title: Blood pressure control and components of the metabolic syndrome: the GOOD survey.
abstract: BACKGROUND
  The GOOD (Global Cardiometabolic Risk Profile in Patients with Hypertension Disease) survey showed that blood pressure control was significantly worse in hypertensive patients with metabolic syndrome and/or diabetes mellitus than in those with essential hypertension only. This analysis aimed to investigate which components of the metabolic syndrome are primarily associated with poor blood pressure control.
  
  
  METHODS
  The GOOD survey was designed as an observational cross-sectional survey in 12 European countries to assess the cardiometabolic risk profile in patients with essential hypertension. Investigators were randomly selected from a list of general practitioners (70% of investigators) and a list of specialists such as internists, cardiologists and hypertension specialists (30% of investigators). Data from 3,280 outpatients with hypertension, aged at least 30 years who were receiving antihypertensive treatment or had newly diagnosed hypertension according to the European Society of Hypertension and the European Society of Cardiology criteria, were included in the analyses. Blood pressure control, body mass index (BMI), waist circumference, serum triglycerides, total and high density lipoprotein (HDL) cholesterol measurements were compared in patients with diabetes mellitus and metabolic syndrome, with diabetes mellitus only, with metabolic syndrome only, and with neither metabolic syndrome nor diabetes mellitus.
  
  
  RESULTS
  The highest blood pressure values were found in patients with metabolic syndrome with or without diabetes mellitus. Blood pressure was significantly lower in patients with diabetes mellitus only. The highest BMI, waist circumference and serum triglycerides, and the lowest HDL cholesterol levels among the groups studied occurred in patients with metabolic syndrome, either with or without diabetes mellitus.
  
  
  CONCLUSIONS
  Among the components of the metabolic syndrome, it is not impaired glucose tolerance which is associated with the poor response to antihypertensive treatment. Instead, visceral obesity and dyslipidemia components of the metabolic syndrome, i.e. hypertriglyceridemia and low HDL cholesterol levels, are associated with resistance to antihypertensive treatment.
authors.affiliation: Medizinische Klinik IV (Endocrinology and Nephrology), Charité, Berlin, Germany. walter.zidek@charite.de
authors.forename: Walter
authors.initials: W
authors.lastname: Zidek
authors.forename: Lisa
authors.initials: L
authors.lastname: Naditch-Brûlé
authors.forename: Stefano
authors.initials: S
authors.lastname: Perlini
authors.forename: Csaba
authors.initials: C
authors.lastname: Farsang
authors.forename: Sverre E
authors.initials: SE
authors.lastname: Kjeldsen
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D015992:Body Mass Index; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D004351:Drug Resistance; D005060:Europe / Q000453:epidemiology; D005260:Female; D006184:Habits; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D050152:Intra-Abdominal Fat / Q000473:pathology; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000473:pathology; D019338:Polypharmacy; D012307:Risk Factors; D055105:Waist Circumference
chemical_list: D000959:Antihypertensive Agents; D008055:Lipids; D003404:Creatinine