de la Sierra Alejandro, Romero Ramón, Bonet Josep, Pérez Montserrat, López Juan S, Ravella Ramón, Aguilera María T
Servicio de Medicina Interna, Hospital Clínic, Barcelona, Spain.
Med Clin (Barc). 2006 Mar 25;126(11):406-9. doi: 10.1157/13086123.
Metabolic syndrome (MS) constitutes a risk factor for the development of both type 2 diabetes and cardiovascular disease. The aim of the present study was to assess the prevalence and clinical characteristics of metabolic syndrome in a sample of the hypertensive population.
Cross-sectional epidemiological study in 19,039 hypertensive patients attended in primary care centres. MS was defined using the National Education Cholesterol Program (NCEP) and the International Diabetes Federation (IDF) criteria.
The 44.6% of patients presented MS using NCEP criteria. This proportion rose to 61.7% when IDF criteria were applied. Compared with hypertensives without MS, those who fulfilled criteria were significantly (p < 0.0001) older, more frequently women, had higher blood pressure values, a poorer blood pressure control (14.4% vs 27.8%) despite the use of more antihypertensive drugs, and suffered more frequently of cardiovascular disease. Other significant abnormalities included higher serum total cholesterol, uric acid, and a decreased estimated glomerular filtration rate.
MS is present in almost half of an unselected hypertensive population (two thirds using the newest criteria). It is more frequent in women than in men and it is associated with mild abnormalities in renal function. MS patients are more refractory to antihypertensive treatment, even with a higher number of antihypertensive drugs.
代谢综合征(MS)是2型糖尿病和心血管疾病发生的危险因素。本研究的目的是评估高血压人群样本中代谢综合征的患病率及临床特征。
对19039例在基层医疗中心就诊的高血压患者进行横断面流行病学研究。采用美国国家胆固醇教育计划(NCEP)和国际糖尿病联盟(IDF)标准定义代谢综合征。
采用NCEP标准时,44.6%的患者患有代谢综合征。应用IDF标准时,这一比例升至61.7%。与无代谢综合征的高血压患者相比,符合标准的患者年龄显著更大(p < 0.0001),女性更常见,血压值更高,尽管使用了更多的降压药,但血压控制更差(14.4%对27.8%),且心血管疾病的患病率更高。其他显著异常包括血清总胆固醇、尿酸升高以及估计肾小球滤过率降低。
在未经选择的高血压人群中,近一半存在代谢综合征(按照最新标准则为三分之二)。女性比男性更常见,且与肾功能轻度异常相关。代谢综合征患者对抗高血压治疗更具难治性,即便使用了更多的降压药。