Relationship of metabolic syndrome with pulse pressure in patients with essential hypertension.
BACKGROUND
Pulse pressure is largely dependent on arterial stiffness. Recent studies have documented reduced large artery compliance in nondiabetic subjects with metabolic syndrome (MS). The aim of our study was to analyze, in a group of patients with essential hypertension and without diabetes mellitus, the influence of MS on clinic and 24-h pulse pressures.


METHODS
A total of 528 hypertensive subjects, aged 18 to 72 years, who were free of cardiovascular and renal diseases were enrolled. Of the subjects, 41% had MS. In all subjects routine blood chemistry, echocardiographic examination, and 24-h ambulatory blood pressure monitoring were performed.


RESULTS
When compared with subjects without MS, hypertensive patients with MS exhibited more elevated clinic pulse pressures (66 +/- 16 v .58 +/- 14 mm Hg; P < .00001) and 24-h (51 +/- 9 v .48 +/- 7 mm Hg; P = .00001). These results held even after correction for age, sex, stroke volume, mean pressures, and total cholesterol. The regression line relating PP with age was steeper in patients with MS than in those without MS. Multivariate regression models confirmed that the relationships of MS with clinic (beta = 0.12; P = .003) and 24-h PP (beta = 0.11; P = .01) were independent from several confounding factors.


CONCLUSIONS
The elevated levels of clinic and 24-h PP observed in hypertensive patients with MS may reflect increased large arteries stiffness and may therefore contribute to explain the enhanced cardiovascular risk associated with MS.
Mulè
Giuseppe
G
Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Cattedra di Medicina Interna e Unità Operativa di Medicina Interna, Nefrologia ed Ipertensione, Università di Palermo, Palermo, Italy. giusemme@unipa.it
Nardi
Emilio
E
Cottone
Santina
S
Cusimano
Paola
P
Incalcaterra
Francesca
F
Palermo
Alessandro
A
Giandalia
Maria Ester
ME
Mezzatesta
Giovanni
G
Andronico
Giuseppe
G
Cerasola
Giovanni
G
D000328:Adult; D000368:Aged; D001158:Arteries / Q000503:physiopathology*; D001794:Blood Pressure; D001795:Blood Pressure Determination; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000503:physiopathology*; D008875:Middle Aged; D011673:Pulsatile Flow; D011674:Pulse; D012307:Risk Factors