Metabolic syndrome in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) Study - Daily life blood pressure, cardiac damage, and prognosis
Metabolic syndrome in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) Study - Daily life blood pressure, cardiac damage, and prognosis
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DOI：
10.1161/01.hyp.0000251933.22091.24
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发表时间：
2007-01-01
期刊：
影响因子：
8.3
通讯作者：
Sega, Roberto
中科院分区：
文献类型：
--
作者：
Mancia, Giuseppe;Bombelli, Michele;Sega, Roberto
2013年，从意大利北部25岁至74岁的人群中确定了代谢综合征的患病率(国家胆固醇教育计划成人治疗小组III标准)及其与日常生活血压、心脏损伤和预后的关系。还测量了家庭血压、24小时血压和左心室重量指数(超声心动图)。在148个月内登记了心血管和非心血管死亡。代谢综合征的发生率为16.2%，其中办公室血压升高最常见(95.4%)，血糖异常最少(31.5%)。代谢综合征患者的家庭和/或24小时平均血压经常升高，左心室重量指数和左心室肥厚的发生率也较高，即使在对包括血压在内的组间差异进行调整后也是如此。调整后的心血管和全因死亡率在代谢综合征患者中更高(+71.0%和+37.0%；P<；0.05)，随着左心室肥厚或“在职”和“外出”血压升高而进一步显著增加。增加的风险与代谢综合征的血压和血糖成分有关，其余成分没有影响。因此，代谢综合征在地中海人群中很常见，它显著增加了死亡的长期风险。心脏异常、在家中和24小时血压升高在代谢综合征中很常见，它们的发生进一步增加了风险。然而，代谢综合征成分对风险的贡献是不平衡的，主要与血压和血糖异常有关。
The prevalence of the metabolic syndrome (National Cholesterol Education Program Adult Treatment Panel III criteria) and its relationships with daily life blood pressures, cardiac damage, and prognosis were determined in 2013 subjects from a Northern Italian population aged 25 to 74 years. Home blood pressure, 24-hour blood pressure, and left ventricular mass index (echocardiography) were also measured. Cardiovascular and noncardiovascular deaths were registered over 148 months. Metabolic syndrome was found in 16.2% of the sample, an office blood pressure elevation being the most frequent (95.4%) and the blood glucose abnormality the least frequent (31.5%) component. There was in metabolic syndrome a frequent elevation in home and/or 24-hour average blood pressure, as well as a greater left ventricular mass index and prevalence of left ventricular hypertrophy, which was manifest even when data were adjusted for between-group differences, including blood pressure. The adjusted risk of cardiovascular and all-cause mortality was greater in metabolic syndrome subjects (+ 71.0% and +37.0%; P < 0.05), a further marked increase being observed with left ventricular hypertrophy or "in-office" and "out-of-office" blood pressure elevations. The increased risk was related to the blood pressure and the blood glucose component of metabolic syndrome, with no contribution of the remaining components. Thus, metabolic syndrome is common in a Mediterranean population in which it significantly increases the long-term risk of death. Cardiac abnormalities and increases in home and 24-hour blood pressure are common in metabolic syndrome, and their occurrence further enhances the risk. The contribution of metabolic syndrome components to the risk, however, is unbalanced and mainly related to blood pressure and glucose abnormalities.