Association between metabolic syndrome and parameters of 24-hour blood pressure ambulatory monitoring

Abstract

Objective: To investigate associations between metabolic syndrome (MS) and 24-hour blood pressure parameters as a measure of cardiovascular risk (CVR). Subjects and methods: 136 hypertensive subjects, of both sexes, aged between 29 and 83 years were studied. CVR was defined as having at least three of the following conditions: 1) systolic/diastolic blood pressure (BP) ≥ 140/90 mmHg, absence/atennuation of nighttime fall in BP during sleep, pulse pressure (PP) ≥ 53 mmHg; 2) 24-h PP > 53 mmHg, 3) nighttime PP > 53 mmHg, 4) daytime PP > 53 mmHg and 5) nighttime fall in BP during sleep. Results: The 24-h PP, daytime PP and nighttime PP were elevated in 54% of the population. Hypertriglyceridemia (52%), low HDL (72.8%), abdominal obesity (60.3%), MS (58.1%), dyslipidemia (88.8%), overweight (74.3%) and obesity (33.8%) were also elevated. Age-adjusted MS was associated with higher CVR (OR = 4.5 and 3.6), 24-h PP (OR = 2.3 and 4.7), and daytime PP (OR = 2.2 and 4.6). Conclusions: MS was highly prevalent and correlated with altered 24-hour blood pressure parameters. Arq Bras Endocrinol Metab. 2011;55(6):383-8 Keywords Ambulatory blood pressure monitoring; arterial hypertension; cardiovascular risk; pulse pressure RESUMO Objetivo: Investigar associação entre síndrome metabólica (SM) e parâmetros da monitorização da pressão arterial de 24 horas (MAPA) como medida de risco cardiovascular (RCV). Sujeitos e métodos: Foram estudados 136 pacientes hipertensos, ambos sexos, idade entre 29 e 83 anos. RCV foi definido pela presença de, no mínimo, três das seguintes condições: 1) pressão arterial sistólica/diastólica ≥ 140/90 mmHg, ausência/atenuação do descenso noturno e pressão de pulso (PP) ≥ 53 mmHg, 2) pressão de pulso 24h (PP24h), 3) sono (PPS), 4) vigília (PPV) e 5) descenso noturno. Resultados: PPV, PPS e PP24h estiveram aumentadas em 54% dos pacientes. Hipertrigliceridemia (52%), HDL baixo (72,8%), obesidade abdominal (60,3%), SM (58,1%), dislipidemia (88,8%), sobrepeso (74,3%) e obesidade (33,8%) estavam elevados. SM, ajustada pela idade, foi associada a elevado RCV (OR = 4,5 e OR = 3,6), a PP24h (OR = 2,3 e OR = 4,7) e a PPS (OR = 2,2 e OR = 4,6). Conclusões: SM foi altamente prevalente e correlacionada aos parâmetros da pressão arterial de 24 horas alterados. Arq Bras Endocrinol Metab. 2011;55(6):383-8 Descritores

Ambulatory Blood Pressure Profiles and Correlation with Cardiovascular Risk Factors in a Sample of 390 University Employees in Tanzania

“…This finding is similar to that found by investigators in Brazil as well as in a large population-based study that included subjects from Europe, Asia and South America. 41,42 In the study by Yang et al, 42 mean 24-hour systolic BP had the strongest hazard ratio of predicting cardiovascular events when compared to other ABPM profiles. The fact that mean ambulatory BP showed stronger correlations with the modifiable risk factors like hypercholesterolemia, hyperuricemia and obesity, suggests that most of the BP increase in this population is related to lifestyle, and that control measures should target lifestyle modification.…”

Are the metabolic syndrome, blood pressure pattern, and their interaction responsible for the right ventricular remodeling?

“…However, studies were mostly focused on left ventricular remodeling [1][2][3][4] as the right ventricle (RV) has long been neglected in the estimation of overall cardiac function and also because echocardiographic estimation was difficult in everyday clinical practice because of complex geometry. Studies have shown that MS was associated with altered 24-h blood pressure (BP) parameters including a nondipping pattern [5]. Studies have shown that MS was associated with altered 24-h blood pressure (BP) parameters including a nondipping pattern [5].…”