ВЛИЯНИЕ МЕТАБОЛИЧЕСКОГО СИНДРОМА НА ПОРАЖЕНИЕ СЕРДЦА У БОЛЬНЫХ АРТЕРИАЛЬНОЙ ГИПЕРТОНИЕЙ

Abstract

Aim: To evaluate structural and functional heart abnormalities in patients with arterial hypertension (AH) with and without metabolic syndrome. Materials and methods: The study included 303 patients with AH I, II and III, aged from 25 to 70 years (mean±SD 52±18 years). All patients were categorized into 3 groups according to severity of AH (AH I, II and III corresponded to groups 1, 2 and 3, respectively). Within each group, patients were subdivided into 2 subgroups: without metabolic syndrome (n=151) and with metabolic syndrome (n=152). Assessments included measurements of blood glucose and lipids, 24-hour monitoring of blood pressure, echocardiography with calculation of myocardial mass index of left ventricle and the use of conventional and tissue myocardial dopplerography. Results: Already at early stage of AH (gr. I), 60% patients with metabolic syndrome and 32% patients without metabolic abnormalities had some degree of left ventricular remodeling, including concentric type of remodeling in 12 and 20%, excentric hypertrophy in 18 and 6%, concentric left ventricular hypertrophy in 30 and 6%, respectively. In AH I, an increase of myocardial mass index of left ventricle was found in 39% of patients with metabolic syndrome and in 12% patients without it. In patients with AH I, abnormalities of left ventricular diastolic function according to the results of tissue myocardial dopplerography was seen in 82% of patients with metabolic syndrome and in 42% of patients without metabolic syndrome. Patients with AH I–III and metabolic syndrome had almost 5-fold higher probability of heart abnormalities than AH patients without metabolic disturbances (odds ratio 4.8, 95% confidence interval 1.9–6.4, p 50 years). Conclusion: Metabolic syndrome contributes to heart abnormalities irrespective of gender, age and AH grade.