Metabolic syndrome in patients with essential hypertension
Vázquez Vigoa, A.; Vázquez Cruz, A.; Calderín, R.O.; Buchaca, E.F.; Cruz Alvarez, N.M.; Jiménez Paneque, R.; Luño, J.
Nefrologia Publicacion Oficial de la Sociedad Espanola Nefrologia 23(5): 423-431
2003
ISSN/ISBN: 0211-6995 PMID: 14658168 Document Number: 561640
We have studied 218 patients with Essential Hypertension. The aim of this study was to determine the prevalence of Metabolic Syndrome (MS) and Insulin resistance (IR) in hypertensive patients and to know the vascular risk associated with MS. Blood pressure (BP), body mass index (BMI), plasma insulin and serum lipids were measured. Plasma glucose was measured basal and after two hours of an oral load of 75 g. Vascular damage was evaluated by measurement of thickening of Intimal/Media complex (TI/MC) in carotid artery by ecco doppler ultrasonography and by the presence of microalbuminuria. IR was estimated by the calculation of the HOMA index of IR. A prevalence of MS of 62% was found and MS was statistically significant associated to vascular damage (p = 0.000). Fifty seven percent of the hypertensive patients who had MS had hypertrigliceridemia which was also related to vascular damage. The prevalence of microalbuminuria (MA) in this population of hypertensive patients was 28% and the presence of MA was significantly associated to (TI/MC) (p = 0000). The hypertensive patients who had vascular damage (a pathological value of TI/MC and or MA) were more frequently males with higher BP, higher BMI (30.45 +/- 4 vs 28.9 +/- 4.3 p = 0.014), more elevated plasma insulin levels (37.38 +/- 22 vs 24.86 +/- 12 p = 0.000) and higher triglyceride levels (2.33 +/- 1.29 vs 1.93 +/- 1.08 p = 0.019). IR was found in 75% of the patients. In a multivariate logistic analysis the independent variables that define vascular damage in hypertensive patients were: Age (p = 0.05), male sex (p = 0.01), Systolic BP (p = 0.002) and IR (p = 0.001). In conclusion, MS is a frequent finding in hypertensive patients. The presence of MS of any of their components increase the vascular risk (TI/MC of carotid artery and microalbuminuria). IR is a common finding in these patients and appears to be one of the most important markers of vascular risk.