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Peripheral wave reflection and endothelial function in untreated essential hypertensive patients with and without the metabolic syndrome.

Abstract：

OBJECTIVE:Metabolic syndrome is associated with a high risk of cardiovascular disease in hypertension. We evaluated whether metabolic syndrome is associated with early vascular alterations, such as increased peripheral wave reflections and endothelial dysfunction, in untreated essential hypertensive patients. METHODS:Augmentation index and pulse wave velocity were determined with applanation tonometry in 391 untreated hypertensive patients and 166 controls. Endothelium-dependent response was assessed as flow-mediated dilation of the brachial artery. Metabolic syndrome was defined according to the latest National Cholesterol Education Program Adult Treatment panel III. RESULTS:Hypertensive patients showed significantly (P < 0.001) increased augmentation index and central pulse wave velocity, as well as reduced flow-mediated dilation, compared with controls. No further impairment in augmentation index or flow-mediated dilation was observed between patients with or without the metabolic syndrome components and with increasing number of metabolic syndrome. Age and systolic blood pressure, but no other single factor of the metabolic syndrome, resulted as significant predictors of augmentation index and flow-mediated dilation. Female gender was associated with increased augmentation index (P < 0.05) in the presence of the metabolic syndrome. Central pulse wave velocity was selectively impaired by metabolic syndrome in both genders. Finally, reactive hyperemia was reduced in patients with the metabolic syndrome and decreased significantly with the increasing number of metabolic syndrome. CONCLUSIONS:In untreated hypertensive patients, the presence of metabolic syndrome, which selectively impairs central pulse wave velocity, does not account for a further deterioration of peripheral wave reflection and conduit artery endothelial function. Our results suggest that blood pressure, age and gender are important determinants of peripheral vascular structural and functional parameters in these subjects, irrespective of the metabolic syndrome.

journal_name

J Hypertens

journal_title

Journal of hypertension

authors

Plantinga Y,Ghiadoni L,Magagna A,Giannarelli C,Penno G,Pucci L,Taddei S,Del Prato S,Salvetti A

doi

10.1097/HJH.0b013e3282fa7158

subject

Has Abstract

pub_date

2008-06-01 00:00:00

pages

1216-22

issue

eissn

0263-6352

issn

1473-5598

pii

00004872-200806000-00022

journal_volume

pub_type

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Peripheral wave reflection and endothelial function in untreated essential hypertensive patients with and without the metabolic syndrome.