However, the effect of MetS and clusters of MetS components on CBP has not yet been described in large populations. The effects of Mets and the selected cluster of MetS components on large artery stiffness and thickness have been described in a previous report from the MARE Consortium 23. Metabolic syndrome (MetS) is a complex construct encompassing several clusters of five components (low HDL cholesterol, increased fasting glucose, increased triglyceride, elevated waist circumference, and elevated peripheral blood pressure). Moreover, interventional studies showed that specific antihypertensive drug treatment differentially impacts on brachial and CSBP 21, 22. And CBP was a stronger predictor of CV events than brachial BP 18, 19, 20. These differences decreases with advancing age and are affected by sex, body height, and cardiovascular risk factors (e.g., dyslipidemia, diabetes, and smoking) 16.Īs peripheral tissues to central (aortic) rather than brachial pressures, CBP has shown a stronger association with left ventricular hypertrophy, intima-media thickness, and pulse wave velocity 17. Therefore, brachial SBP is higher than central systolic blood pressure (CSBP). Whereas mean arterial pressure (MBP) and diastolic blood pressure (DBP) are relatively constant along the arterial tree, the height of the pressure pulse is amplified from the aorta toward peripheral arteries 15. Indeed, recent research has focused on accelerated to healthy/supernormal vascular aging 3, 4, 5 and the possible role of vascular geometry 6 aortic stiffness as an independent predictor of cardiovascular morbidity 7 and its association with the progression of cognitive impairment 8 and multiple organ damage 9, 10, 11 the definition of a “normality threshold” for clinical purposes 12 and the role of arterial aging in response to treatment 13 and the issue of central blood pressure in routine clinical practice 14. This challenge has paralleled the increasing attention to large arteries. However, the accuracy of peripheral systolic and diastolic blood pressure in reflecting central blood pressure has been questioned since 2007 2. Many epidemiological and interventional studies showed an undeniable beneficial effect of lowering brachial blood pressure for cardiovascular (CV) and renal outcomes 1. Future studies are needed to confirm they identify subjects at high risk of accelerated arterial aging and, thus, need more intensive clinical management.īrachial blood pressure measurement is the most widely used approach in managing hypertension in daily clinical practice. We identified “risky clusters” of MetS variables associated with high CSBP.
After controlling for age, male sex, non HDL cholesterol, diabetes mellitus, and mean arterial pressure, only specific clusters of MetS components were associated with a higher CSBP and some of them were significant in women but not in men. MetS was associated with a 50% greater odds of having higher CSBP. CBP was measured noninvasively and acquired from pulse wave analysis by applanation tonometry. MetS was defined according to the NCEP-ATP III criteria ( GHTBW, glucose, high-density lipoprotein cholesterol, triglyceride, blood pressure, waist circumference).
We studied 15,609 volunteers (43% women) from 10 cohorts worldwide who participated in the Metabolic syndrome and Artery REsearch Consortium. We aimed to describe the effect of MetS and clusters of its components on CBP in a large population and to identify whether this effect differs in men and women. The effect of metabolic syndrome (MetS) and clusters of its components on central blood pressure (CBP) has not been well characterized.
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