Key result
Metabolic syndrome in hypertensive patients linked to ~255% higher incidence of new-onset diabetes.
Why the study?
The impact of current hypertension management guidelines on cardiovascular risk factors in hypertensive patients with and without metabolic syndrome was unclear.
Does usual recommended care for hypertension adequately control cardiovascular risk factors in hypertensive patients with metabolic syndrome compared to those without?
Cohort (n=549)
Does usual recommended care for hypertension adequately control cardiovascular risk factors in hypertensive patients with metabolic syndrome compared to those without?
Absolute Event Rate: 7.8% vs 2.2%
p-value: p=<.001
Usual hypertension care achieves similar blood pressure goals in patients with and without metabolic syndrome, but leaves those with metabolic syndrome at higher global cardiovascular risk, suggesting current guidelines may be insufficient for this subgroup.
May warrant closer diabetes monitoring in hypertensive patients with metabolic syndrome; extends observational associations but leaves causal effects and interventions open.
The authors analyzed the impact of present guidelines for hypertension management on cardiovascular (CV) risk factors in hypertensive patients with and without the metabolic syndrome (MS). Results in 549 nondiabetic hypertensive patients with a mean follow-up of 3.8+/-1.2 years on usual recommended care were reviewed. At baseline, 231 (42.1%) patients had MS and, per the definition, showed significantly higher values of traditional CV risk factors than non-MS patients. At the end of follow-up, blood pressure levels were similar in both groups; the lipid profile tended to improve in MS patients. Eighteen MS patients (7.8%) and 7 non-MS patients (2.2%) developed diabetes (P<.001). Prevalence of microalbuminuria was reduced in both groups, but it remained significantly higher in MS patients. Usual care of hypertensive patients achieved similar blood pressure and low-density lipoprotein cholesterol goals, both in MS and non-MS patients. Global CV risk, however, remained higher in MS patients, as suggested by a 3-fold higher incidence of new-onset diabetes (absolute increase of 5.6%) and a 2-fold increase in microalbuminuria.
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Segura et al. (2007) conducted a cohort in Hypertension (n=549). Metabolic syndrome vs. No metabolic syndrome was evaluated on New-onset diabetes (p=<.001). Metabolic syndrome in hypertensive patients was associated with a higher incidence of new-onset diabetes compared to those without metabolic syndrome (7.8% vs 2.2%, P<.001).
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