Metabolic syndrome in hypertensive CAD patients was associated with significantly poorer blood pressure control at the <140/90 mmHg target compared to those without it (50.6% vs 74.8%, OR 0.34, p<0.001).
Cross-Sectional (n=274)
Does the presence of metabolic syndrome reduce the likelihood of achieving blood pressure targets in patients with coronary artery disease and hypertension?
In patients with coronary artery disease and hypertension, the presence of metabolic syndrome is strongly associated with poorer blood pressure control, highlighting a high-risk subgroup requiring more intensive management.
Odds Ratio: 0.34
Absolute Event Rate: 50.6% vs 74.8%
p-value: p=< 0.001
Objective: In patients with established coronary artery disease (CAD), hypertension frequently coexists with metabolic abnormalities within metabolic syndrome (MetS). Evidence describing blood pressure control in CAD patients with concurrent MetS remains limited. The objective of this study was to assess BP control in CAD patients with diagnosed hypertension and to examine the association between a MetS phenotype and achievement of BP targets. Design and method: 274 CAD patients were enrolled for the study. Among those with diagnosed hypertension, BP control was assessed using measured systolic/diastolic BP (SBP/DBP). Cut-off targets were defined as 130/85 or hypertension. Determinants of SBP and DBP were analysed using stratified linear regression models with robust (HC3) standard errors, including BMI, age, sex, lipid profile, diabetes, and number of diseased coronary vessels. Effect modification by MetS was tested in pooled models using interaction terms. Results: Hypertension was present in 88.6% of CAD patients. Among hypertensive patients BP control rates were 66.4% for <140/90 mmHg and 41.6% for <130/80 mmHg. MetS prevalence among hypertensive CAD patients was 34.6%. MetS was associated with substantially poorer BP control at both thresholds (<140/90: 50.6% vs 74.8%, OR 0.34, p < 0.001; <130/80: 22.9% vs 51.6%, OR 0.28, p < 0.001). In stratified robust linear models, no predictor was independently associated with SBP or DBP in the non-MetS subgroup. In the MetS subgroup, older age was independently associated with lower DBP (p = 0.030). MetS significantly modified the association between sex and SBP (p = 0.045), indicating a stronger positive association of male sex with SBP when MetS was present. Conclusions: In this CAD cohort, BP control was suboptimal, particularly for the <130/80 mmHg target. MetS was common and strongly associated with poorer BP control. Beyond average differences in control rates, MetS modified SBP patterns by sex and was associated with an age-related decline in DBP within MetS patients, suggesting clinically relevant heterogeneity in haemodynamic profiles among hypertensive CAD patients with metabolic syndrome.
Popiolek-Kalisz Joanna (Fri,) conducted a cross-sectional in Coronary artery disease and hypertension (n=274). Metabolic syndrome vs. Absence of metabolic syndrome was evaluated on Blood pressure control <140/90 mmHg (OR 0.34, p=< 0.001). Metabolic syndrome in hypertensive CAD patients was associated with significantly poorer blood pressure control at the <140/90 mmHg target compared to those without it (50.6% vs 74.8%, OR 0.34, p<0.001).