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(Hypertension. 2005;45:597.)
© 2005 American Heart Association, Inc.

Original Articles

Components of the Metabolic Syndrome and Carotid Atherosclerosis

Role of Elevated Blood Pressure

Concetta Irace; Claudio Cortese; Elio Fiaschi; Claudio Carallo; Giorgio Sesti; Eduardo Farinaro; Agostino Gnasso

From the Dipartimento di Medicina Sperimentale e Clinica "G. Salvatore" (C.I., E. Fiaschi, C. Carallo, G.S., A.G.), "Magna Græcia" University, Catanzaro, Italy; Dipartimento di Scienze Mediche e Preventive (E. Farinaro), Federico II University, Naples, Italy; Dipartimento di Medicina Interna (C. Cortese), University of Tor Vergata, Rome, Italy.

Correspondence to Agostino Gnasso, MD, Policlinico Mater Domini, Via T Campanella, 88100 Catanzaro, Italy. E-mail gnasso{at}unicz.it

Elevated blood pressure is among the factors that contribute to the metabolic syndrome (MetS). It is not known whether subjects with MetS and elevated blood pressure are at the same cardiovascular risk as subjects with MetS but without elevated blood pressure. To clarify this point, we have evaluated the prevalence of carotid atherosclerosis in subjects with MetS with or without elevated blood pressure. A large population was examined (842 women and 1011 men). Blood pressure, lipids, glucose, and waist were measured by routine methods. Carotid atherosclerosis was evaluated by echo Doppler examination. The prevalence of MetS was 24.4% in women and 28.7% in men. The prevalence of carotid atherosclerosis was 35.1% in women and 37.3% in men (p=NS), and increased with increasing number of MetS components. Age, smoking, and systolic blood pressure (SBP) were associated with the presence of carotid atherosclerosis (logistic model), whereas age, high-density lipoprotein cholesterol, and SBP were associated with the extent of atherosclerosis (linear model). When comparing subjects with an equal number of MetS components, the prevalence of carotid atherosclerosis was significantly higher in subjects with elevated blood pressure than in those without. No difference in carotid atherosclerosis prevalence was found in subjects bearing or not bearing components of the syndrome other than elevated blood pressure. The present findings demonstrate that subjects with MetS and elevated blood pressure have increased carotid atherosclerosis compared with subjects with MetS but without elevated blood pressure. The diagnosis of MetS per se might not adequately identify subjects at elevated cardiovascular risk.

Key Words: atherosclerosis • carotid arteries • hypertension

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