Influence of metabolic syndrome and its components on subclinical organ damage in hypertensive perimenopausal women

摘要

Purpose: We investigated the association between metabolic syndrome (MS), its components and the presence of subclinical organ damage in hypertensive perimenopausal women. Patients/methods: 152 women with newly diagnosed, untreated arterial hypertension (mean age 51.0 ± 3.5 years) were included in the study. In all subjects anthropometrical measurements, 24-hr blood pressure monitoring, echocardiographic examination, and carotid ultrasound were performed. Carotid-femoral pulse wave velocity (PWV) was measured to obtain data on vascular compliance. As the index of early kidney damage both glomerular filtration rate was calculated and albumin/creatinine ratio in the urine sample was measured. A fasting blood sample was taken to measure glucose and lipid concentration. Results: MS was found in 41 % of patients. Patients with MS exhibited elevated left ventricular mass index (LVMI 84.7 vs. 78.8 g/m~2.7, p = 0.03), higher intima-media thickness (IMT 0.67 vs. 0.62 mm, p = 0.003), greater prevalence of LV hypertrophy (30% vs. 13%, p = 0.01), and carotid plaques (24% vs. 15%, p = 0.01). The multivariate regression analysis revealed that components of MS (systolic blood pressure and waist circumference) are stronger predictors of LVM than MS itself. The relationship between MS and LVMI lost its significance when BMI was included in the model, and remained significant for IMT. Conclusion: In hypertensive perimenopausal women components of MS are stronger predictors of subclinical organ damage than MS itself. Left ventricular mass and hypertrophy are more strongly correlated with increasing body weight than with the presence of MS. MS, independently of BMI, influences the level of subclinical atherosclerosis in the study group.