Metabolic syndrome and multiple organ damage in essential hypertension.
OBJECTIVE
We investigated the prevalence of the metabolic syndrome (MS) in hypertensive patients categorized according to the number of markers of organ damage (OD) in order to assess the value of a systematic search for cardiac and extra-cardiac OD in the MS setting.


METHODS
A total of 3119 untreated and treated essential hypertensives included in the Evaluation of Target Organ Damage in Hypertension (ETODH), an observational registry of hypertension-related OD, were considered for this analysis. All patients underwent extensive investigation for left ventricular hypertrophy (LVH) or LV concentric remodeling (cardiac OD), carotid plaques and/or intima-media thickening (vascular OD) and microalbuminuria (MA) and/or increased serum creatinine (renal OD). Subjects were classified as: positive for none (group 0), one (group I), two (group II) or three markers (group III) of OD.


RESULTS
MS prevalence rates progressively rose across the groups stratified according to the OD score, reaching a 2.3-fold increase in group III compared with their MS counterparts in group 0. The distribution of subjects with and without the MS across the groups was 15% vs 29% (group 0), 32% vs 38% (group I), 39% vs 26% (group II) and 14% vs 7% (group III), respectively. Thus, subjects having two or three markers of OD were 53% among those with MS and 33% (p<0.01) among those without it.


CONCLUSIONS
Our findings indicate a strong association between the MS and OD by showing that a clustering of two or three markers of OD is the prevalent cardiovascular phenotype in MS hypertensives referred to a specialist center and call for a systematic evaluation of cardiac and extracardiac OD in this setting.
Cuspidi
Cesare
C
Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milano, Italy. cesare.cuspidi@unimib.it
Valerio
Cristiana
C
Giudici
Valentina
V
Negri
Francesca
F
Sala
Carla
C
Zanchetti
Alberto
A
Mancia
Giuseppe
G
D000328:Adult; D000419:Albuminuria / Q000453:epidemiology; D050197:Atherosclerosis / Q000473:pathology; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D008076:Cholesterol, HDL / Q000097:blood; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D004596:Electroretinography; D005215:Fasting; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology*; D007668:Kidney / Q000000981:diagnostic imaging; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012160:Retina / Q000473:pathology; D012307:Risk Factors; D017539:Tunica Intima / Q000503:physiopathology; D017540:Tunica Media / Q000503:physiopathology; D014463:Ultrasonography; D020257:Ventricular Remodeling
D001786:Blood Glucose; D008076:Cholesterol, HDL; D003404:Creatinine