ABC | Volume 110, Nº6, June 2018

Artigo Original Catharina et al Síndrome metabólica na hipertensão Arq Bras Cardiol. 2018; 110(6):514-521 Table 1 – General characteristics of hypertensive patients with and without metabolic syndrome Patients with MetS (n = 157) Patients without MetS (n = 79) p-value Clinical data Age (years) 63 (56 – 70) 65 (56 – 71) 0.39 White race (%) 122 (77) 52 (65) 0.05 Female gender (%) 106 (67) 47 (59) 0.23 BMI (kg/m 2 ) 31 (27 – 34) 26 (23 – 28) < 0.01 WC (cm) 100 ± 13 89 ± 12 < 0.01 FFM (Kg) 54 (46 – 62) 52 (44 – 63) 0.13 FM (Kg) 24 (19 – 31) 17 (13 – 23) < 0.01 TBW (%) 74 (72 – 75) 73 (72 – 75) 0.03 BMR (cal/day) 1672 (1436 – 1947) 1616 (1369 – 1954) 0.23 Office SBP(mmHg) 142 (134 – 150) 146 (132 – 154) 0.39 Office DBP(mmHg) 82 (75 – 89) 82 (80 – 88) 0.44 Office HR (bpm) 67 (61 – 76) 64 (58 – 72) 0.01 24h-ABPM SBP(mmHg) 128 (118 – 139) 129 (118 – 136) 0.78 24h-ABPM DBP(mmHg) 77(70 – 81) 78 (70 – 86) 0.28 ABPM HR (bpm) 64 ± 14 64 ± 13 0.94 Uncontrolled office BP (%) 96 (61) 48 (60) 0.97 TODs MA ≥ 30 (mg.g –1 ), n (%) 31 (20) 3 (4) < 0.01 PWV ≥ 10 (m.s –1 ), n (%) 68 (43) 35 (44) 0.94 LVH, n (%) 83 (53) 44 (55) 0.96 Medication Total anti-HA drugs 3 (2 – 4) 3 (2 – 4) 0.27 Diuretics, n (%) 123 (78) 64 (80) 0.75 CCBs, n (%) 112 (71) 42 (52) < 0.01 ACEIs, n (%) 36 (22) 26 (32) 0.13 ARAs, n (%) 108 (69) 48 (60) 0.27 Beta-blockers, n (%) 67 (43) 28 (35) 0.39 Spironolactone, n (%) 33 (21) 8 (10) 0.06 Central α-agonists, n (%) 24 (15) 8 (10) 0.37 Oral antidiabetics, n (%) 90 (57) 16 (20) < 0.01 Statins, n (%) 111 (70) 51 (63) 0.41 Antiplatelet drugs, n (%) 67 (43) 23 (29) 0.06 Values are expressed as mean ± standard deviation or median (1st, 3rd quartiles), according to data distribution. Continuous variables were compared using unpaired Student´s t-test or Mann-Whitney test, according to data distribution. Categorical variables were compared by chi-square test. BMI: body mass index; WC: waist circumference; FFM: fat free mass; FM: fat mass; TBW: total body water; BMR: basal metabolic rate; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; ABPM: ambulatory blood pressure monitoring; LVH: left ventricular hypertrophy; MA: microalbuminuria; PWV: pulse wave velocity; CCBs: calcium channel blockers; ACEIs: angiotensin converting enzyme inhibitors; ARAs: angiotensin II receptor antagonist; TODs: target organ damages. confounders. Although our study does not affirm causality between this association, it seems reasonable to say that the metabolic derangements associated with MetS promote alterations in the vasculature and the kidney that might lead to RHTN and chronic kidney disease. 32 Furthermore, the increased renal impairment in patients with MetS is probably linked to the underlying condition of prior hypertension in these patients 33 (Figure 1). In this context, our findings highlighted the importance of improving strategies to prevent cardiovascular and renal outcomes. Still, it points out that not only RHTN patients require a close clinical attention, but also mild to moderate hypertensive subjects, who demonstrated a high prevalence of MetS comparable to RHTN patients. 517