Effect of metabolic syndrome or type II diabetes mellitus on the occurrence of recurrent vascular events in hypertensive patients

Patients with hypertension and manifest vascular disease are at high risk for recurrent cardiovascular diseases. It is unknown if the metabolic syndrome further increases the risk in these patients. This study aims to quantify the effect of metabolic syndrome and type II diabetes on cardiovascular e...

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Bibliographic Details
Published in:Journal of human hypertension Vol. 22; no. 5; pp. 358 - 365
Main Authors: Vlek, A L M, van der Graaf, Y, Spiering, W, Visseren, F L J
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 01.05.2008
Nature Publishing
Nature Publishing Group
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Antihypertensive agents
Aortic aneurysms
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - etiology
Cardiovascular system
Cerebral infarction
Cerebrovascular diseases
Complications and side effects
Coronary artery disease
Diabetes
Diabetes mellitus
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - epidemiology
Diuretics
Epidemiology
Female
Follow-Up Studies
Health Administration
Heart attacks
Heart diseases
Humans
Hypertension
Hypertension - complications
Hypertension - epidemiology
Incidence
Insulin
Insulin resistance
Male
Medical sciences
Medicine
Medicine & Public Health
Metabolic syndrome
Metabolic Syndrome - complications
Metabolic Syndrome - epidemiology
Metabolic syndrome X
Middle Aged
Myocardial infarction
Netherlands - epidemiology
original-article
Patients
Pharmacology. Drug treatments
Physical activity
Proportional Hazards Models
Prospective Studies
Public Health
Recurrence
Risk factors
Risk groups
Stroke
Survival Rate
Vascular diseases
Netherlands
metabolic syndrome
diabetes mellitus type II
epidemiology
cardiovascular diseases
Endocrinopathy
Type 2 diabetes
Human
Hypertension
Metabolic diseases
Cardiovascular disease
Epidemiology
ISSN:0950-9240, 1476-5527
Online Access:Get full text
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Summary:Patients with hypertension and manifest vascular disease are at high risk for recurrent cardiovascular diseases. It is unknown if the metabolic syndrome further increases the risk in these patients. This study aims to quantify the effect of metabolic syndrome and type II diabetes on cardiovascular events in hypertensive patients with vascular disease. A total of 2196 hypertensive patients with vascular disease (cerebrovascular disease (34%), coronary heart disease (50%), peripheral arterial disease (28%), abdominal aortic aneurysm (13%)) from the Second Manifestations of Arterial Disease study were followed for up to 10 years (mean 3.9 years) for death, stroke and myocardial infarction. Age and sex adjusted hazard ratios (HR) were calculated for hypertensive patients with metabolic syndrome but without diabetes ( n =775) and for hypertensive patients with type II diabetes ( n =381), compared to merely hypertensive patients ( n =1040). Forty-nine percent had metabolic syndrome (NCEP ATPIII definition) and 17% had type II diabetes. Metabolic syndrome predicted vascular death (HR 1.41, 95% confidence interval (CI) 1.01–1.98), stroke (HR 1.36, 95% CI 0.85–2.16) and myocardial infarction (HR 1.40, 95% CI 0.97–2.01). Type II diabetes accounted for even higher risks of vascular end points (HR 1.41–1.64). The effect of metabolic syndrome on future events could not be explained by the presence of type II diabetes. Even in high-risk patients with hypertension and vascular disease, presence of metabolic syndrome or type II diabetes identifies patients at high risk for future cardiovascular events. Identifying metabolic syndrome patients may direct therapy focusing on treatment of insulin resistance by reducing weight and increasing physical activity.
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ISSN:0950-9240
1476-5527
DOI:10.1038/jhh.2008.5