title: Metabolic Syndrome and Cardiovascular Risk in Elderly Treated Hypertensive Patients.
abstract: BACKGROUND
  The independent prognostic significance of the metabolic syndrome (MetS) in the elderly is not yet clear. We investigated the association between MetS and cardiovascular risk (composite endpoint of stroke and coronary events) in elderly treated hypertensive patients.
  
  
  METHODS
  Cardiovascular outcome was evaluated in 1,191 elderly treated hypertensive patients (≥60 years). Among them, 578 (48.5%) had MetS according to a modified joint interim statement definition (body mass index in place of waist circumference).
  
  
  RESULTS
  During the follow-up (9.1±4.9 years, range 0.4-20 years), 139 strokes and 120 coronary events occurred. In univariate analysis, patients with MetS had higher risk of the composite endpoint (hazard ratio (HR) 1.322, 95% confidence interval (CI) 1.035-1.688, P < 0.05). Among the single components of MetS, only blood pressure (BP) level and impaired fasting glucose/diabetes were significantly associated with increased cardiovascular risk. After adjustment for age, previous events, estimated glomerular filtration rate (eGFR), left ventricular (LV) hypertrophy and left atrial (LA) enlargement, the prognostic relevance of MetS was attenuated (HR 1.245, 95% CI 0.974-1.591, P = 0.08). After further adjustment for the above-mentioned variables and ambulatory BP parameters and impaired fasting glucose/diabetes, Cox regression analysis showed that MetS was not independently associated with increased cardiovascular risk (HR 1.090, 95% CI 0.805-1.475, P = 0.58).
  
  
  CONCLUSIONS
  In elderly treated hypertensive patients, MetS is associated with increased cardiovascular risk, but not independently of BP and glucose levels and of organ damage.
authors.affiliation: Dipartimento di Medicina e Scienze dell'Invecchiamento, Università "Gabriele d'Annunzio", Chieti, Italy; Centro di Ricerca Clinica, Fondazione Università "Gabriele d'Annunzio", Chieti, Italy. pierdomenico@unich.it santedonato.pierdomenico@fastwebnet.it.
authors.forename: Sante D
authors.initials: SD
authors.lastname: Pierdomenico
authors.affiliation: Centro di Ricerca Clinica, Fondazione Università "Gabriele d'Annunzio", Chieti, Italy.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Pierdomenico
authors.affiliation: Dipartimento di Medicina e Scienze dell'Invecchiamento, Università "Gabriele d'Annunzio", Chieti, Italy;
authors.forename: Roberta
authors.initials: R
authors.lastname: Di Tommaso
authors.affiliation: Dipartimento di Medicina e Scienze dell'Invecchiamento, Università "Gabriele d'Annunzio", Chieti, Italy;
authors.forename: Francesca
authors.initials: F
authors.lastname: Coccina
authors.affiliation: Dipartimento di Medicina e Scienze dell'Invecchiamento, Università "Gabriele d'Annunzio", Chieti, Italy;
authors.forename: Silvio
authors.initials: S
authors.lastname: Di Carlo
authors.affiliation: Dipartimento di Medicina e Scienze dell'Invecchiamento, Università "Gabriele d'Annunzio", Chieti, Italy; Centro di Ricerca Clinica, Fondazione Università "Gabriele d'Annunzio", Chieti, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Cuccurullo
authors.affiliation: Dipartimento di Medicina e Scienze dell'Invecchiamento, Università "Gabriele d'Annunzio", Chieti, Italy; Centro di Ricerca Clinica, Fondazione Università "Gabriele d'Annunzio", Chieti, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Porreca
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D016208:Databases, Factual; D029721:Drosophila Proteins; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009419:Nerve Tissue Proteins; D009687:Nuclear Proteins; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D014157:Transcription Factors
chemical_list: D000959:Antihypertensive Agents; D029721:Drosophila Proteins; D009419:Nerve Tissue Proteins; D009687:Nuclear Proteins; D014157:Transcription Factors; C073099:pros protein, Drosophila
keywords: blood pressure; coronary events; elderly; hypertension; metabolic syndrome; stroke.