Evidence for no global effect of metabolic syndrome per se on early hypertensive sequelae.
OBJECTIVE
In the present study we assessed the impact of metabolic syndrome (MS) and its components on markers of cardiovascular and renal damage in a population of essential hypertensives.


METHODS
A total of 651 consecutive, untreated and non-diabetic hypertensives (age 54 +/- 12 years, 340 males) who were included in the 3H Study, an ongoing registry of hypertension-related target organ damage, were considered for analysis. Left ventricular mass was indexed both for body surface area (LVMBSA) and for height2.7 (LVMheight2.7). Diastolic function was estimated by means of both conventional and tissue Doppler imaging (TDI) methods. Arterial stiffness was evaluated on the basis of carotid to femoral pulse wave velocity (c-f PWV) and microalbuminuria (MA) as albumin to creatinine ratio (ACR) 22-300 mg/g in men and 31-300 mg/g in women in two non-consecutive morning spot urine samples.


RESULTS
MS (Adult Treatment Panel III criteria) was present in 201 hypertensives (30.9%). Hypertensives with MS had increased logACR (by 10%, P = 0.01) and higher prevalence of MA (17 versus 8%, P < 0.001). Both groups exhibited similar values of LVMBSA, transmitral and TDI-derived indexes and c-f PWV (NS for all) while LVMheight2.7 was significantly higher in hypertensives with MS (by 2.6 g/m2.7, P = 0.023). Multiple regression analysis revealed that MS was an independent predictor only of logACR (beta = 0.110, P = 0.007) and MA (odds ratio = 2.577, P < 0.001), while components of blood pressure affected all studied indices of organ damage.


CONCLUSIONS
MS per se does not deteriorate cardiac adaptations and aortic stiffness beyond haemodynamic load in hypertension. The MS-related unfavourable effect is limited to the level of the glomerulus.
Tsioufis
Costas
C
Department of Cardiology, Hippokration Hospital, Athens, Greece. ktsioufis@hippocratio.gr
Tsiachris
Dimitris
D
Dimitriadis
Kyriakos
K
Chartzoulakis
George
G
Selima
Maria
M
Chatzis
Dimitris
D
Taxiarchou
Efstathios
E
Stefanadis
Christodoulos
C
Kallikazaros
Ioannis
I
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000175:diagnosis / Q000453:epidemiology*; D015415:Biomarkers; D001783:Blood Flow Velocity; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011673:Pulsatile Flow; D012042:Registries; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology*
D015415:Biomarkers