Metabolic syndrome shown to have no effect on wave reflections except when using WHO criteria
Document Actions
Although metabolic syndrome is associated with increased arterial stiffness, it is still unknown whether the association between metabolic syndrome and arterial stiffness differs depending on the metabolic syndrome definition used. Furthermore, data concerning the association between metabolic syndrome and wave reflections is still limited. This study including 732 hypertensive patients without diabetes and previous treatment aimed to investigate the relationships of arterial stiffness and wave reflections with metabolic syndrome. To this end, metabolic syndrome was defined by four current definitions plus a score: ATP III, AHA, WHO, IDF and a metabolic syndrome summative score (GISSI). The latter encompasses male sex, age, hypertension, BMI, serum triglycerides, HDL cholesterol and fasting glucose (cutoff point of the score for metabolic syndrome: 28). Arterial stiffness was assessed by measuring carotid-femoral pulse wave velocity (PWVc-f) whereas wave reflections were estimated by using heart rate-corrected augmentation index (AIx(75)). Compared to hypertensive patients without metabolic syndrome, those with metabolic syndrome had higher PWVc-f by any metabolic syndrome definition. In contrast, there was no significant difference in AIx(75) between the two groups except when using the WHO criteria. After adjusting for age, gender, LDL cholesterol, and smoking, an independent association was found between PWVc-f and GISSI score and metabolic syndrome components in patients presenting with metabolic syndrome. However, after further adjusting for systolic blood pressure or body mass index, this relationship was no longer significant. Among various underlying mechanisms discussed by the authors, endothelial dysfunction may link arterial stiffness and metabolic syndrome. In conclusion, these study results show that arterial stiffness is increased in metabolic syndrome patients regardless of the definition used. In contrast, metabolic syndrome had no effect on wave reflections except when using WHO criteria.
Abstract
