Andreadis Emmanuel A, Tsourous George I, Tzavara Chara K, Georgiopoulos Dimitrios X, Katsanou Panagiota M, Marakomichelakis George E, Diamantopoulos Emmanuel J
4th Department of Internal Medicine and Unit of Vascular Medicine, Evangelismos State General Hospital, Athens, Greece.
Am J Hypertens. 2007 May;20(5):558-64. doi: 10.1016/j.amjhyper.2006.12.001.
Although the metabolic syndrome (MetS) is associated with adverse cardiovascular disease (CVD) risk in the general population, it is not clear whether its existence is independently associated with CVD in hypertensives. We investigated the presence of MetS in subjects with hypertension and its impact on the incidence of CVD.
We prospectively investigated 1007 hypertensive individuals. The MetS was assessed using the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria. The incidence of fatal and nonfatal cardiovascular events was ascertained during a median follow-up period of 2.1 years.
The prevalence of MetS was 42.1% (39.0% in men and 44.7% in women). In addition to hypertension, four MetS components were present in 3.6% of the individuals, three in 13.7%, two in 24.8%, and only one in 33.7%. The incidence of cardiac, cerebrovascular, and total cardiovascular events/1000 person-years was higher among MetS subjects than among those without (31.0% v 21.3%, P = .050, 25.5% v 13.7%, P = .045, and 55.4% v 35.8% P = .009, respectively). After adjustment, MetS subjects had higher risk for cardiac, cerebrovascular, and total cardiovascular events (by 72%, 90%, and 75%, respectively). Hypertensive subjects with three or more components of MetS had threefold higher risk for cardiac events, 2.59 for cerebrovascular, and 2.26 for total cardiovascular events compared with those with no other component.
The MetS is a significant predictor of cardiovascular morbidity and mortality. The clustering of three or more components of the syndrome in addition to hypertension recognizes a population of even higher cardiovascular risk independently of other traditional risk factors.
虽然代谢综合征（MetS）与普通人群不良心血管疾病（CVD）风险相关，但尚不清楚其存在是否与高血压患者的CVD独立相关。我们调查了高血压患者中MetS的存在情况及其对CVD发病率的影响。
我们对1007名高血压个体进行了前瞻性研究。采用美国国家胆固醇教育计划成人治疗组第三次报告（NCEP-ATP III）标准评估MetS。在中位随访期2.1年期间确定致命和非致命心血管事件的发生率。
MetS的患病率为42.1%（男性为39.0%，女性为44.7%）。除高血压外，3.6%的个体存在4个MetS组分，13.7%存在3个，24.8%存在2个，33.7%仅存在1个。MetS患者中心脏、脑血管和总心血管事件的发生率/每1000人年高于无MetS者（分别为31.0%对21.3%，P = 0.050；25.5%对13.7%，P = 0.045；55.4%对35.8%，P = 0.009）。调整后，MetS患者发生心脏、脑血管和总心血管事件的风险更高（分别高72%、90%和75%）。与无其他组分的高血压患者相比，具有3个或更多MetS组分的高血压患者发生心脏事件的风险高3倍，脑血管事件风险高2.59倍，总心血管事件风险高2.26倍。
MetS是心血管疾病发病率和死亡率的重要预测指标。除高血压外，该综合征3个或更多组分的聚集表明这部分人群的心血管风险更高，且独立于其他传统风险因素。
