Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0948265 (metabolic syndrome)
 24,271 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Limited evidence is available about the relationship between ambulatory heart rate (HR) and target organ damage (TOD) in uncomplicated hypertension. We sought to investigate the association between ambulatory HR and subclinical cardiac, vascular and renal markers of TOD in never-treated essential hypertensives. A total of 580 subjects with recently diagnosed (<or= 1 year) grade 1 and 2 hypertension, categorized by tertiles of HR levels, assessed by two 24-h ambulatory blood pressure monitoring at 1- to 4-week interval, sex and the presence or absence of TOD were considered for this analysis. All subjects also underwent laboratory and ultrasonographic investigations searching for microalbuminuria (MA), left ventricular hypertrophy (LVH) and carotid atherosclerosis (carotid thickening/plaque). In the whole population, as well as in both genders, LVH, carotid atherosclerosis and MA prevalence rates did not significantly increase with 48-h HR tertiles. When patients were categorized according to the presence or absence of TOD (that is, LVH, carotid atherosclerosis or MA) no significant intergroup differences in 48-h HR were found. Furthermore, average 48-h HR was similar in patients without organ involvement as in those with one, two or three TOD signs. Finally, in a multivariate analysis age, 48-h systolic blood pressure and metabolic syndrome assessed by ATP III criteria, but not HR were independently associated with TOD. Our findings showing that 48-h ambulatory HR is not associated with markers of TOD do not support the view that a faster HR may have an additive value in predicting organ damage in the early phases of essential hypertension.
 ...
PMID:Ambulatory heart rate and target organ damage in never-treated essential hypertensives. 1782 95

Obesity is the main intermediate phenotype of primary hypertension (PH), and increased fat mass is directly related to target organ damage (TOD) and metabolic syndrome (MS). The aim of the study was to assess the sensitivity and specificity of body mass index (BMI), percentile-based, definitions of obesity [BMI > 95th percentile (pc)], and overweight (BMI > 85th pc), and BMI thresholds for cardiovascular (cv) complications (BMIcv) described by Katzmarzyk et al. (Pediatrics 114:198-205, 2004) in predicting risk of TOD and MS in 122 adolescents with PH. Our results indicated that the prevalence of left ventricular hypertrophy (LVH) and carotid intima-media thickness (cIMT) above 2 standard deviations (SDS) was the same, irrespective of the criteria used. BMIcv was more sensitive as a marker of LVH than were the cut-off values of the 85th pc and 95th pc of BMI (87.5%, 75%, 62.5%, respectively; P < 0.0001). BMIcv thresholds and cut-off values of the 85th pc of BMI were of the same sensitivity in predicting the presence of MS (95.8% and 95.8%, respectively) and were more sensitive than the cut-off values of the BMI 95th pc (87.5%; P = 0.02). Metabolic abnormalities, including insulin resistance, were more marked in patients with greater BMI, irrespective of cut-off value. However, only when a stratification system using the 85th pc of BMI was used, were the differences significant for a homoeostasis model assessment for insulin resistance (HOMA-IR) and for serum concentrations of high-density lipoprotein (HDL)-cholesterol, triglycerides and adiponectin. We concluded that BMIcv is more sensitive for diagnosing the presence of LVH and that the cut-off value of the 85th pc of BMI is more sensitive for predicting presence of MS in children with PH.
 ...
PMID:Different BMI cardiovascular risk thresholds as markers of organ damage and metabolic syndrome in primary hypertension. 1825 58

Metabolic dysfunction and the state of cardiovascular system were studied in 80 women with surgical climacterium. Dynamics of metabolic syndrome formation and left ventricular structural-functional changes were investigated. It was confirmed that the majority of patients with surgical climacterium developed metabolic syndrome in the first 3 years after operation. Arterial hypertension was formed in 2/3 of women with surgical climacterium after 6 months from the moment of operation. Left ventricular remodeling was mainly represented by eccentric left ventricular hypertrophy, occurring at the background of combination of abdominal obesity, insulin resistance, " non-dipper " type of 24-hour arterial pressure profile and hypokinetic variant of hemodynamics. Diastolic dysfunction of the left ventricle was registered both in the presence of hypertrophy and at the background of its normal function.
 ...
PMID:[Peculiarities of cardiovascular and metabolic disturbances in women after ovariectomy]. 1826 Sep 47

The authors assessed the effect of an angiotensin receptor blocker (candesartan)-based regimen on electrocardiographic left ventricular hypertrophy (ECG-LVH) in 276 patients with hypertension, including 141 with the metabolic syndrome (MS). Baseline blood pressure (BP) and ECG-LVH parameters did not differ in patients with and without MS. At the study's end, BP had decreased similarly in both groups. At baseline, 26.1% of patients with MS and 24.7% without MS exhibited ECG-LVH by Cornell product (CorP) criteria (P=NS); 26.8% and 17.2%, respectively, by Sokolow-Lyon product (SokP) (P=.01); 11.4%and 11.8% by Cornell voltage (CorV) (P=NS); and 12.4% and 6.5% by Sokolow-Lyon voltage (SokV) (P=.01). At the study's end, in the MS group, prevalence of ECG-LVH was reduced to 19.5% from 26.1% (P=.001), to 8.5% from 11.4% (P=.01), and to 24.4% from 26.8%(P=.03) by CorP, CorV, and SokP, respectively. In patients without MS, only the CorP criterion showed a significant decrease in ECG-LVH prevalence, declining to 20.5% (P=.01). The relative risk reduction of ECG-LVH was higher in patients with MS according to CorV and SokP criteria (P<.01).
 ...
PMID:Electrocardiographic left ventricular hypertrophy regression induced by an angiotensin receptor blocker-based regimen in hypertensive patients with the metabolic syndrome: data from the SARA Study. 1832 61

Traditional risk factors such as hypertension, diabetes, dyslipidemia, obesity and metabolic syndrome, as well as additional nontraditional risk factors, can damage the kidney directly and by promoting intrarenal atherogenesis. Evidence indicates that increased oxidative stress and inflammation may mediate most of the effects of risk factors on the kidney. Clinical studies have demonstrated a relationship between oxidative stress and inflammatory biomarkers, and a few studies indicate an inverse correlation of oxidative stress biomarkers with estimated glomerular filtration rate (eGFR). Further, surrogate indexes of atherosclerosis such as intima-media thickness and aortic pulse wave velocity have been demonstrated to be related to plasma concentrations of markers of endothelial activation, inflammation and fibrosis in patients with different stages of chronic kidney disease (CKD). Moreover, plasma concentrations of high-sensitivity C-reactive protein have been shown to be increased and related to left ventricular mass in CKD individuals having left ventricular hypertrophy. In contrast, in these patients, decreases in fetuin-A plasma levels have been reported. Considering the complex background of the pathophysiological changes characterizing CKD patients, we can consider cardiovascular disease a multifactorial complication of CKD.
 ...
PMID:Oxidative stress, inflammation and cardiovascular disease in chronic renal failure. 1844 11

Placebo-controlled clinical trials have shown that atorvastatin is beneficial in patients with myocardial ischemia, established coronary artery disease, hypertension and 3 other cardiovascular risk factors (e.g. left-ventricular hypertrophy, type 2 diabetes, smoking), and in diabetes, but not in patients with calcific aortic stenosis. Recently, intensive low density lipoprotein (LDL)-cholesterol lowering with atorvastatin 80 mg/day has been shown to have a greater clinical benefit than atorvastatin 10 mg/day in patients with coronary heart disease and one other high-risk factor (previous myocardial infarction, coronary revascularization or angina), and to be superior to moderate lipid lowering with pravastatin (40 mg/day) in patients with an acute coronary syndrome. However, a smaller study comparing lovastatin 5 mg/day with atorvastatin 80 mg/day was unable to detect any difference in outcomes in patients with stable coronary disease, despite the greater LDL-cholesterol lowering with the atorvastatin, possibly because it was not powered to do so. In a retrospective cohort study, atorvastatin 10 mg/day, pravastatin 20 mg/day, simvastatin 20 mg/day, lovastatin 20 mg/day and fluvastatin 20 mg/day had similar efficacy as secondary prevention after acute myocardial infarction. At present, the evidence from clinical trials is favouring the intensity of the effect on LDL-cholesterol and/or C-reactive protein (CRP) with atorvastatin 80 mg, rather than the use of atorvastatin per se, when greater benefits are observed with the 80 mg dose of atorvastatin compared to other statins. Thus, at present, it is not clear whether atorvastatin is superior to other statins in some indications (coronary heart disease, acute coronary syndromes) or whether it is the intensive lipid lowering that is responsible for the superiority. Atorvastatin has little or no ability to increase high density lipoprotein (HDL)-cholesterol, and this may be a disadvantage in patients with metabolic syndrome or diabetes, where low HDL-cholesterol is a key feature. Thus, other statins should probably be preferred to atorvastatin in patients with diabetes/metabolic syndrome. Alternatively, atorvastatin can be used in combination with a fibrate to increase HDL-cholesterol in patients with diabetes/metabolic syndrome.
 ...
PMID:Is atorvastatin superior to other statins? Analysis of the clinical trials with atorvastatin having cardiovascular endpoints. 1847 65

A growing body of evidence indicates that the clustering of metabolic and hemodynamic abnormalities characterizing the metabolic syndrome is associated with a prevalence of subclinical damage in a variety of organs, such as left ventricular hypertrophy, thickening or atherosclerotic plaques of carotid arteries, microalbuminuria and deranged renal function. This is clinically relevant since these markers of target organ damage are associated with an increased risk of cardiovascular fatal and nonfatal events. The contribution of the metabolic syndrome to target organ damage in hypertensives is presumably responsible for a substantial increase in cardiovascular fatal and nonfatal events. Thus, target organ damage should be routinely searched for in hypertensives with metabolic syndrome in order to define initial therapeutic strategies and to monitor treatment-induced protection.
 ...
PMID:Metabolic syndrome and target organ damage: role of blood pressure. 1851 Apr 89

Severe or important blood pressure elevations are associated with the risk of cardiovascular disease. However, a significant proportion of myocardial infarctions and strokes occur in subjects with only slight elevations or even with normal blood pressure. Both the coexistence of other cardiovascular risk factors, such as diabetes or dyslipidemia, or those recently recognized, such as elevations of C-reactive protein or abdominal obesity and metabolic syndrome, or the presence of target organ damage, such as microalbuminuria, left ventricular hypertrophy, mild renal dysfunction or increased intima-media thickness, all indicate the existence of a high cardiovascular risk in mild hypertensives or in subjects with normal or high-normal blood pressure. Unfortunately, these high-risk patients are often not recognized and thus under-treated. The 2003 European Societies of Hypertension and Cardiology guidelines emphasize the importance of a complete risk assessment and stratification in subjects at all blood pressure categories. The search for other cardiovascular risk factors and target organ damage should be encouraged. Identification of these high-risk patients may allow an earlier indication for antihypertensive treatment and for correction of all cardiovascular risk factors. The objective would be to impair the progression or to induce the regression of silent vascular damage before a clinical event develops.
 ...
PMID:Early detection and management of the high-risk patient with elevated blood pressure. 1856 4

The GOOD survey investigated the global cardiometabolic risk profile in adult patients with hypertension across 289 sites in four European regions (Northwest, Mediterranean, Atlantic European Mainland and Central Europe). Demographic, lifestyle, clinical and laboratory data were collected from eligible patients (n=3370) during a single clinic visit. In Central Europe, represented by Hungary, 44% of the participants had type II diabetes compared with 33% in the Atlantic European Mainland, and 26% in the Northwest and the Mediterranean regions. The prevalence of metabolic syndrome was also significantly higher in Central Europe (68%) and the Atlantic European Mainland (60%) than in the Northwest and the Mediterranean regions (50 and 52%, respectively). Fasting blood glucose, total cholesterol and triglyceride levels were all highest in Central Europe compared with the other three regions (P<0.001). In the Atlantic European Mainland, more patients had uncontrolled blood pressure (80%) compared with the other three regions (70-71%). Declared alcohol consumption was highest in the Atlantic European Mainland and exercise lowest in Central Europe. The prevalence of congestive heart failure, left ventricular hypertrophy, coronary artery disease and stable/unstable angina was higher in Central Europe compared with the other regions, whereas a family history of premature stroke or myocardial infarction, stroke, coronary revascularization and transient ischaemic attacks was all highest in the Atlantic European Mainland. These data indicate that many hypertensive patients across Europe have multiple cardiometabolic risk factors with the prevalence higher in Central Europe and the Atlantic European Mainland compared with Northwest and Mediterranean regions.
 ...
PMID:Inter-regional comparisons of the prevalence of cardiometabolic risk factors in patients with hypertension in Europe: the GOOD survey. 1900 76

Metabolic syndrome is defined as an association of central obesity and several other cardiometabolic risk factors. Dysfunctional visceral adipose tissue and inflammatory status appear to be involved in its genesis. New definitions have decreased the threshold for glycaemia and one has lowered the threshold for waist circumference, leading to an increase in the prevalence of metabolic syndrome. However, the impact on mortality with these new definitions is lower than with the National Cholesterol Education Program-Adult Treatment Panel III 2001 definition. An increase in waist circumference, along with increased glycaemia, triglycerides and/or blood pressure is more highly associated with an increased risk of mortality than are other associations, while a decrease in high density lipoprotein cholesterol increases risk of coronary heart disease. The risk of sudden death and stroke is particularly notable with metabolic syndrome. Metabolic syndrome is associated with an increase in heart rate, pulse pressure, arterial stiffness and left ventricular hypertrophy, impairment of diastolic function, enlargement of the left atrium and atrial fibrillation. In the 2007 European recommendations for the management of high blood pressure, metabolic syndrome is now taken into consideration for both risk stratification and in selecting the optimal therapeutic strategy for arterial hypertension.
 ...
PMID:Recent advances in metabolic syndrome and cardiovascular disease. 1904 42


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>