Metabolic syndrome is associated with early signs of organ damage in nondiabetic, hypertensive patients

Leoncini G, Ratto E, Viazzi F, Vaccaro V,Parodi D, Parodi A, Falqui V, Tomolillo C, DeferrariG, Pontremoli R (University of Genoa, Genoa, Italy).Metabolic syndrome is associated with early signs oforgan damage in nondiabetic, hypertensive patients.J Intern Med 2005; 257: 454–460.Objectives. Hypertensive patients with metabolicsyndrome (MS) are at greater risk for cardiovasculardisease. To get a better understanding of the patho-physiology underlying this association, we evaluatedthe relationship between MS and subclinical organdamage in essential hypertensive patients.Design and setting. A total of 354 untreated,nondiabetic patients with primary hypertensionwere included in the study. A modified ATP IIIdefinition for MS was used, with body mass indexreplacing waist circumference. Albuminuria wasmeasured as albumin to creatinine ratio, leftventricular mass index (LVMI) was assessed byechocardiography and carotid abnormalities byultrasonography.Results. The prevalence of MS was 25%. Patientswith MS were more likely to be smokers (P ¼ 0.004)and had higher serum uric acid levels (P ¼ 0.004).Moreover, they showed higher urinary albuminexcretion (P ¼ 0.0004) and LVMI (P ¼ 0.0006),increased intima-media thickness (P ¼ 0.045), aswell as higher prevalence of microalbuminuria(P ¼ 0.03) and left ventricular hypertrophy (LVH;P ¼ 0.003). After adjusting for age, gender andduration of hypertension, we found that thepresence of MS entails a twofold greater risk formicroalbuminuria (P ¼ 0.04), LVH (P ¼ 0.003)and carotid abnormalities (P < 0.05). Whenpatients were stratified according to the number ofcomponents of MS, albuminuria (P ¼ 0.002) andLVMI (P ¼ 0.005) increased progressively acrosscategories.Conclusions. Metabolic syndrome is associated withsubclinical organ damage in nondiabetic, essentialhypertensive patients. These data may, in part,explain the high cardiovascular morbidity andmortality that is observed in hypertensive patientswith MS.Keywords: hypertension, left ventricular hypertrophy,metabolic syndrome, microalbuminuria.