Target organ changes in essential hypertensive patients amplified by the metabolic syndrome across age groups

To study the association of the metabolic syndrome (ATP III criteria) with cardiovascular alterations pertaining to target organ damage (TOD: left ventricular hypertrophy, carotid abnormalities, and microalbuminuria) in essential hypertensive patients in relation to age, 3266 untreated and treated hypertensives were classified in three categories of age: I (17 to 40 yrs), II (41 to 64 yrs) and III (>64 yrs). After adjusting for several confounders, the presence of the metabolic syndrome increased the risk of left ventricular hypertrophy by 2.5 (P=0.003), of carotid abnormalities by 2.2 (P=0.005) and of microalbuminuria by 1.5 (P=0.01). Across all age groups, the prevalence of left ventricular hypertrophy, carotid thickening and microalbuminuria was higher in patients with the metabolic syndrome than in those without metabolic syndrome (P<0.01, P<0.05, P≤0.05 for all age groups, respectively). According to the authors’ conclusion, the presence of a metabolic syndrome phenotype amplifies TOD regardless of patient's age and therefore increases cardiovascular risk. This synergistic effect may accelerate the early development of target organ changes in young hypertensives, whilst accelerating the age-related cardiovascular changes in the elderly.

Abstract