Document Detail

Metabolic syndrome and target organ damage in untreated essential hypertensives.
MedLine Citation:
PMID:  15361772     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The prevalence and the relationship between metabolic syndrome, and target organ damage (TOD) in essential hypertensive patients has not been fully explored to date. OBJECTIVE: To investigate the association between metabolic syndrome, as defined by the ATP III report, and cardiac and extracardiac TOD, as defined by the 2003 ESH-ESC guidelines for management of hypertension, in a large population of never-treated essential hypertensives. METHODS: A total of 447 grade 1 and 2 hypertensive patients (mean age 46 +/- 12 years) who were attending a hypertension hospital outpatient clinic for the first time underwent the following procedures: (i) physical examination and repeated clinic blood pressure measurements; (ii) routine examinations; (iii) 24-h urine collection for microalbuminuria; (iv) 24-h ambulatory blood pressure monitoring; (v) echocardiography; and (vi) carotid ultrasonography. Metabolic syndrome was defined as involving at least three of the following alterations: increased waist circumference, increased triglycerides, decreased high-density lipoprotein cholesterol, increased blood pressure, or high fasting glucose. Left ventricular hypertrophy (LVH) was defined according to two different criteria: (i) 125 g/m in men and 110 g/m in women; (ii) 51 g/h in men and 47 g/h in women. RESULTS: The 135 patients with metabolic syndrome (group I) were similar for age, sex distribution, known duration of hypertension and average 24-h, daytime and night-time ambulatory blood pressure to the 312 patients without it (group II). The prevalence of altered left ventricular patterns (LVH and left ventricular concentric remodelling) was significantly higher in group I (criterion a = 30%, criterion b = 42%) than in group II (criterion a = 23%, criterion b = 30%, P < 0.05 and P < 0.01, respectively). A greater urinary albumin excretion (17 +/- 35 versus 11 +/- 23 mg/24 h, P = 0.04) was also found in group I compared to group II. There were no significant differences between the two groups in the prevalence of carotid intima-media thickening and plaques. CONCLUSIONS: These results from a representative sample of untreated middle-aged hypertensives show that: (i) the metabolic syndrome is highly prevalent in this setting and (ii) despite similar ambulatory blood pressure values, patients with metabolic syndrome have a more pronounced cardiac and extracardiac involvement than those without it.
Cesare Cuspidi; Stefano Meani; Veronica Fusi; Barbara Severgnini; Cristiana Valerio; Eleonora Catini; Gastone Leonetti; Fabio Magrini; Alberto Zanchetti
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  22     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-13     Completed Date:  2005-01-31     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  1991-8     Citation Subset:  IM    
Istituto di Medicina Cardiovascolare, Centro di Fisiologia e Ipertensione, Università degli Studi di Milano, Ospedale Maggiore Policlinico, IRCCS, Milan, Italy.
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MeSH Terms
Albuminuria / etiology*
Carotid Arteries / ultrasonography*
Hypertension / complications*,  physiopathology,  ultrasonography*
Metabolic Syndrome X / complications*
Middle Aged
Tunica Intima / ultrasonography
Tunica Media / ultrasonography
Ventricular Dysfunction, Left / etiology
Ventricular Remodeling

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