population mean clinic and 48-h ambulatory blood pressures were 146/96 and 136/87 mmHg, respectively. In all, 197 patients (38%) had no metabolic syndrome components other than high blood pressure, 171 (33%) had one, 109 (21%) had two and 42 (8%) had three or four components. The four groups did not differ in age, clinic blood pressure, average 48-h, daytime, night-time systolic and diastolic blood pressure, and percentages of nocturnal fall in systolic and diastolic blood pressure. Furthermore, the distribution of three different ambulatory blood pressure patterns (DD, ND-ND and VD) was similar in the four groups: I=54.6%, 23.0%, 22.4%; II=51.1%, 21.7%, 27.2%; III=51.9%, 23.6%, 24.5%; and IV=52.7%, 27.2%, 25.1%, respectively. CONCLUSIONS: Our findings indicate that no significant relationship exists between the extent of metabolic alterations and ambulatory blood pressure levels or circadian variations in blood pressure in uncomplicated essential hypertensive patients.
Cesare Cuspidi; Stefano Meani; Cristiana Valerio; Eleonora Catini; Veronica Fusi; Carla Sala; Alberto Zanchetti
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Blood pressure monitoring     Volume:  10     ISSN:  1359-5237     ISO Abbreviation:  Blood Press Monit     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-03     Completed Date:  2005-10-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9606438     Medline TA:  Blood Press Monit     Country:  England    
Other Details:
Languages:  eng     Pagination:  175-80     Citation Subset:  IM    
Istituto di Medicina Cardiovascolare, Centro Interuniversitario di Fisiologia Clinica e Ipertensione, Ospedale Maggiore, IRCCS, Milano and Istituto Auxologico Italiano IRCCS, Università degli Studi di Milano, Milano, Italy.
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MeSH Terms
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Circadian Rhythm*
Hypertension / complications*,  diagnosis,  physiopathology*
Metabolic Syndrome X / complications*,  physiopathology*
Middle Aged

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