Department of Internal Medicine, Seoul National University Hospital, Republic of Korea.
Int J Cardiol. 2013 Jul 1;166(3):633-9. doi: 10.1016/j.ijcard.2011.11.095. Epub 2011 Dec 20.
The implication of metabolic syndrome (MetS) in the hypertensive population has not been known. The prevalence and the risk factors of MetS among the hypertensive population were investigated.
The first to the fourth Korean National Health and Nutrition Examination Survey (KNHANES) held from 1998 to 2008, nationally representative cross-sectional survey, were analyzed. MetS was defined following NCEP-ATP III guideline.
In the general population, MetS prevalence was about 27%, however, it was doubled in the hypertensive population, reaching almost 60%. This trend was consistent through the first to the fourth KNHANES. Moreover, although the prevalence of hypertension as well as MetS among the general population has been slightly decreasing, MetS prevalence among the hypertensive population continues to rise which is more obvious among younger patients than the general population both in men and in women. In a multivariate analysis, high BMI, menopause, smoking and daily alcohol intake were suggested as independent risk factors of MetS in hypertensive population. Finally, the presence of MetS was associated with increased prevalence of target organ damage, such as stroke, coronary artery disease and chronic renal disease.
MetS prevalence among hypertensives was much higher than expected. Moreover, MetS increased target organ damage in hypertensives. Investigation of metabolic status when initiating hypertension control could help establish more effective overall risk control.
代谢综合征(MetS)在高血压人群中的意义尚不清楚。本研究旨在调查高血压人群中 MetS 的患病率及其相关危险因素。
本研究分析了 1998 年至 2008 年期间进行的全国代表性横断面调查——韩国国家健康和营养检查调查(KNHANES)的第 1 至第 4 次调查数据。MetS 的诊断标准采用 NCEP-ATP III 指南。
在一般人群中,MetS 的患病率约为 27%,但在高血压人群中,MetS 的患病率几乎翻了一番,达到近 60%。这种趋势在第 1 至第 4 次 KNHANES 调查中均一致。此外,尽管一般人群中高血压和 MetS 的患病率略有下降,但高血压人群中 MetS 的患病率仍在继续上升,在男性和女性中,年轻患者的上升趋势比一般人群更为明显。多因素分析提示,高 BMI、绝经、吸烟和每日饮酒是高血压人群中 MetS 的独立危险因素。最后,MetS 的存在与靶器官损害(如卒中和冠心病、慢性肾病)的患病率增加相关。
高血压人群中 MetS 的患病率高于预期。此外,MetS 增加了高血压患者的靶器官损害。在开始控制高血压时,对代谢状态进行评估可能有助于更好地进行整体风险控制。