Association of Metabolic Syndrome and Blood Pressure Nondipping Profile in Untreated Hypertension

• Published in: American journal of hypertension Vol. 22; no. 3; pp. 307 - 313
• Main Authors: Hermida, Ramón C., Chayán, Luisa, Ayala, Diana E., Mojón, Artemio, Domínguez, María J., Fontao, María J., Soler, Rita, Alonso, Ignacio, Fernández, José R.
• Format: Journal Article
• Language: English
• Published: Basingstoke Oxford University Press 01.03.2009; Nature Publishing Group
• Subjects: Adult; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure - physiology; Blood Pressure Monitoring, Ambulatory; Cardiology. Vascular system; Circadian Rhythm - physiology; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Creatine - blood; Cross-Sectional Studies; Female; Fibrinogen - metabolism; Glomerular Filtration Rate; Heart Rate - physiology; Humans; Hypertension - complications; Hypertension - physiopathology; Logistic Models; Male; Medical sciences; Metabolic Syndrome - complications; Metabolic Syndrome - physiopathology; Middle Aged; Motor Activity - physiology; Smoking - epidemiology; Uric Acid - metabolism; Hypertension; Cardiovascular disease; Arterial pressure; Blood pressure
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1038/ajh.2008.358

Background There is a marked association between metabolic syndrome (MS) and increased cardiovascular risk. Moreover, nondipping (patients with <10% decline in the asleep relative to the awake blood pressure (BP) mean) has also been associated with increased cardiovascular morbidity and mortality. Methods We investigated the association between MS and impaired nocturnal BP decline in 1,770 nondiabetic, untreated hypertensive patients (824 men and 946 women), 48.7 ± 13.2 years of age. BP was measured by ambulatory monitoring for 48 h to increase reproducibility of the dipping pattern. Physical activity was simultaneously monitored every minute by wrist actigraphy. Results MS was present in 42.4% of the patients. The prevalence of a nondipper BP profile was significantly higher in patients with MS (46.1% vs. 37.5% in patients without MS, P < 0.001). Patients with MS were characterized by significant elevations in uric acid (5.9 mg/dl vs. 5.2 mg/dl, P < 0.001), fibrinogen (314 mg/dl vs. 304 mg/dl, P = 0.021), and globular sedimentation rate (13.8 mm vs. 11.6 mm, P < 0.001). Nondipping was significantly associated to the presence of MS in a multiple logistic regression model adjusted by other significant confounding factors, including age, serum creatinine, and cigarette smoking. The single most relevant factor in the definition of MS associated to nondipping was elevated waist perimeter. Conclusions This study documents a significant increase of a blunted nocturnal BP decline in patients with MS. Patients with MS were also characterized by elevated values of relevant markers of cardiovascular risk, including fibrinogen and globular sedimentation rate. American Journal of Hypertension 2009; doi:10.1038/ajh.2008.358