The Relationship between the Risk Profile of Arterial Hypertension and the Features of Metabolic Syndrome-Study on 129 Patients

Abstract

The objective of study was to assess the severe evolution of arterial hypertension evaluated by ambulatory blood pressure monitoring in middle aged hypertensive patients with metabolic syndrome and its relationship with anthropometric and biochemical parameters and with the presence of type 2 diabetes mellitus. Methods: 129 hypertensive patients diagnosed with metabolic syndrome (MetS) according to the Adult Treatment Panel (ATP) III criteria were evaluated by ambulatory blood pressure monitoring (ABPM) parameters: 24-hour variability (diurnal index), heart rate, pulse pressure; anthropometric parameters: body mass index, waist circumference and laboratory data: serum levels of triglycerides, cholesterol, LDL-cholesterol, HDL-cholesterol, uric acid. Statistical analysis including two-taliled Student test-t for comparison of means between two groups and multivariate logistic regression analysis was performed to identify independent predictors for the evolution with diurnal index lower than 10% (nondipper status). Results: the non-dipper status was present in 76% of the hypertensive patients with MetS, significantly frequent in patients with type 2 diabetes mellitus (p=0.0033). The „non-dipper” status was associated with increased mean values of waist circumference (121.17 cm versus 115.29 cm, p=0.0245), body mass index (32.19 kg/m² versus 28.65 kg/m², p=0.0003), duration of diabetes mellitus (2.89 years versus 1.45 years, p=0.0338), heart rate (75.86 beats/min versus 71.13 beats/min, p=0.0467) and triglycerides (266.11mg/dL versus 220.87 mg/dL, p= 0.0078). Independent risk predictors for nondipping status were body mass index and triglyceride levels (p<0.0001). Conclusion: In hypertensive patients with MetS the risk for „non-dipper” status is in relation with increasing waist circumference, body mass index, heart rate, triglycerides, and the presence and duration of type 2 diabetes mellitus.