Combined Effects of Diet and Antihypertensive Drugs on Adipose Metabolism in Overweight Hypertensive Patients

Abstract

Introduction: Metabolic syndrome (MS), a cluster of cardiovascular risk (CR) factors, can be a risk factor for Heart Failure (HF), last step of several cardiac pathologies. When some of the parameters which constitute MS are in a range of values that we can consider Border-Line (BL), they don't involve, in regard to the actually guidelines, an increase of CR percentage sufficient to place indications for their therapeutic correction. Even if these parameters BL are not so elevated, when present simultaneously in the same subject, they can contribute in augmenting not-so-negligibly CR profile. Objective: Our aim has been to evaluate if in a population of patients (pts) with cardiac damage clinically evident, as HF, a cluster of CR factors as MS and, in particular, MS with some BL values, can be greatly represented. Methods and results: We evaluated 550 consecutive pts with HF, defined by ACC/AHA guidelines, admitted for the first time to our Out-patients Clinic for the Management of Heart Failure. In 167 we had parameters to define the presence or the absence of MS (by AACE 2003, 2004 correction, definition) (96 M, 171 F, average age 73,5 years, range 52-90). MS was present in 62 pts (37,1%; 35 M, 27 F, average age 73,5 years) whereas 75 pts (15%; 17 M, 8 F, average age 73,5 years) showed BL values for some of the parameters of MS (Blood Pressure 130-139/80-89 mmHg;Triglycerides 150-199 mg/dl) with other classic parameters of MS. In a age-matched asymptomatic population without clinically evident cardiac damage, like that evaluated in Brisighella Heart Study, the prevalence of MS was 28% and the one of BL MS was 8,3%. Conclusions: The greater prevalence of MS and, in particular, of BL MS in a population of pts with HF respect to a population of asymptomatic subjects underlines how these cluster of CR factors are more represented in subjects who had already manifested cardiac damage in a clinically evident manner. This suggests that not only MS but also BL MS can determine a not-negligible augment of CR that an early therapeutic intervention also versus BL MS could prevent.