Influence of the metabolic syndrome on aortic stiffness in never treated hypertensive patients.
OBJECTIVE
Metabolic syndrome (MS) carries an increased risk for cardiovascular events and there is a growing awareness that large artery stiffening is a powerful predictor of cardiovascular morbidity and mortality. Little is known about the relationship of MS with aortic stiffness. The aim of our study was to analyze, in patients with essential hypertension, the influence of MS, defined according to the criteria proposed by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATP III), on carotid-femoral pulse wave velocity (PWV), a measure of aortic stiffness.


METHODS
Ninety-three untreated essential hypertensives, aged between 23 and 61 years, without diabetes mellitus, were studied. All subjects underwent routine blood chemistry, oral glucose tolerance test with glucose and insulin determinations, albumin excretion rate (AER) measurement, 24-h ambulatory blood pressure monitoring, and measurement of carotid-femoral PWV, by means of a computerized method.


RESULTS
Patients with MS (n = 28) showed higher age-adjusted carotid-femoral PWV (10.1 +/- 1.4 vs 9.3 +/- 1.4 m/s; p = 0.01) when compared to subjects without MS. This difference held after controlling for gender and for 24-h mean blood pressure (MBP) (p = 0.02) and lost its statistical significance after further adjustment for AER. In a multiple regression model, excluding the individual components of MS, in which metabolic syndrome was added along with age, gender, smoking habit, LDL cholesterol, HOMA index, 24-h MBP and 24-h heart rate, MS remained independently associated with carotid-femoral PWV (beta = 0.29; p = 0.002). The statistical significance of this association disappeared after the inclusion into this model of AER.


CONCLUSIONS
Metabolic syndrome is associated with an increased aortic stiffness. Main explanatory factors of this association are age, systolic blood pressure and albumin excretion rate.
Mulè
Giuseppe
G
Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Cattedra di Medicina Interna e Centro Ipertensione, Università di Palermo, Italy. guisemme@email.it
Cottone
Santina
S
Mongiovì
Rosalia
R
Cusimano
Paola
P
Mezzatesta
Giovanni
G
Seddio
Giovanna
G
Volpe
Vito
V
Nardi
Emilio
E
Andronico
Giuseppe
G
Piazza
Giuseppe
G
Cerasola
Giovanni
G
D000328:Adult; D000367:Age Factors; D000419:Albuminuria; D001011:Aorta / Q000473:pathology*; D018660:Blood Pressure Monitoring, Ambulatory; D002339:Carotid Arteries / Q000473:pathology; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2; D004548:Elasticity; D005260:Female; D005263:Femoral Artery / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology*; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors