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(Hypertension. 2008;52:799.)
© 2008 American Heart Association, Inc.

Editorial Commentaries

Metabolic Syndrome and Hypertension

A Dangerous Cocktail for Older Women?

Luc Djoussé; J. Michael Gaziano

From the Divisions of Aging (L.D., J.M.G.) and Preventive Medicine (J.M.G.), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School (L.D., J.M.G.), Boston, Mass; and Massachusetts Veterans Epidemiology and Research Information Center (J.M.G.), Boston Veterans Affairs Healthcare System, Jamaica Plain, Mass.

Correspondence to Luc Djoussé, MD, MPH, DSc, FAHA, Division of Aging, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 1620 Tremont St, Third Floor, Boston, MA 02120. E-mail ldjousse@rics.bwh.harvard.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Cardiovascular disease (CVD) remains the leading cause of death for men and women despite substantial progress in medical and surgical treatment.¹ Because the life expectancy in women is greater than that of men, the resulting burden of CVD in older women is a major public health issue. With the rising rate of obesity, it is anticipated that the incidence and prevalence of hypertension will continue to increase in both men and women during the next decades. Despite the proven efficacy of antihypertensive drugs, dietary and behavioral modification, and the overwhelming evidence supporting the increased risk of CVD in hypertensive subjects, why is it that hypertension remains a major public health issue worldwide?

The lack of an adequate answer to this key question is a consequence of the complex nature of the hypertensive phenotype and the interplay across various factors that influence the management of hypertension. One potential explanation is that comorbid conditions may exert an important role through their synergistic effects on CVD risk or their influence on the management of hypertension. Among comorbid conditions, type 2 diabetes is associated with a 2- to 3-fold increased risk of CVD. The underlying insulin resistance is known to cluster with other metabolic derangements, including dyslipidemia and higher levels of inflammatory cytokines. In 1988, Raeven² described the concept of the metabolic syndrome (MS) as a cluster of hypertension, insulin resistance or glucose intolerance, abdominal obesity, and atherogenic dyslipidemia resulting in a prothrombotic and proinflammatory state.³ MS is highly prevalent in the United States . . . [Full Text of this Article]

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