Metabolic syndrome and target organ damage in untreated essential hypertensives

Cesare Cuspidi, Stefano Meani, Veronica Fusi, Barbara Severgnini, Cristiana Valerio, Eleonora Catini, Gastone Leonetti, Fabio Magrini, Alberto Zanchetti

Research output: Contribution to journalArticle

154 Citations (Scopus)

Abstract

Background: The prevalence and the relationship between metabolic syndrome, and target organ damage (TOD) in essential hypertensive patients has not been fully explored to date. Objective: To investigate the association between metabolic syndrome, as defined by the ATP III report, and cardiac and extracardiac TOD, as defined by the 2003 ESH-ESC guidelines for management of hypertension, in a large population of never-treated essential hypertensives. Methods: A total of 447 grade 1 and 2 hypertensive patients (mean age 46 ± 12 years) who were attending a hypertension hospital outpatient clinic for the first time underwent the following procedures: (i) physical examination and repeated clinic blood pressure measurements; (ii) routine examinations; (iii) 24-h urine collection for microalbuminuria; (iv) 24-h ambulatory blood pressure monitoring; (v) echocardiography; and (vi) carotid ultrasonography. Metabolic syndrome was defined as involving at least three of the following alterations: increased waist circumference, increased triglycerides, decreased high-density lipoprotein cholesterol, increased blood pressure, or high fasting glucose. Left ventricular hypertrophy (LVH) was defined according to two different criteria: (i) 125 g/m2 in men and 110 g/m2 in women; (ii) 51 g/h2.7 in men and 47 g/h2.7 in women. Results: The 135 patients with metabolic syndrome (group I) were similar for age, sex distribution, known duration of hypertension and average 24-h, daytime and night-time ambulatory blood pressure to the 312 patients without it (group II). The prevalence of altered left ventricular patterns (LVH and left ventricular concentric remodelling) was significantly higher in group I (criterion a = 30%, criterion b = 42%) than in group II (criterion a = 23%, criterion b = 30%, P <0.05 and P <0.01, respectively). A greater urinary albumin excretion (17 ± 35 versus 11 ± 23 mg/24 h, P = 0.04) was also found in group I compared to group II. There were no significant differences between the two groups in the prevalence of carotid intima-media thickening and plaques. Conclusions: These results from a representative sample of untreated middle-aged hypertensives show that: (i) the metabolic syndrome is highly prevalent in this setting and (ii) despite similar ambulatory blood pressure values, patients with metabolic syndrome have a more pronounced cardiac and extracardiac involvement than those without it.

Original languageEnglish
Pages (from-to)1991-1998
Number of pages8
JournalJournal of Hypertension
Volume22
Issue number10
DOIs
Publication statusPublished - Oct 2004

Fingerprint

Hypertension
Left Ventricular Hypertrophy
Blood Pressure
Hospital Outpatient Clinics
Urine Specimen Collection
Ambulatory Blood Pressure Monitoring
Sex Distribution
Ventricular Remodeling
Age Distribution
Waist Circumference
HDL Cholesterol
Physical Examination
Echocardiography
Albumins
Fasting
Ultrasonography
Triglycerides
Adenosine Triphosphate
Guidelines
Glucose

Keywords

  • Cardiac and extracardiac target organ damage
  • Hypertension
  • Metabolic syndrome

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine

Cite this

Cuspidi, C., Meani, S., Fusi, V., Severgnini, B., Valerio, C., Catini, E., ... Zanchetti, A. (2004). Metabolic syndrome and target organ damage in untreated essential hypertensives. Journal of Hypertension, 22(10), 1991-1998. https://doi.org/10.1097/00004872-200410000-00023

Metabolic syndrome and target organ damage in untreated essential hypertensives. / Cuspidi, Cesare; Meani, Stefano; Fusi, Veronica; Severgnini, Barbara; Valerio, Cristiana; Catini, Eleonora; Leonetti, Gastone; Magrini, Fabio; Zanchetti, Alberto.

In: Journal of Hypertension, Vol. 22, No. 10, 10.2004, p. 1991-1998.

Research output: Contribution to journalArticle

Cuspidi, C, Meani, S, Fusi, V, Severgnini, B, Valerio, C, Catini, E, Leonetti, G, Magrini, F & Zanchetti, A 2004, 'Metabolic syndrome and target organ damage in untreated essential hypertensives', Journal of Hypertension, vol. 22, no. 10, pp. 1991-1998. https://doi.org/10.1097/00004872-200410000-00023
Cuspidi, Cesare ; Meani, Stefano ; Fusi, Veronica ; Severgnini, Barbara ; Valerio, Cristiana ; Catini, Eleonora ; Leonetti, Gastone ; Magrini, Fabio ; Zanchetti, Alberto. / Metabolic syndrome and target organ damage in untreated essential hypertensives. In: Journal of Hypertension. 2004 ; Vol. 22, No. 10. pp. 1991-1998.
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AU - Leonetti, Gastone

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