Objectives. The aim of our study was to analyse, in a wide group of essential hypertensive patients without diabetes mellitus, the influence of metabolic syndrome (MS) (defined according to the criteria laid down in the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults) on markers of preclinical cardiac, renal and retinal damage. Design. Cross-sectional study.
Setting. Outpatient hypertension clinic.
methods. and Subjects A total of 353 young and middle-aged hypertensives, free from cardiovascular and renal diseases (and 37% of whom had MS), underwent echocardiographic examination, microalbuminuria determination and non-mydriatic retinography. Results. When compared with subjects without MS, hypertensive patients with MS exhibited more elevated left ventricular (LV) mass (either normalized by body surface area or by height elevated by a power of 2.7), higher myocardial relative wall thickness, albumin excretion rate (AER) and a greater prevalence of LV hypertrophy (57.7% vs. 25.1%; P 124 μmol L−1 (1.4 mg dL−1) in women), overt proteinuria, major non-cardiovascular diseases, dyslipidaemia requiring pharmacological treatment, and known diabetes or fasting glycaemia ≥126 mg dL−1. Of the remaining hypertensive individuals 45 were also excluded, because of suboptimal echocardiographic tracings (39 subjects) or unreliable urine collections (six patients). Hence, the final statistical analysis involved 353 patients. Before entering the study, 230 hypertensives had been pharmacologically treated. These patients were studied for at least 2 weeks, after the discontinuation of all antihypertensive drugs. Written informed consent was obtained from each patient and the study was approved by the local ethics committee. Study design
In all subjects careful clinical history and physical...