title: Effect of clustering of metabolic syndrome factors on capillary and cerebrovascular impairment.
abstract: BACKGROUND
  Hypertension and metabolic disorders, attended by impaired microcirculation, represent major risk factors for cerebrovascular impairment, as well as being individual components of the metabolic syndrome (MetS). Aim of the study was to establish whether mild hypertensives, aged ≤65years, may be affected by progressive microvascular damage impairing cerebrovascular perfusion, related to a progressive clustering of MetS components.
  
  
  METHODS
  Twenty-two normotensives with no MetS component (NTN-0), 29 hypertensives with no (HTN-0), 30 with one (HTN-1), 29 with two (HTN-2), 27 with three (HTN-3), 25 with all four (HTN-4) MetS components, were recruited. The study required office and twenty-four hour ambulatory blood pressure monitoring and video capillaroscopy. Functional (fCD), anatomical (aCD) and recruited (RECR) phalangeal skin capillarity were assessed. Cerebral vasodilatory reserve was measured by the breath-holding index (BHI), using transcranial Doppler, in HTN-1 and HTN-2 with MetS.
  
  
  RESULTS
  The fCD and aCD were reduced in hypertensives and progressively reduced in those with MetS, while RECR was also impaired. BHI was lower in HTN-2 than in HTN-1 (p<0.001). BHI was correlated with fCD in HTN-1 (.396, p: .046), HNT-2 (.497, p: .011), and with aCD in HTN-2 (.494, p: .012), by partial Pearson test.
  
  
  CONCLUSIONS
  The findings show that hypertensives exhibit an increasing microvascular rarefaction with MetS progression and that an impaired cerebral perfusion occurs when the MetS is established. The data underline the importance of preventing MetS in mild hypertensives, as it causes microvascular damage and impairs cerebral arterial perfusion.
authors.affiliation: Department of Neurosciences, Division of Neurology-Stroke Unit, Hypertension, Italy. pietro.nazzaro@uniba.it
authors.forename: Pietro
authors.initials: P
authors.lastname: Nazzaro
authors.forename: Gabriella
authors.initials: G
authors.lastname: Schirosi
authors.forename: Domenico
authors.initials: D
authors.lastname: Mezzapesa
authors.forename: Marco
authors.initials: M
authors.lastname: Petruzzellis
authors.forename: Lucia
authors.initials: L
authors.lastname: Pascazio
authors.forename: Gabriella
authors.initials: G
authors.lastname: Serio
authors.forename: Lorenzo
authors.initials: L
authors.lastname: De Benedittis
authors.forename: Francesco
authors.initials: F
authors.lastname: Federico
mesh_terms: D000328:Adult; D018660:Blood Pressure Monitoring, Ambulatory; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000503:physiopathology*; D008833:Microcirculation / Q000502:physiology*; D020678:Microscopic Angioscopy; D008875:Middle Aged; D011379:Prognosis; D012039:Regional Blood Flow; D012189:Retrospective Studies; D012307:Risk Factors