Age and target organ damage in essential hypertension: role of the metabolic syndrome.
OBJECTIVE
We sought to investigate the association of the metabolic syndrome (MS) with cardiovascular alterations in essential hypertensives in relation to age.


METHODS
A total of 3266 untreated and treated hypertensive patients categorized in three age groups (I: 17 to 40 years; II: 41 to 64 years; III: >64 years) were considered for this analysis. All patients underwent extensive investigations searching for target organ damage (TOD). The MS was defined according to Advanced Technology Laboratories (ATP) III criteria.


RESULTS
In the entire population, the risk of left ventricular hypertrophy (LVH), carotid abnormalities, and microalbuminuria increased by 2.5 (P = .003), 2.2 (P = .005), and 1.5 times (P = .01), respectively, in the presence of MS after adjusting for several confounders. Prevalence of LVH (group I: 39% v 22%; group II: 53% v 35%; group III: 69% v 52%, P < .01 for all), carotid thickening (group I: 8% v 2%; group II 29% v 19%; group III: 69% v 52%, P < .05 for all) and microalbuminuria (group I: 20% v 11%; group II: 16% v 8%; group III: 18% v 11%, P </= .05 for all) was significantly higher in patients with MS than in their counterparts across all age groups.


CONCLUSIONS
In hypertensive patients the MS amplifies TOD regardless of patient's age, thus increasing cardiovascular risk. This synergistic effect may accelerate the early development of TOD in young hypertensives and enhance the age-associated cardiovascular alterations in the elderly.
Cuspidi
Cesare
C
Department of Clinical Medicine, Prevention and Applied Biotechnologies, University of Milano-Bicocca, Milan, Italy. dhipertensione@libero.it
Meani
Stefano
S
Valerio
Cristiana
C
Sala
Carla
C
Fusi
Veronica
V
Zanchetti
Alberto
A
Mancia
Giuseppe
G
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000419:Albuminuria / Q000453:epidemiology / Q000209:etiology*; D002318:Cardiovascular Diseases / Q000209:etiology*; D002340:Carotid Artery Diseases / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology / Q000209:etiology*; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors