title: Metabolic syndrome and ambulatory arterial stiffness index in non-diabetic patients with primary hypertension.
abstract: Increased arterial stiffness and the presence of metabolic syndrome (MS) have been shown to predict cardiovascular events in patients with primary hypertension. We investigated the relationship between a recently proposed index of arterial stiffness derived from ambulatory blood pressure (BP) monitoring and MS in 156 untreated, non-diabetic patients with primary hypertension. Ambulatory arterial stiffness index (AASI) was defined as 1 minus the regression slope of diastolic over systolic BP readings obtained from 24-h recordings. A modified National Cholesterol Education Program definition for MS was used, with body mass index replacing waist circumference. The prevalence of MS was 23%. Patients with MS were more frequently male (0.0291) and had increased serum uric acid (P=0.0005), high-sensitivity C-reactive protein (P=0.0259), as well as total and low-density lipoprotein (LDL)-cholesterol (P=0.0374 and P=0.0350, respectively) as compared to those without MS. After adjusting for these confounders, the association between AASI and the presence of MS was statistically significant (P=0.0257). Moreover, the prevalence of increased AASI (upper tertile, that is >or=0.550) was greater in patients with MS (P=0.0156). After adjusting for age and 24-h mean BP, the presence of MS entailed a more than twofold greater risk for increased AASI (0.0280). MS is associated with increased AASI in non-diabetic patients with primary hypertension. These data support the role of this new index of arterial stiffness as a marker of risk and help to explain the high cardiovascular morbidity and mortality that is observed in hypertensive patients with MS.
authors.affiliation: Department of Cardio-Nephrology, Azienda Ospedaliera Universitaria San Martino, Genoa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Leoncini
authors.forename: E
authors.initials: E
authors.lastname: Ratto
authors.forename: F
authors.initials: F
authors.lastname: Viazzi
authors.forename: V
authors.initials: V
authors.lastname: Vaccaro
authors.forename: A
authors.initials: A
authors.lastname: Parodi
authors.forename: V
authors.initials: V
authors.lastname: Falqui
authors.forename: N
authors.initials: N
authors.lastname: Conti
authors.forename: C
authors.initials: C
authors.lastname: Tomolillo
authors.forename: G
authors.initials: G
authors.lastname: Deferrari
authors.forename: R
authors.initials: R
authors.lastname: Pontremoli
mesh_terms: D000419:Albuminuria / Q000453:epidemiology / Q000209:etiology; D001158:Arteries / Q000503:physiopathology*; D018660:Blood Pressure Monitoring, Ambulatory; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D016009:Chi-Square Distribution; D004548:Elasticity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology*; D007558:Italy / Q000453:epidemiology; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology*; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood
chemical_list: D008077:Lipoproteins, LDL; D014527:Uric Acid; D002097:C-Reactive Protein