ABC | Volume 110, Nº6, June 2018

Artigo Original Catharina et al Síndrome metabólica na hipertensão Arq Bras Cardiol. 2018; 110(6):514-521 Figure 1 – Diagrammatic representation of the metabolic syndrome effects on hypertension and resistant hypertension (RHTN). Abbreviations: renin-angiotensin- aldosterone system (RAAS); central nervous system (CNS). Metabolic Syndrome Kidney damage Microalbuminuria ↑ ENDOTHELIAL DYSFUNCTION ↑ DIABEES ↑ CNS ↑ LEPTIN ↑ OXIDATIVE STRESS ↑ INFLAMMATION ↑ INSULIN RESISTANCE ↑ RAAS ↓ADIPONECTIN ↑ VISCERALFAT Hypertension Resistant Hypertension Table 3 – Multiple logistic regression for the presence of metabolic syndrome* Odds ratio 95% CI p-value LAR > 3.7 4.13 1.38 – 12.34 0.01 HR (bpm) 0.97 0.92 – 1.03 0.39 MA > 30 (mg.g –1 ) 8.51 1.53 – 47.14 0.01 hs-CRP (mg.dL –1 ) 2.92 0.83 – 10.19 0.09 RHTN 3.75 1.09 – 12.92 0.03 * The variables in this model were also adjusted for age, gender and race. MetS: metabolic syndrome; hs-CRP: high-sensitivity c-reactive protein; HR: heart rate; MA: microalbuminuria; RHTN: resistant hypertension; LAR > 3.7: leptin adiponectin ratio > 3.7 (the cutoff value was determined by median value). with MetS . Given the alterations that MetS confers on RHTN, future clinical trials can begin to address this important topic. Once the syndrome is identified, lifestyle changes and a different therapeutic approach can enhance the prognosis of the disease. Indeed, further studies on LAR in a larger hypertensive population withMetS is needed to assess whether this marker is sensitive and specific for identifying those who are at risk for developing MetS. The LAR could be used as a relatively easy, minimally-invasive tool for early MetS diagnosis and, consequently, decrease the chance of maladaptive effects caused by this syndrome. Author contributions Conception and design of the research, Obtaining financing and Writing of the manuscript: Catharina AS, Faria AP; Acquisition of data: Sabbatini AR, Catharina AS, Ritter AMV, Faria AP; Analysis and interpretation of the data and Statistical analysis: Catharina AS, Modolo R, Ritter AMV, Faria AP; Critical revision of the manuscript for intellectual content: Sabbatini AR, Catharina AS, Modolo R, Ritter AMV, Lopes HF, Moreno Junior H. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding This study was partially funded by FAPESP, CNPq and CAPES. Study Association This study is not associatedwith any thesis or dissertationwork. Ethics approval and consent to participate This study was approved by the Ethics Committee of the Universidade Estadual de Campinas under the protocol number 188.161 (CAAE: 11189712.8.0000.5404). All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study. 519