Central obesity, dyslipidemia linked to poor antihypertensive treatment response
MedWire News: Study findings show some components of the metabolic syndrome, namely visceral obesity, high triglyceride levels, and low levels of high-density lipoprotein (HDL) cholesterol, are associated with resistance to antihypertensive treatment.
Previous analysis of the cross-sectional Global Cardiometabolic Risk Profile in Patients with Hypertension Disease (GOOD) survey has shown significantly worse blood pressure control in hypertensive patients with the metabolic syndrome and/or Type 2 diabetes than in those with essential hypertension alone.
To investigate which factors confer resistance to antihypertensive treatment, Walter Zidek (Charité, Berlin, Germany) and co-workers used data from the same survey to compare blood pressure, body mass index (BMI), waist circumference, serum triglycerides, and total and HDL-cholesterol measurements in participants with Type 2 diabetes and the metabolic syndrome, Type 2 diabetes only, metabolic syndrome only, and neither condition.
The participants included 3280 outpatients with hypertension, aged at least 30 years, who were receiving antihypertensive treatment or had newly diagnosed hypertension. Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III criteria.
Reporting in the journal Cardiovascular Diabetology, the authors confirm that blood pressure is influenced by the metabolic syndrome, irrespective of the presence or absence of Type 2 diabetes.
Both systolic and diastolic blood pressure were significantly higher in patients with metabolic syndrome only, than in patients with Type 2 diabetes only.
“As disturbed glucose metabolism is present in both metabolic syndrome and Type 2 diabetes, other factors of the metabolic syndrome are likely to be responsible for the tendency towards higher blood pressure in patients with metabolic syndrome,” write the authors.
The highest BMI, waist circumference, serum triglycerides, and the lowest HDL-cholesterol levels were all observed in patients with the metabolic syndrome, either with or without Type 2 diabetes.
Furthermore, patients with the metabolic syndrome only had significantly higher BMI, waist circumference, serum triglycerides, and significantly lower HDL-cholesterol than patients with Type 2 diabetes only.
These findings were not influenced by the number of antihypertensive therapies the patients were receiving. “Among the components of the metabolic syndrome, it is not impaired glucose tolerance which is associated with the response to antihypertensive treatment,” conclude the authors.
“Instead, both visceral obesity and the dyslipidemia of the metabolic syndrome, ie, hypertriglyceridemia and low HDL-cholesterol levels, are associated with resistance to antihypertensive treatment."
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By Jenny Grice