P-453: Hypertensive complications associated with metabolic syndrome

Abstract

Objective of the study was the investigation of the prevalence of cardiac complications in patients suffering from metabolic syndrome (MS) and hypertension.

Patients with hypertension followed in our Hypertension Unit and fulfilling at least 3 of the 5 risk criteria of NCEP / ATP-III : abdominal obesity (waist circumference of > 102 cm for men, and > 88 cm in women), triglycerides > 150 mg/dl, HDL-C < 40 mg/dl for men and < 50 mg/dl for women, blood pressure > 130/85 mmHg, and fasting glucose >110 mg/dl, were included in the study. All patients were evaluated by recording past history for coronary heart disease (CHD), office and home blood pressure as well as 24h-ABPM, ECG, M-Mode echocardiography and fasting plasma glucose to insulin ratio (FPG/FPI). No one was under antihypertensive or antilipidemic therapy. As left ventricular hypertrophy (LVH) characterized a left ventricular mass index (LVMI) > 125 gm/m2 for men and > 110 gm/m2 for women, using the criteria of Penn convention. Left ventricular wall thickness – LVWT (the sum of intraventricular septal thickness and of psterior wall thickness) was used as another parameter of LVH.

From the 143 studied patients (82 M/ 61 F, aged 17–81 years), 11 patients (5%) had CHD and 65 (45.5%) LVH. The LVWT was found to be significantly related to pulse pressure (P<0.003) and significantly inversely related to FPG/FPI ratio (insulin sensitivity index). Multiple regression analysis with these relationships together and confounding factors age, sex, BMI, waist, and duration of hypertension as independent variables showed FPI to be the only significant variable explaining 41% of the variation in LVWT, while duration of hypertension was the main determinant for the presence of CHD (P= 0.0044).

We conclude that LVH was present in about 46% of hypertensives with metabolic syndrome and the main determinant was the FPG/FPI ratio, while duration of hypertension was also a significant factor for the development of CHD.

Complications, Hypertension, Metabolic Syndrome