Metabolic Syndrome Complicates Hypertension Management

To investigate these effects, Dr. Rosario Rossi of the Policlinico Hospital in Modena and associates studied 350 hypertensive postmenopausal women (mean age 55 years). Of these subjects, 180 had the metabolic syndrome and 170 did not.

Women with the metabolic syndrome had a larger waist circumference and body mass index and increased levels of glucose and triglycerides. They also had significantly higher concentrations of highly sensitive C-reactive protein, a more compromised endothelial function, and greater left ventricular mass.

They were also less responsive to antihypertensive treatment, showing a more modest improvement in both endothelial dysfunction and subclinical inflammation compared with those who didn't have metabolic syndrome.

Compared with isolated hypertension patients, the researchers conclude, those with hypertension and metabolic syndrome have "a more severe risk profile and response to therapy is less favorable."

Dr. Luc Djoussi, co-author of an accompanying editorial, stated that "obesity and other features of metabolic syndrome appear to increase the challenge in managing hypertension in older women, thereby underscoring the importance of maintaining a healthier weight."

"Future studies," Dr. Djoussi of Brigham & Women's Hospital and Harvard Medical School, Boston, added, "are needed to examine whether the coexistence of hypertension and metabolic syndrome disproportionately leads to mortality, stroke, heart attack, or other major cardiovascular events in the general population."

Hypertension 2008;52:865-872.