title: Multidisciplinary Treatment of the Metabolic Syndrome Lowers Blood Pressure Variability Independent of Blood Pressure Control.
abstract: Blood pressure (BP) variability (BPV) contributes to target organ damage independent of BP. The authors examined the effect of a 1-year multidisciplinary intervention on BPV in patients with the metabolic syndrome (MetS) as defined by criteria from the Third Report of the Adult Treatment Panel. Forty-four nondiabetic patients underwent clinical and biochemical profiling, 24-hour ambulatory BP monitoring (ABPM), body composition, carotid intima-media thickness, and carotid-femoral pulse wave velocity (PWV). The intervention targeted all MetS components. BPV was assessed by the standard deviation of daytime systolic BP derived from ABPM. Patients with low and high BPV (lower or higher than the median daytime standard deviation of 11.6 mm Hg) did not differ in regards to systolic and diastolic BP, age, fasting glucose, glycated hemoglobin, and body mass index, but the high-variability group had higher values of low-density lipoprotein and leg fat. The 1-year intervention resulted in weight reduction but not BP-lowering. BPV declined in the high-variability group in association with lowering of PWV, C-reactive protein, glycated hemoglobin, alanine aminotransferase, asymmetric dimethylarginine, and increased high-density lipoprotein cholesterol. A multidisciplinary intervention independent of BP-lowering normalized BPV, lowered PWV, and enhanced metabolic control.
authors.affiliation: Sackler Faculty of Medicine, Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center Medical Center, Tel Aviv, Israel.
authors.forename: Yonit
authors.initials: Y
authors.lastname: Marcus
authors.affiliation: Faculty of science, Holon Institute of Technology, Holon, Israel.
authors.forename: Elad
authors.initials: E
authors.lastname: Segev
authors.affiliation: Sackler Faculty of Medicine, Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center Medical Center, Tel Aviv, Israel.
authors.forename: Gabi
authors.initials: G
authors.lastname: Shefer
authors.affiliation: Sackler Faculty of Medicine, Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center Medical Center, Tel Aviv, Israel.
authors.forename: Jessica
authors.initials: J
authors.lastname: Sack
authors.affiliation: Sackler Faculty of Medicine, Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center Medical Center, Tel Aviv, Israel.
authors.forename: Brurya
authors.initials: B
authors.lastname: Tal
authors.affiliation: Sackler Faculty of Medicine, Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center Medical Center, Tel Aviv, Israel.
authors.forename: Marianna
authors.initials: M
authors.lastname: Yaron
authors.affiliation: Physical Therapy, University of Haifa, Haifa, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Carmeli
authors.affiliation: Sackler Faculty of Medicine, Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center Medical Center, Tel Aviv, Israel.
authors.forename: Lili
authors.initials: L
authors.lastname: Shefer
authors.affiliation: Sackler Faculty of Medicine, Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center Medical Center, Tel Aviv, Israel.
authors.forename: Miri
authors.initials: M
authors.lastname: Margaliot
authors.affiliation: Sackler Faculty of Medicine, Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center Medical Center, Tel Aviv, Israel.
authors.forename: Rona
authors.initials: R
authors.lastname: Limor
authors.affiliation: Sackler Faculty of Medicine, Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center Medical Center, Tel Aviv, Israel.
authors.forename: Suzan
authors.initials: S
authors.lastname: Gilad
authors.affiliation: Sackler Faculty of Medicine, Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center Medical Center, Tel Aviv, Israel.
authors.forename: Yael
authors.initials: Y
authors.lastname: Sofer
authors.affiliation: Sackler Faculty of Medicine, Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center Medical Center, Tel Aviv, Israel.
authors.forename: Naftali
authors.initials: N
authors.lastname: Stern
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D059168:Carotid Intima-Media Thickness; D038441:Diet, Mediterranean; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000178:diet therapy / Q000503:physiopathology / Q000628:therapy; D008297:Male; D024821:Metabolic Syndrome / Q000178:diet therapy / Q000503:physiopathology* / Q000628:therapy*; D008875:Middle Aged; D063177:Pulse Wave Analysis / Q000379:methods