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Metabolic syndrome may be associated with increased arterial stiffness even in the absence of hypertension: A study in 84 cases and 82 controls
Authors:Pauliina Kangas  Antti J Tikkakoski  Anna M Tahvanainen  Miia H Leskinen  Jani M Viitala  Mika Kähönen  Tiit Kööbi  Onni J Niemelä  Jukka T Mustonen  Ilkka H Pörsti
Institution:1. School of Medicine, University of Tampere, 33014 Tampere, Finland;2. Department of Clinical Physiology, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland;3. Laboratory and Medical Research Unit, Seinäjoki Central Hospital, Hanneksenrinne 7, 60220 Seinäjoki, Finland;4. Department of Internal Medicine, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland
Abstract:

Objective

To evaluate the hemodynamic characteristics of metabolic syndrome (MetS) in the absence and presence of hypertension.

Materials/Methods

Altogether 166 subjects without previously diagnosed cardiovascular disease, diabetes, or antihypertensive medication, were allocated to four groups: control, hypertension only, MetS without hypertension, and MetS with hypertension (mean age 44–46 years). Cut-point for hypertension was blood pressure ≥ 140/90 mmHg. Other criteria of MetS were as defined by Alberti et al. 2009. Hemodynamic variables were measured using whole-body impedance cardiography and pulse wave analysis.

Results

Pulse wave velocity was higher in hypertensive and normotensive subjects with MetS than controls (p < 0.05), and in the hypertensive MetS group than subjects with hypertension only (p < 0.05). Aortic pulse pressure was higher in the two hypertensive groups than the two normotensive groups (p < 0.05). Systemic vascular resistance index was higher in the hypertensive than normotensive MetS group (p < 0.05), and in the group with hypertension alone than in controls (p < 0.05). Heart rate was higher in the hypertensive Mets group than in controls and subjects with hypertension only (p < 0.05). Cardiac index did not differ, while stroke index was lower in both groups with MetS than groups without MetS. Augmentation pressure was higher in the hypertensive MetS group than in controls and normotensive MetS group (p < 0.05).

Conclusions

Pulse wave velocity, an acknowledged marker of arterial stiffness, was associated with MetS even in the absence of hypertension. This emphasizes the importance of the prevention and treatment of MetS.
Keywords:AGEs  glycation end-products  AIx  augmentation index  ANOVA  one-way analysis of variance  BMI  body mass index  CI  confidence interval  eGFR  estimated creatinine-based glomerulus filtration rate  HDL  high-density lipoprotein  HOMA-IR  homeostasis model assessment of insulin resistance  HT  hypertensive group  HT-MetS  hypertensive metabolic syndrome group  LDL  low-density lipoprotein  MetS  metabolic syndrome  NT-MetS  normotensive metabolic syndrome group  PWA  pulse wave analysis  PWV  pulse wave velocity  SE  standard error of the mean  SVRI  systemic vascular resistance index
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