Metabolic Syndrome in Hypertensive Patients

Abstract

Cardiovascular disease is the principal cause of morbidity and mortality in Brazil with a mortality coefficient of 442 per 100,000 inhabitants (1). In 90% of the individuals with a diagnosis of arterial hypertension, no causal agent is identified; however, current knowledge tends to suggest the importance of increased BMI (particularly as a result of visceral fat) in the physiopathology of this disease. In 1988, Reaven and Hoffman (2) identified the following components of a specific syndrome that would define increased cardiovascular risk: insulin resistance, glucose intolerance, hyperinsulinemia, elevated triglycerides, reduced HDL cholesterol, and arterial hypertension. The prevalence of metabolic syndrome increases substantially with aging, as does the incidence of diabetes (3). Metabolic syndrome is strongly predictive of future diabetes (4), and its presence in hypertensive patients who may be at risk for diabetes should be investigated. The objective of the present study was to evaluate the prevalence of metabolic syndrome in hypertensive, nondiabetic outpatients. This cross-sectional study included 102 hypertensive outpatients consecutively seen between December 2003 and May 2005 at a teaching hospital in Brazil. All patients included were aged >18 years with systemic arterial hypertension diagnosed according to the criteria defined by the IV Brazilian Guidelines for Arterial Hypertension (5). Exclusion criteria consisted of secondary hypertension, clinical or laboratory evidence of congestive heart failure, coronary disease, history of cerebral vascular accident, valve defect, or diabetes. The following variables were evaluated: age, sex, BMI, arterial pressure, waist circumference, total …