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血压控制良好和血压抵抗的高血压患者的代谢综合征相关特征

Metabolic Syndrome-Related Features in Controlled and Resistant Hypertensive Subjects.

作者信息

Catharina Arthur Santa, Modolo Rodrigo, Ritter Alessandra Mileni Versuti, Sabbatini Andréa Rodrigues, Lopes Heno Ferreira, Moreno Junior Heitor, Faria Ana Paula de

机构信息

Faculdade de Ciências Médicas - Universidade Estadual de Campinas (UNICAMP), Campinas, SP - Brazil.

Instituto do Coração (InCor) - Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brazil.

出版信息

Arq Bras Cardiol. 2018 Jun;110(6):514-521. doi: 10.5935/abc.20180076.

Abstract

BACKGROUND

Metabolic syndrome (MetS) is widespread among hypertensive patients. Clinical features and potential biomarkers of MetS in the presence of hypertension and resistant hypertension (RHTN) represent a great area of interest for investigation.

OBJECTIVE

The purpose of this study was to evaluate the prevalence of MetS and the clinical features associated with it in resistant and mild to moderate hypertensives.

METHODS

This cross-sectional study included 236 patients, (i) 129 mild to moderate hypertensive patients and (ii) 107 patients with RHTN. We measured blood pressure (BP) and adipokines levels, and performed bioelectrical impedance analysis. Microalbuminuria (MA), cardiac hypertrophy and arterial stiffness were also assessed. The significance level of alpha = 0.05 was adopted.

RESULTS

We found a MetS prevalence of 73% in resistant and 60% in mild-to-moderate hypertensive patients. In a multiple regression analysis, MA (odds ratio = 8.51; p = 0.01), leptin/adiponectin ratio (LAR) (odds ratio = 4.13; p = 0.01) and RHTN (odds ratio = 3.75; p = 0.03) were independently associated with the presence of MetS apart from potential confounders.

CONCLUSIONS

Our findings suggest that both resistant and controlled hypertensive subjects have a high prevalence of MetS. In addition, MetS-related metabolic derangements may cause early renal and hormonal changes. Finally, LAR may be useful as a reliable biomarker for identifying those hypertensive subjects who are at risk for developing MetS.

摘要

背景

代谢综合征(MetS)在高血压患者中广泛存在。高血压和顽固性高血压(RHTN)患者中MetS的临床特征和潜在生物标志物是一个极具研究价值的领域。

目的

本研究旨在评估顽固性高血压患者以及轻度至中度高血压患者中MetS的患病率及其相关临床特征。

方法

这项横断面研究纳入了236例患者,(i)129例轻度至中度高血压患者和(ii)107例RHTN患者。我们测量了血压(BP)和脂肪因子水平,并进行了生物电阻抗分析。还评估了微量白蛋白尿(MA)、心脏肥大和动脉僵硬度。采用α = 0.05的显著性水平。

结果

我们发现顽固性高血压患者中MetS的患病率为73%,轻度至中度高血压患者中为60%。在多元回归分析中,除潜在混杂因素外,MA(比值比 = 8.51;p = 0.01)、瘦素/脂联素比值(LAR)(比值比 = 4.13;p = 0.01)和RHTN(比值比 = 3.75;p = 0.03)与MetS的存在独立相关。

结论

我们的研究结果表明,顽固性高血压患者和血压得到控制的高血压患者中MetS的患病率均较高。此外,与MetS相关的代谢紊乱可能导致早期肾脏和激素变化。最后,LAR可能作为一种可靠的生物标志物,用于识别有发生MetS风险的高血压患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4db5/6023630/b3c985cf5ed3/abc-110-06-0514-g01.jpg

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