Rossi Rosario, Nuzzo Annachiara, Origliani Giorgia, Modena Maria Grazia
Institute of Cardiology, Policlinico Hospital, University of Modena and Reggio Emilia, Azienda Policlinico di Modena, Modena, Italy.
Hypertension. 2008 Nov;52(5):865-72. doi: 10.1161/HYPERTENSIONAHA.108.110478. Epub 2008 Oct 13.
Metabolic syndrome is increasingly recognized as an important cardiovascular risk factor in hypertension, but its influence on the cardiovascular risk profile in hypertensive postmenopausal women has not been studied. The aim of the present study was to investigate the impact of metabolic syndrome on the cardiovascular risk profile and the response to treatment. We enrolled 350 hypertensive postmenopausal women, 55+/-6 years of age (range 47 to 60 years of age). Patients were divided into 2 groups according to the presence of metabolic syndrome. Compared with those without, women with metabolic syndrome had higher waist circumference, body mass index, and levels of glucose, triglycerides, and HDL cholesterol, as would be expected, based on definition. In addition, patients with metabolic syndrome had a cardiovascular risk profile less favorable, characterized by a significantly higher highly sensitive C-reactive protein (2.2+/-0.6 versus 1.7+/-0.7 ng/L; P<0.01), a more compromised endothelial function (flow-mediated vasodilation 2.4+/-2.2 versus 4.4+/-2.5%; P=0.01), and a significantly higher left ventricular mass (44+/-15 versus 41+/-16 g/m(2.7)). Also, antihypertensive treatment induced a more modest improvement of both endothelial dysfunction and subclinical inflammation in women with metabolic syndrome. The results of our study show that in postmenopausal women, there are 2 different forms of hypertension: that which is isolated, and that which is associated with metabolic syndrome. This last form is related to a more severe risk profile, and response to therapy is less favorable.
代谢综合征日益被认为是高血压中一个重要的心血管危险因素，但它对绝经后高血压女性心血管风险状况的影响尚未得到研究。本研究的目的是调查代谢综合征对心血管风险状况及治疗反应的影响。我们纳入了350名年龄在55±6岁（范围47至60岁）的绝经后高血压女性。根据是否存在代谢综合征将患者分为两组。与无代谢综合征的女性相比，有代谢综合征的女性腰围、体重指数以及血糖、甘油三酯和高密度脂蛋白胆固醇水平更高，这正如根据定义所预期的那样。此外，有代谢综合征的患者心血管风险状况更差，其特征为高敏C反应蛋白显著更高（2.2±0.6对1.7±0.7 ng/L；P<0.01），内皮功能受损更严重（血流介导的血管舒张2.4±2.2对4.4±2.5%；P=0.01），以及左心室质量显著更高（44±15对41±16 g/m(2.7)）。而且，降压治疗在有代谢综合征的女性中引起的内皮功能障碍和亚临床炎症改善更为适度。我们的研究结果表明，在绝经后女性中，存在两种不同形式的高血压：孤立性高血压和与代谢综合征相关的高血压。后一种形式与更严重的风险状况相关，对治疗的反应也较差。
