7.3 Association of Organ Damage with the Metabolic Syndrome (MS) as Diagnosed in Hypertension and Lipid Clinics: The PRO

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High Blood Press Cardiovasc Prev 2007; 14 (3): 145-196 1120-9879/07/0003-0145/$44.95/0 © 2007 Adis Data Information BV. All rights reserved.

Metabolic Aspects and Mechanisms 7.3 Association of Organ Damage with the Metabolic Syndrome (MS) as Diagnosed in Hypertension and Lipid Clinics: The PROMISE Survey A. Zanchetti,1 A.L. Catapano,2 S. Bertolini,3 on behalf of Sperimentatori degli studi PROMISE HT & DYS (1) University of Milan and Istituto Auxologico Italiano, Mi Milan; (2) University of Milan, Mi Milan; (3) University di Genoa, Genoa, It Italy Introduction: There is evidence that the cluster of cardiovascular risk factors commonly defined MS occurs rather frequently, but whether it is found more frequently among patients primarily seen because of raised blood pressure (hypertension setting) or because of lipid disturbances (dyslipidemia setting) is unknown. Likewise, although MS is known to be associated with increased cardiovascular and all-case mortality, its association with subclinical organ damage has been investigated in relatively small groups of subjects, and never compared between subjects diagnosed in different clinical settings. Objectives: To investigate and compare prevalence of MS among patients attending hypertension or lipid clinics, and analyse whether organ damage is more frequent in MS subjects than in hypertensive or dyslipidemic subjects without MS. Methods: Subjects consecutively attending 30 hypertension and 20 lipid clinics throughout Italy, and not receiving antihypertensive and lipid-lowering therapies, had measurements of sitting blood pressure, waist circumference, BMI, serum total and HDL-cholesterol, creatinine, glucose (fasting), triglycerides (fasting). MS was diagnosed according to ATP III criteria. All patients were subjected to echocardiography, carotid ultrasound and urine collection for microalbuminuria. Results: 691 subjects were enrolled from hypertension clinics, and 660 from lipid clinics. Central analysis of echocardiograms for defining prevalence of left ventricular hypertrophy (and its geometric patterns), intima-media thickness of common carotids and number of carotid plaques, and presence of microalbuminuria is currently being done. Comparisons between subjects with and without MS, as well as from subjects from different settings will be presented. Supported by Sanofi-Aventis Italy.