Metabolic syndrome is associated with aortic stiffness in untreated essential hypertension
Giuseppe Schillaci1, Matteo Pirro, Gaetano Vaudo
1University of Perugia, Perugia, Italy. skill@unipg.it
Insights
Metabolic syndrome increases aortic stiffness in hypertension, a key cardiovascular risk factor. This study found the metabolic syndrome independently linked to higher aortic pulse wave velocity in untreated hypertensive patients.
Area of Science:
- Cardiology
- Vascular Biology
- Metabolic Disorders
Background:
- Metabolic syndrome is a known cardiovascular disease predictor in hypertension.
- Large-artery stiffness is an emerging cardiovascular risk factor.
- The link between metabolic syndrome and aortic stiffness in hypertension requires further investigation.
Purpose of the Study:
- To investigate the association between the metabolic syndrome and aortic stiffness in patients with essential hypertension.
- To determine if the metabolic syndrome contributes to increased aortic stiffness, explaining its prognostic significance.
Main Methods:
- A cohort of 169 newly diagnosed, untreated, nondiabetic patients with essential hypertension was studied.
- Patients were classified based on the presence or absence of the metabolic syndrome.
- Aortic and upper limb pulse wave velocity were measured using applanation tonometry.
Main Results:
- Aortic pulse wave velocity was significantly higher in patients with the metabolic syndrome compared to those without (10.0±2.7 vs. 8.8±2.1 m/s, P=0.003).
- Aortic pulse wave velocity correlated with systolic blood pressure and waist circumference, but not BMI.
- Multiple regression analysis revealed that the metabolic syndrome was independently associated with higher aortic pulse wave velocity, alongside age and systolic blood pressure.
Conclusions:
- In untreated hypertension, the metabolic syndrome is independently associated with increased aortic stiffness.
- Central adiposity, indicated by waist circumference, is a significant determinant of aortic stiffness in hypertensive individuals.
- These findings suggest that the metabolic syndrome may partially explain the increased cardiovascular risk associated with hypertension through its impact on aortic stiffness.
Abstract:
Metabolic syndrome is a powerful predictor of cardiovascular disease in hypertension, and large-artery stiffness is increasingly recognized as a cardiovascular risk factor. We hypothesized that the adverse prognostic significance of the metabolic syndrome in hypertension might be explained in part by its association with aortic stiffness. A total of 169 newly diagnosed, never treated, nondiabetic patients with essential hypertension (men 55%, 48+/-11 years) were classified by the presence (n=45) or absence (n=124) of the metabolic syndrome. All patients underwent aortic and upper limb pulse wave velocity determination by means of an applanation tonometry-based method. Aortic pulse wave velocity had a direct correlation with office and 24-hour systolic pressure (r=0.42 and 0.31, respectively), as well as with waist circumference (r=0.35, all P<0.001), but not with body mass index (r=0.10, P=not significant). Aortic pulse wave velocity was higher in the subgroup with the metabolic syndrome (10.0+/-2.7 versus 8.8+/-2.1 m/s; P=0.003), whereas upper limb velocity did not differ in the 2 groups (8.6+/-1.4 versus 8.7+/-1.5 m/s; P=not significant). In a multiple regression, aortic pulse wave velocity was independently associated with age, systolic blood pressure, and the metabolic syndrome. Only diastolic BP independently predicted upper limb pulse wave velocity. We conclude that in untreated hypertension, the metabolic syndrome is independently associated with a higher aortic, but not upper limb, pulse wave velocity. Central, but not general, adiposity is an important determinant of aortic stiffness in hypertension.
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