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ȣ - 530779 45 |
| Metabolic risk of morning hypertension in treated hypertensive patients.
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| 충북대학교 의과대학 내과학교실 순환기내과¹ ,고혈압 연구 네트워크² |
| 김기현¹, 이주희¹,배장환¹ ,박정배² ,박창규² ,윤호중² ,최동주²,안영근² ,신준한² ,임세중² ,배장호² ,김동운¹ ² |
Background and Objectives; Morning hypertension and metabolic syndrome have been reported as important risk factors for cardiovascular events. However data about the relation of morning hypertension and metabolic syndrome are lacking upto now. Therefore, we analyzed the variables related to metabolic syndrome in morning hypertension subgroup in treated hypertensive patients.
Methods;1087 hypertensive patients on anti-hypertensive medication at least for 6 months were evaluated in the control of Hypertension Research Network including 9 university grade hospitals in Korea. They measured home blood pressures (BP) for 7 days and were checked baseline characteristics and laboratory data. We defined “morning hypertension” as morning-evening systolic or diastolic BP difference is more than 10 mmHg and morning BP is 135/85 mmHg or higher. Patients were categorized metabolic syndrome (MS) or not according to NCEP-ATP III metabolic syndrome criteria (for obesity, a waist circumference >90 cm in male or >80 cm in female).
Results;1087 patients (519 males and 568 females) were evaluated and there were 173 patients (15.9%) demonstrated morning hypertension and 514 patients (48.2%) had metabolic syndrome by definition. Metabolic syndrome is more prevalent in all enrolled patients than general population and even more morning hypertensive patients having metabolic syndrome (59.41% vs. 46.09%, p=0.001). Patients with morning hypertension showed higher waist circumference (88.9±8.4cm vs. 87.3±8.4cm, p=p=0.026) and waist-to-hip ratio (90.2±5.1% vs. 88.9±5.6%, p=0.007) despite same BMI. Laboratory data were comparable in two groups and there was no difference in DM status (P=0.64), but impaired fasting glucose (IFG) was more prevalent in patients with morning hypertension (P=0.021).
Conclusion;The patients with morning hypertension showed significantly higher prevalence of metabolic syndrome that related with worse metabolic parameters such as increased waist circumference, waist-to-hip ratio and IFG. That suggests the need for more aggressive intervention for controlling BP and metabolic variables in morning hypertensive patients.
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