ASSOCIATION OF PLASMA METANEPHRINES LEVELS WITH CARDIOMETABOLIC RISK IN ESSENTIAL HYPERTENSIVE INDIVIDUALS

Abstract

Objective: The aim of the study was to evaluate a possible relationship between plasma metanephrine concentrations and some surrogate parameters of cardio-metabolic damage such as carotid intima media thickness (IMT), cardiac left ventricular mass (LVM) and left ventricular hypertrophy (LVH) in patients with essential hypertension (EH). Design and method: From January 2021 to September 2022, we consecutively enrolled 719 essential hypertensive patients (367 men and 352 women, mean age 52.2 ± 15 years) without cardiovascular complications, distinguishing patients in quartiles according to plasma metanephrine concentration (PMC). Results: compared with the first quartile, the highest PMC quartile was associated with the highest levels of of 24-h μalbuminuria (20.1 ± 8.9 mg/24 h and 11.4 ± 6.2 mg/24 h, p = 0.04), serum creatinine (0.96 ± 0.2 mg/dl vs 0.90 ± 0.22 mg/dl; p = 0.002), plasma calcium (9.5 ± 0.4 mg/dl vs 9.38 ± 0.4 mg/dl; p = 0.004) and a lower prevalence of metabolic syndrome (18% vs 32%; p = 0.001). More male hypertensives belonged to the fourth quartile than to the first quartile (64% vs 43%, p<0.001). Moreover, we found that the fourth PMC quartile was associated with higher values of 24h-ABPM diastolic blood pressure (78.8 ± 9.0 mmHg vs 76.3 ± 9.1 mmHg; p = 0.007), higher values of left ventricular myocardial mass indexed for body surface area (LVMi) (89.0 ± 27.0 g/m2 vs 81.8 ± 21.9 g/m2; p = 0.01) and left ventricular hypertrophy (LVH) (18% vs 11%, p = 0.031) prevalence than the first PMC quartile. PMC was also found to be an independent predictor of the presence of LVH and μalbuminuria. Conclusions: Our results revealed that higher PMC values are strongly associated with increased LVMi and μalbuminuria that, together with elevated blood pressure values, are strictly correlated with higher risk of atherosclerosis and cardiovascular complications.