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Pulse hypertension: a new component of the metabolic syndrome in elderly women?

A Mazza1, S Zamboni, V Tikhonoff

  • 1Department of Internal Medicine, General Hospital Rovigo, Rovigo, Italy.

Journal of Human Hypertension
|June 15, 2007
PubMed

Insights

Metabolic syndrome (MS) predicts coronary heart disease (CHD) mortality in elderly women with untreated hypertension but not treated hypertension. Pulse pressure is the most predictive blood pressure value in treated women.

Area of Science:

  • Cardiology
  • Gerontology
  • Metabolic Diseases

Background:

  • Arterial hypertension (HT) classification for metabolic syndrome (MS) lacks consensus due to varying blood pressure (BP) cutoffs.
  • Understanding the relationship between HT, MS, and coronary heart disease (CHD) mortality is crucial for population health.

Purpose of the Study:

  • To evaluate which arterial hypertension (HT) categorization best defines metabolic syndrome (MS) in relation to coronary heart disease (CHD) mortality at a population level.
  • To assess gender-specific risks of CHD mortality associated with different MS definitions in older adults.

Main Methods:

  • A 12-year follow-up study of 3257 subjects aged 65 years and older.
  • Metabolic syndrome (MS) defined using National Education Cholesterol Program criteria with three HT categories: MS-1 (SBP ≥130 and DBP ≥85 mmHg), MS-2 (SBP ≥130 or DBP ≥85 mmHg), and MS-3 (PP ≥75 mmHg in men, ≥80 mmHg in women).
  • Gender-specific adjusted hazard ratios (HR) for CHD mortality derived from Cox analysis, considering antihypertensive treatment status.

Main Results:

  • In women with untreated MS, CHD mortality risk was significantly higher across all HT categorizations (MS-1: HR 1.73, MS-2: HR 1.75, MS-3: HR 2.39).
  • In women with treated MS, only the MS-3 definition (pulse pressure ≥80 mmHg) showed a significantly increased risk of CHD mortality (HR 1.92).
  • Metabolic syndrome (MS) did not predict CHD mortality in men.

Conclusions:

  • Metabolic syndrome (MS) predicts coronary heart disease (CHD) mortality in elderly women with untreated hypertension.
  • For elderly women with treated hypertension, pulse pressure is the most predictive indicator of CHD mortality within the context of MS.
  • Current HT classifications for MS require refinement, particularly for predicting cardiovascular outcomes in older populations.

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