AASI is inversely related to GFR in arterial hypertension. This may help to explain the increased CV risk associated with mild-to-moderate renal dysfunction.

The elevated levels of clinic and 24-h PP observed in hypertensive patients with MS may reflect increased large arteries stiffness and may therefore contribute to explain the enhanced cardiovascular risk associated with MS.

Some reports have suggested that white-coat hypertension (WCH) is associated with some features of the metabolic syndrome (MetS). These metabolic disturbances, instead of WCH per se, may potentially explain the greater extent of end-organ damage sometimes observed in WCH subjects (WCHs) when compared to normotensive individuals (NTs). The aim of the present cross-sectional study was to compare left ventricular (LV) structure and function in three groups of subjects: WCHs with MetS, WCHs without MetS and NTs. A total of 145 WCHs, 35% of whom had MetS, were enrolled. As controls, 35 NTs were also studied. In all subjects, routine blood chemistry, echocardiographic examination and 24-h ambulatory blood pressure monitoring were performed. When compared with WCHs without MetS, those with MetS showed higher LV mass indexed by height elevated by a power of 2.7 (LVMH 2.7 ) (49.6714.8 vs 38.979.8 g/m 2.7 ; Po0.0001). The same parameter was greater in WCHs without MetS than in NTs (3278 g/m 2.7 ; P ¼ 0.004). Moreover, the E-wave deceleration time was longer in WCHs with MetS than in those without it (236.2766.4 vs 200.5730.8 ms; Po0.0001). The relationship of MetS with LVMH 2.7 was confirmed in multivariate regression models. Our results seem to suggest that MetS may have a deleterious influence on LV structure and function in WCH. However, WCH, being associated with an increased LV mass, also in subjects without MetS, may not be considered as an innocuous phenomenon.

The intima-media thickness (IMT) is considered as a surrogate marker for atherosclerotic disease. The aim of this study was to analyze the relationship of carotid IMT with fetuin-A in patients with essential hypertension (EH) and normal renal function. The plasma levels of fetuin-A, interleukin 6 (IL-6), tumor necrosis factor-a (TNF-a) and the biomarker of oxidative stress 8-isoPGF2alpha were assayed in samples from 105 untreated EH patients. Carotid IMT measurements were also performed. EH was studied overall and after dividing in EH with IMT X and o0.9 mm. All of the biomarkers were significantly different between the two subgroups, in particular, the fetuin-A level was lower in the patients with an IMT X0.9 mm. In the overall group, the linear analysis of correlation demonstrated that the IMT was significantly inversely correlated with the fetuin-A level (r ¼ À0.40, Po0.0001) and directly with TNF-a (r ¼ 0.39, Po0.0001), IL-6 (r ¼ 0.38, Po0.0001) and 8-iso-PGF2alpha (r ¼ 0.356, Po0.0003). The multiple regression analysis performed that assigned IMT as a dependent variable showed that fetuin-A (b ¼ À0.268, Po0.0001) was independently correlated with the IMT. Receiver-operator curves demonstrated that fetuin-A levels have a predictive power of IMT40.9 mm (AUC (area under the curve) 0.738, Po0.0001). Our results suggest that in EH, fetuin-A is associated with the IMT independently of oxidative stress and renal function, thus predicting increases in the IMT.