Metabolic Syndrome and Morphofunctional Characteristics of the Left Ventricle in Clinically Hypertensive Nondiabetic Subjects

• Published in: American journal of hypertension Vol. 19; no. 2; pp. 199 - 205
• Main Authors: Grandi, Anna M., Maresca, Andrea M., Giudici, Elena, Laurita, Emanuela, Marchesi, Chiara, Solbiati, Francesco, Nicolini, Eleonora, Guasti, Luigina, Venco, Achille
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.2006; Oxford University Press; Elsevier Science
• Subjects: Antihypertensive agents; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure - physiology; Blood Pressure Monitoring, Ambulatory; Body Mass Index; Cardiology. Vascular system; Cardiovascular system; diastolic function; Echocardiography, Doppler; essential hypertension; Experimental diseases; Female; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Hypertension - complications; Hypertension - diagnostic imaging; Hypertension - physiopathology; Hypertrophy, Left Ventricular - diagnostic imaging; Hypertrophy, Left Ventricular - etiology; Hypertrophy, Left Ventricular - physiopathology; Male; Medical sciences; Metabolic syndrome; Metabolic Syndrome - complications; Metabolic Syndrome - diagnostic imaging; Metabolic Syndrome - physiopathology; Middle Aged; Myocardial Contraction - physiology; myocardial hypertrophy; Pharmacology. Drug treatments; Ventricular Function, Left - physiology; essential hypertension; myocardial hypertrophy; diastolic function; Metabolic syndrome; Human; Hypertension; Cardiovascular disease; Left ventricle
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1016/j.amjhyper.2005.07.024

The study was aimed to evaluate the impact of the metabolic syndrome on left ventricular (LV) structure and function in nondiabetic patients, never treated with antihypertensive or lipid-lowering drugs. Eighty-eight patients, with recent finding of clinic BP >140 or 90 mm Hg, underwent 24-h blood pressure (BP) monitoring, echocardiogram, evaluation for metabolic syndrome (Adult Treatment Panel III criteria). Metabolic syndrome was diagnosed in 38 subjects (43.2%) (metabolic syndrome+). Age, gender, 24-h systolic and diastolic BP were similar between metabolic syndrome+ and metabolic syndrome− groups, whereas body mass index, clinic and 24-h heart rate, fasting glycemia, and triglycerides were significantly higher and HDL-cholesterol lower in metabolic syndrome + subjects. The prevalence of sustained hypertension (24-h BP >125 or 80 mm Hg) was similar between the two groups. Relative wall thickness and LV mass were significantly greater in the metabolic syndrome+ group, also after correction for body mass index. The LV systolic function was similar between the two groups, whereas all the parameters of diastolic function, but the mitral E/A ratio, were significantly lower in the metabolic syndrome+ group. From multiple regression analysis the main independent determinant of LV mass index was the presence of metabolic syndrome, followed by the 24-h systolic BP. Nondiabetic patients with metabolic syndrome showed more pronounced alterations of LV geometry and function compared with subjects without metabolic syndrome. These greater preclinical myocardial abnormalities were not accounted for by difference in age, gender, or 24-h BP and can be reasonably ascribed to the interplay of the metabolic syndrome components, making the metabolic syndrome in itself a relevant clinical problem, possibly a cardiovascular disease equivalent, that deserves aggressive treatment.