Metabolic Syndrome-Related Features in Controlled and Resistant Hypertensive Subjects

Abstract

BackgroundMetabolic syndrome (MetS) is widespread among hypertensive patients. Clinical features and potential biomarkers of MetS in the presence of hypertension and resistant hypertension (RHTN) represent a great area of interest for investigation.ObjectiveThe purpose of this study was to evaluate the prevalence of MetS and the clinical features associated with it in resistant and mild to moderate hypertensives.MethodsThis cross-sectional study included 236 patients, (i) 129 mild to moderate hypertensive patients and (ii) 107 patients with RHTN. We measured blood pressure (BP) and adipokines levels, and performed bioelectrical impedance analysis. Microalbuminuria (MA), cardiac hypertrophy and arterial stiffness were also assessed. The significance level of alpha = 0.05 was adopted.ResultsWe found a MetS prevalence of 73% in resistant and 60% in mild-to-moderate hypertensive patients. In a multiple regression analysis, MA (odds ratio = 8.51; p = 0.01), leptin/adiponectin ratio (LAR) (odds ratio = 4.13; p = 0.01) and RHTN (odds ratio = 3.75; p = 0.03) were independently associated with the presence of MetS apart from potential confounders.ConclusionsOur findings suggest that both resistant and controlled hypertensive subjects have a high prevalence of MetS. In addition, MetS-related metabolic derangements may cause early renal and hormonal changes. Finally, LAR may be useful as a reliable biomarker for identifying those hypertensive subjects who are at risk for developing MetS.

A Proposed Inflammatory Score of Circulating Cytokines/Adipokines Associated with Resistant Hypertension, but Dependent on Obesity Parameters

“…Recently, we have found a huge prevalence of metabolic syndrome in these RHTN subjects (73%), which may explain the high IS. Interestingly, the HTN group also showed a considerable prevalence of the syndrome (60%), 21 which might justify the worsening of their score in our present study. In addition, the HTN group was older than the RHTN group, and hence an increased IS could be attributed to age.…”

Overview of the Pathogenesis, Genetic, and Non-Invasive Clinical, Biochemical, and Scoring Methods in the Assessment of NAFLD

“…We should check for other signs related to metabolic syndrome, such as hypertension, diabetes mellitus, and abdominal obesity. to guide us in diagnosing NAFLD [2,64,65,66,67,68]. The diagnosis of NAFLD requires evidence of hepatic steatosis; in the absence of other causes of liver fat accumulation.…”

Perfil epidemiológico, aptidão cardiopulmonar e qualidade de vida relacionada à saúde de pacientes com insuficiência cardíaca

“…Os níveis pressóricos elevados produzem ou agravam a hipertrofia do VE estimulando o crescimento celular e a fibrose, o que justifica a relação entre a HAS e o desenvolvimento de IC (BOMBIG; PÓVOA, 2008;PONIKOWSKI et al, 2016;CATHARINA et al, 2018).…”

“…Pessoas hipertensas apresentam maior incidência e prevalência de IAM e IC, justificada pela propensão à doença aterosclerótica que pode evoluir até a obstrução arterial coronariana total ou parcial, estando os indivíduos hipertensos de longa data em risco exponencial para futura cardiomiopatia isquêmica secundária (BOMBIG; PÓVOA, 2008;PONIKOWSKI et al, 2016;CATHARINA et al, 2018).…”

“…A HAS foi encontrada em quase 85% dos indivíduos do presente estudo. Sabe-se que a incidência de IC é de duas a três vezes maior em idosos com história clínica de HAS, visto que o desenvolvimento de DAC, AVE e IAM são mais comuns do que em indivíduos normotensos (PONIKOWSKI et al, 2016;CATHARINA et al, 2018;SOUZA ROSA, 2018). O DM e as dislipidemias são importantes fatores de risco para o desenvolvimento de IC.…”