Inflammatory status, arterial stiffness and central hemodynamics in hypertensive patients with metabolic syndrome

Introduction: Inflammatory state is activated in metabolic syndrome and may explain part of the adverse prognosis of this entity.Arterial stiffness, central blood pressures and wave reflections are independent predictors of cardiovascular risk.This study investigates the relation between low-grade inflammation and arterial stiffness and central hemodynamics in patients with metabolic syndrome.Methods: We studied 106 consecutive hypertensive patients with metabolic syndrome.Arterial stiffness was assessed by carotid-femoral (c-f) and carotid-radial (c-r) pulse wave velocity (PWV).Central blood pressures were evaluated by pulse wave analysis and heart rate corrected augmentation index (AIx 75 ) was used as a measure of wave reflections.White blood cell count (WBC), high sensitivity C-reactive protein (hsCRP) and fibrinogen were measured as inflammatory markers.Results: In univariable analysis, PWVc-f correlated with both hsCRP (p < 0.01) and fibrinogen (p < 0.01), while PWVc-r correlated with hsCRP (p Z 0.05).Regarding central blood pressures, aortic SBP correlated positively with hsCRP (p < 0.05) and marginally with fibrinogen (p Z 0.06) and WBC (p Z 0.08).Interestingly, no correlation was found between AIx 75 and any of these biomarkers.After adjustment for age, gender, smoking, mean arterial pressure, heart rate, waist circumference, glucose, total and HDL cholesterol, PWVc-f was independently related to hsCRP (p < 0.001) and fibrinogen (p < 0.01), while a marginal independent correlation was also found between PWVc-r and hsCRP (p Z 0.06).Furthermore, aortic PP independently associated with fibrinogen (p < 0.05) whereas marginal associations demonstrated between aortic SBP and hsCRP and fibrinogen (p Z 0.06 for both).