Clinica Medica II, Department of Internal Medicine, Fondazione IRCCS San Matteo, Università di Pavia, Pavia, Italy.
J Hum Hypertens. 2013 Jul;27(7):412-6. doi: 10.1038/jhh.2012.61. Epub 2012 Dec 13.
The Global Cardiometabolic Risk Profile in Patients with hypertension disease (GOOD) survey investigated the global cardiometabolic risk profile in 3464 adult outpatients with hypertension across 289 sites in 12 European countries. The pulse pressure and heart rate profile of the survey population was evaluated according to the presence or absence of metabolic syndrome and/or type 2 diabetes mellitus. History and treatment of hypertension were not counted as criteria for metabolic syndrome as they applied to all patients. Out of the 3370 recruited patients, 1033 had metabolic syndrome and 1177 had neither metabolic syndrome nor diabetes. When compared with patients with no metabolic syndrome or diabetes, patients with metabolic syndrome had higher pulse pressure (59±14 vs. 55±14 mm Hg) and heart rate (75.2±11.0 vs. 72.5±10.0 beats per min) (P<0.001 for both), independent of the concomitant presence or absence of diabetes, despite a more prevalent use of β-blockers. In conclusion, in hypertensive outpatients the presence of metabolic syndrome is associated with increased heart rate and pulse pressure, which may at least in part reflect increased arterial stiffness and increased sympathetic tone. This may contribute, to some extent, to explaining the increased cardiovascular risk attributed to the presence of metabolic syndrome.
在 12 个欧洲国家的 289 个地点，对 3464 名成年高血压门诊患者进行了一项名为《高血压患者全球心血管代谢风险概况（GOOD）》的调查，以评估调查人群的脉压和心率特征，根据代谢综合征和/或 2 型糖尿病的存在与否进行评估。既往高血压病史和治疗情况不作为代谢综合征的标准，因为这些情况适用于所有患者。在招募的 3370 名患者中，有 1033 名患者患有代谢综合征，1177 名患者既没有代谢综合征也没有糖尿病。与没有代谢综合征或糖尿病的患者相比，患有代谢综合征的患者脉压更高（59±14 比 55±14mmHg），心率更快（75.2±11.0 比 72.5±10.0 次/分）（均 P<0.001），无论是否同时存在糖尿病，尽管β受体阻滞剂的使用率更高。总之，在高血压门诊患者中，代谢综合征的存在与心率和脉压的增加有关，这至少在一定程度上反映了动脉僵硬度的增加和交感神经张力的增加。这在一定程度上可以解释与代谢综合征存在相关的心血管风险增加。
