Терапевтический архив (Jun 2009)
Affection of target organs in hypertensive patients with and without metabolic syndrome
Abstract
Aim. To study damage to the heart, kidneys and vessels in patients with arterial hypertension (AH) of different severity with and without metabolic syndrome. Material and methods. The trial enrolled 303 patients with AH of the first-third degree aged 25-70 years (mean age 52 ± 18 years), 110 males and 193 females. The patients were matched by sex and age. All the patients were divided into two groups: group 1 (n = 151) without metabolic syndrome (MS) and group 2 (n = 152) with MS. The following parameters were studied: lipid spectrum, blood glucose, glomerular filtration rate, MAU, data of 24-h blood pressure monitoring, echocardiography, Doppler ultrasonography of the brachiocephalic arteries. Results. Early AH was accompanied with diastolic LV myocardial dysfunction, subnormal glomerular filtration rate and the presence of MAU. In AH of the second degree there was LV remodeling. In AH of the third degree left ventricular myocardial mass (LVMM) and thickness of intima-medial complex (TIM) were increased. Close correlations were found between the disturbance of diastolic function and MAU, thickness of interventricular septum and thickness of the inferior wall and LVMM index with MAU. Less manifest correlation existed between diastolic dysfunction and TIM, thickness of the interventricular septum and thickness of the inferior wall and TIM. Conclusion. The presence of metabolic syndrome contributes to earlier and more serious damage of the target organs in patients with arterial hypertension.