Key result
Metabolic syndrome in hypertensive patients was associated with increased aortic pulse wave velocity compared to controls (adjusted beta 0.89 m/s; 95% CI 0.28-1.51; P=0.005).
Cross-Sectional (n=227)
Metabolic syndrome in hypertensive patients is associated with increased aortic stiffness, which appears to be partly driven by inflammation and intima-media thickening.
Should not yet change hypertension management; hypothesis-generating for metabolic syndrome accelerating aortic stiffening.
Background and aims Metabolic syndrome (MetS) is currently considered to raise the risk for type 2 diabetes and cardiovascular events. It has been suggested that part of this risk excess may be due to a cluster of additional factors associated with MetS. We aimed to investigate the role of inflammation on the ventricular-vascular coupling in patients with MetS. Methods and results We enrolled a total of 227 hypertensive patients (106 with MetS and 121 without MetS) matched for age and gender. Aortic pulse wave velocity (aPWV), intima-media thickness (IMT) and high sensitivity C-reactive protein (CRP) increased according to the number of MetS components. Patients with MetS showed increased aPWV (11.5 ± 3.7 vs. 10.3 ± 2.5 m/s, P = 0.03) compared with controls. In a model adjusted for age, sex, heart rate and mean blood pressure, aPWV resulted increased in patients with CKD (beta 1.29 m/s, 95%CI 0.61–1.96 m/s, P < 0.001) and MetS (beta 0.89 m/s, 95%CI 0.28–1.51 m/s, P = 0.005). After additional adjustment for CRP and IMT, the slope of aPWV was respectively reduced by 16% and 62%, suggesting that inflammation and intima-media thickening could contribute to aortic stiffening in patients with MetS. In these patients, aPWV was also associated with left-ventricular mass index (beta 0.79 g/m 2.7 , 95%CI 0.05–1.52 g/m 2.7 , P = 0.05). Conclusion MetS is characterized by an inflammation-dependent acceleration in cardiovascular ageing. This pattern of pathophysiological abnormalities may contribute to amplify the burden of cardiovascular risk in patients with MetS.
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Zanoli et al. (2018) conducted a cross-sectional in Hypertension with metabolic syndrome (n=227). Metabolic syndrome vs. Hypertensive patients without metabolic syndrome was evaluated on Aortic pulse wave velocity (aPWV) (beta 0.89 m/s, 95% CI 0.28-1.51, p=0.005). Metabolic syndrome in hypertensive patients was associated with increased aortic pulse wave velocity compared to controls (adjusted beta 0.89 m/s; 95% CI 0.28-1.51; P=0.005).
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