Significant elevation of ambulatory pulse pressure in patients with metabolic syndrome
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Nondipping nocturnal blood pressure (BP; <10% decline in the asleep relative to the awake BP mean) and elevated ambulatory pulse pressure (PP) have been associated with target-organ damage and increased cardiovascular morbidity and mortality. In this cross-sectional study, circadian BP pattern was investigated in 2045 nondiabetic untreated patients with uncomplicated essential hypertension, BP being measured by ambulatory monitoring for 48 consecutive hours. Patients with metabolic syndrome presented a significantly higher 24-h mean systolic BP and a lower mean diastolic BP compared to patients without metabolic syndrome. Likewise, in patients with metabolic syndrome, ambulatory PP was significantly elevated during the entire 24 hours, and the prevalence of an altered nondipper BP profile was significantly higher. Thus, apart from corroborating the significant increased prevalence of blunted nocturnal BP decline in metabolic syndrome patients, this study also points to a higher PP in this patient group. This elevated PP might reflect increased arterial stiffness in metabolic syndrome.
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