Metabolic syndrome is associated with early signs of organ damage in nondiabetic, hypertensive patients.
OBJECTIVE
Hypertensive patients with metabolic syndrome (MS) are at greater risk for cardiovascular disease. To get a better understanding of the pathophysiology underlying this association, we evaluated the relationship between MS and subclinical organ damage in essential hypertensive patients.


METHODS
A total of 354 untreated, nondiabetic patients with primary hypertension were included in the study. A modified ATP III definition for MS was used, with body mass index replacing waist circumference. Albuminuria was measured as albumin to creatinine ratio, left ventricular mass index (LVMI) was assessed by echocardiography and carotid abnormalities by ultrasonography.


RESULTS
The prevalence of MS was 25%. Patients with MS were more likely to be smokers (P = 0.004) and had higher serum uric acid levels (P = 0.004). Moreover, they showed higher urinary albumin excretion (P = 0.0004) and LVMI (P = 0.0006), increased intima-media thickness (P = 0.045), as well as higher prevalence of microalbuminuria (P = 0.03) and left ventricular hypertrophy (LVH; P = 0.003). After adjusting for age, gender and duration of hypertension, we found that the presence of MS entails a twofold greater risk for microalbuminuria (P = 0.04), LVH (P = 0.003) and carotid abnormalities (P < 0.05). When patients were stratified according to the number of components of MS, albuminuria (P = 0.002) and LVMI (P = 0.005) increased progressively across categories.


CONCLUSIONS
Metabolic syndrome is associated with subclinical organ damage in nondiabetic, essential hypertensive patients. These data may, in part, explain the high cardiovascular morbidity and mortality that is observed in hypertensive patients with MS.
Leoncini
G
G
Department of Internal Medicine, University of Genoa, Genoa, Italy.
Ratto
E
E
Viazzi
F
F
Vaccaro
V
V
Parodi
D
D
Parodi
A
A
Falqui
V
V
Tomolillo
C
C
Deferrari
G
G
Pontremoli
R
R
D000419:Albuminuria / Q000209:etiology; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism; D008875:Middle Aged; D012044:Regression Analysis; D012306:Risk; D012907:Smoking; D014280:Triglycerides / Q000097:blood; D017539:Tunica Intima / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014527:Uric Acid / Q000652:urine
D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides; D014527:Uric Acid