Cardiovascular damage occurs more frequently in hypertensive patients with metabolic syndrome than in hypertensive patients without, according to a study in the July issue of the American Journal of Hypertension. Cardiovascular damage occurs more frequently in hypertensive patients with metabolic syndrome than in hypertensive patients without, according to a study in the July issue of the American Journal of Hypertension. The increased hazard is significantly related to increased levels of inflammation and fibrosis.

"Previous studies have shown that metabolic syndrome is associated with an increased susceptibility to develop cardiovascular damage," write Dr. Andrea Ferrucci and associates at the University of Rome La Sapienza, Italy. "Experimental evidence indicates that inflammation and fibrosis could play a critical role in the development of cardiovascular damage in hypertension," they note. "This issue has not been clarified yet in patients with metabolic syndrome."

The researchers examined the association between markers of inflammation and fibrosis with cardiovascular damage in 128 essential hypertensive patients. Fifty-one had metabolic syndrome and 77 did not.

The team measured clinical and biochemical parameters, and echocardiographic examinations with transmitral Doppler and Doppler imaging (TDI) were performed on all patients.

Patients with metabolic syndrome had significantly worse values documented by echocardiography, including higher left ventricular mass, diastolic function, and interventricular septum thickness.

Results of multiple linear regression analysis adjusting for age, sex, and metabolic syndrome components revealed an association between the metabolic syndrome itself and left ventricular mass.

Serum levels of C reactive protein, tumor necrosis factor-alpha, transforming growth factor-beta, and procollagen type 1 carboxy-terminal propeptide were significantly all higher in patients with metabolic syndrome.

When the authors examined the association between these markers and cardiovascular damage separately in the two groups by multiple linear regression analysis, the relationship was significantly stronger in the metabolic syndrome group, especially in regard to left ventricular mass.

The findings may have "significant implications for management of hypertensives with metabolic syndrome by indicating the need of a more aggressive treatment of hypertension in high-risk patients, starting at the prehypertensive state, as already reported," the authors conclude.

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