|
|
||||||||||
|
J Am Coll Cardiol, 2004; 43:1817-1822, doi:10.1016/j.jacc.2003.12.049 © 2004 by the American College of Cardiology Foundation |

* Unit of Internal Medicine, Angiology and Arteriosclerosis, University of Perugia, Perugia, Italy
Department of Cardiology, Perugia General Hospital, Perugia, Italy
Manuscript received November 13, 2003; revised manuscript received December 11, 2003, accepted December 16, 2003.
* Reprint requests and correspondence: Dr. Giuseppe Schillaci, Unit of Internal Medicine, Angiology and Arteriosclerosis, Department of Clinical and Experimental Medicine, University of Perugia Medical School, via Brunamonti 51, 06122 Perugia, Italy.
skill{at}unipg.it
OBJECTIVES: We sought to determine the prognostic significance of the metabolic syndrome in hypertension.
BACKGROUND: Increased cardiovascular risk in hypertensive patients might be partially attributable to metabolic disturbances.
METHODS: We prospectively followed for up to 10.5 years (mean 4.1 years) a total of 1,742 hypertensive patients without cardiovascular disease (55% men; blood pressure [BP] 154/95 mm Hg; age 50 ± 12 years). A modified National Cholesterol Education Program definition for metabolic syndrome was used, with body mass index in place of waist circumference.
RESULTS: During follow-up, 162 patients developed cardiovascular events (2.28 events/100 patient-years). Event rates in the groups with one to five characteristics of the metabolic syndrome were 1.54, 1.96, 2.97, 3.35, and 5.27 per 100 patient-years, respectively (p < 0.001). A total of 593 patients (34%) had the metabolic syndrome. Patients with the syndrome had an almost double cardiovascular event rate than those without (3.23 vs. 1.76 per 100 patient-years, p < 0.001). After adjustment for age, gender, total cholesterol, creatinine, smoking, left ventricular hypertrophy, and 24-h systolic BP, the risk of developing cardiovascular events was still higher in patients with the metabolic syndrome (hazard ratio [HR] 1.73, 95% confidence interval [CI] 1.25 to 2.38). The syndrome was an independent predictor of both cardiac and cerebrovascular events (HRs 1.48 and 2.11, respectively). The adverse prognostic value of the metabolic syndrome was attenuated but still significant among the 1,637 patients without diabetes (HR 1.43, 95% CI 1.02 to 2.08).
CONCLUSIONS: In hypertensive subjects, the metabolic syndrome amplifies cardiovascular risk associated with high BP, independent of the effect of several traditional cardiovascular risk factors.
| ||||||||||||||||
This article has been cited by other articles:
![]() |
G. Schillaci, G. V.L. De Socio, G. Pucci, M. R. Mannarino, J. Helou, M. Pirro, and E. Mannarino Aortic Stiffness in Untreated Adult Patients With Human Immunodeficiency Virus Infection Hypertension, August 1, 2008; 52(2): 308 - 313. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. Ghiadoni, G. Penno, C. Giannarelli, Y. Plantinga, M. Bernardini, L. Pucci, R. Miccoli, S. Taddei, A. Salvetti, and S. Del Prato Metabolic Syndrome and Vascular Alterations in Normotensive Subjects at Risk of Diabetes Mellitus Hypertension, February 1, 2008; 51(2): 440 - 445. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. Guize, F. Thomas, B. Pannier, K. Bean, B. Jego, and A. Benetos All-Cause Mortality Associated With Specific Combinations of the Metabolic Syndrome According to Recent Definitions Diabetes Care, September 1, 2007; 30(9): 2381 - 2387. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Greenstein, M. Tavakoli, M. Mojaddidi, A. Al-Sunni, G. Matfin, and R. A Malik Review: Microvascular complications: evaluation and monitoring relevance to clinical practice, clinical trials, and drug development The British Journal of Diabetes & Vascular Disease, July 1, 2007; 7(4): 166 - 171. [Abstract] [PDF] |
||||
![]() |
S. Inchiostro, G. P. Fadini, S. V. de Kreutzenberg, N. Citroni, and A. Avogaro Is the Metabolic Syndrome a Cardiovascular Risk Factor Beyond Its Specific Components? J. Am. Coll. Cardiol., June 26, 2007; 49(25): 2465 - 2465. [Full Text] [PDF] |
||||
![]() |
A. S. Gami and V. M. Montori Reply J. Am. Coll. Cardiol., June 26, 2007; 49(25): 2465 - 2466. [Full Text] [PDF] |
||||
![]() |
F. Dentali, E. Romualdi, and W. Ageno The metabolic syndrome and the risk of thrombosis Haematologica, March 1, 2007; 92(3): 297 - 299. [Full Text] [PDF] |
||||
![]() |
A. S. Gami, B. J. Witt, D. E. Howard, P. J. Erwin, L. A. Gami, V. K. Somers, and V. M. Montori Metabolic Syndrome and Risk of Incident Cardiovascular Events and Death: A Systematic Review and Meta-Analysis of Longitudinal Studies J. Am. Coll. Cardiol., January 30, 2007; 49(4): 403 - 414. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Mancia, M. Bombelli, G. Corrao, R. Facchetti, F. Madotto, C. Giannattasio, F. Q. Trevano, G. Grassi, A. Zanchetti, and R. Sega Metabolic Syndrome in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) Study: Daily Life Blood Pressure, Cardiac Damage, and Prognosis Hypertension, January 1, 2007; 49(1): 40 - 47. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. Ishizaka, Y. Ishizaka, H. Hashimoto, E.-I. Toda, R. Nagai, and M. Yamakado Metabolic Syndrome May Not Associate With Carotid Plaque in Subjects With Optimal, Normal, or High-Normal Blood Pressure Hypertension, September 1, 2006; 48(3): 411 - 417. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Schillaci, M. Pirro, G. Pucci, M. R. Mannarino, F. Gemelli, D. Siepi, G. Vaudo, and E. Mannarino Different Impact of the Metabolic Syndrome on Left Ventricular Structure and Function in Hypertensive Men and Women Hypertension, May 1, 2006; 47(5): 881 - 886. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Sundstrom, U. Riserus, L. Byberg, B. Zethelius, H. Lithell, and L. Lind Clinical value of the metabolic syndrome for long term prediction of total and cardiovascular mortality: prospective, population based cohort study BMJ, April 15, 2006; 332(7546): 878 - 882. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Fallo, F. Veglio, C. Bertello, N. Sonino, P. Della Mea, M. Ermani, F. Rabbia, G. Federspil, and P. Mulatero Prevalence and Characteristics of the Metabolic Syndrome in Primary Aldosteronism J. Clin. Endocrinol. Metab., February 1, 2006; 91(2): 454 - 459. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Schillaci, G. V.L. De Socio, M. Pirro, G. Savarese, M. R. Mannarino, F. Baldelli, G. Stagni, and E. Mannarino Impact of Treatment With Protease Inhibitors on Aortic Stiffness in Adult Patients With Human Immunodeficiency Virus Infection Arterioscler. Thromb. Vasc. Biol., November 1, 2005; 25(11): 2381 - 2385. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. H. Saely, S. Aczel, T. Marte, P. Langer, G. Hoefle, and H. Drexel The Metabolic Syndrome, Insulin Resistance, and Cardiovascular Risk in Diabetic and Nondiabetic Patients J. Clin. Endocrinol. Metab., October 1, 2005; 90(10): 5698 - 5703. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. Koren-Morag, U. Goldbourt, and D. Tanne Relation Between the Metabolic Syndrome and Ischemic Stroke or Transient Ischemic Attack: A Prospective Cohort Study in Patients With Atherosclerotic Cardiovascular Disease Stroke, July 1, 2005; 36(7): 1366 - 1371. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Schillaci, M. Pirro, G. Vaudo, M. R. Mannarino, G. Savarese, G. Pucci, S. S. Franklin, and E. Mannarino Metabolic Syndrome Is Associated With Aortic Stiffness in Untreated Essential Hypertension Hypertension, June 1, 2005; 45(6): 1078 - 1082. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. N. Hopkins, L. L. Wu, S. C. Hunt, and E. A. Brinton Plasma triglycerides and type III hyperlipidemia are independently associated with premature familial coronary artery disease J. Am. Coll. Cardiol., April 5, 2005; 45(7): 1003 - 1012. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. N. DeMaria, O. Ben-Yehuda, D. Berman, G. K. Feld, B. H. Greenberg, J. D. Knoke, K. U. Knowlton, W. Y.W. Lew, J. Narula, D. Sahn, et al. Highlights of the year in JACC 2004 J. Am. Coll. Cardiol., January 4, 2005; 45(1): 137 - 153. [Full Text] [PDF] |
||||
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |