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Metabolic syndrome, independent of its components, affects adversely cardiovascular morbidity in essential hypertensives
Abstract Background The metabolic syndrome (MS) is widespread among hypertensive patients. However, the net impact of MS on major atherosclerotic events beyond the cardiovascular risk imposed by its individual components remains controversial in this group. We sought to assess both the independent a...
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| Published in: | Atherosclerosis 2016-01, Vol.244, p.66-72 |
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| creator | Georgiopoulos, George Tsioufis, Costas Tsiachris, Dimitrios Dimitriadis, Kyriakos Kasiakogias, Alexandros Lagiou, Fotini Andrikou, Eirini Ioannidis, Ioannis Hatziagelaki, Erifili Tousoulis, Dimitris |
| description | Abstract Background The metabolic syndrome (MS) is widespread among hypertensive patients. However, the net impact of MS on major atherosclerotic events beyond the cardiovascular risk imposed by its individual components remains controversial in this group. We sought to assess both the independent and incremental prognostic role of MS for unfavorable cardiovascular events in a cohort of essential hypertensives. Methods We followed up 2176 essential hypertensives free of cardiovascular disease for a median period of 40 months. All subjects had at least one annual visit. MS was defined according to the updated NCEP III criteria. Endpoint of interest was the incidence of stroke, coronary artery disease (CAD) and their composite. Results MS was present at baseline in 819 hypertensives (37.6%). MS group presented increased prevalence of resistant hypertension in comparison to MS free group (18.4% versus 10.6%, p |
| doi_str_mv | 10.1016/j.atherosclerosis.2015.10.099 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1753230831</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0021915015301830</els_id><sourcerecordid>1753230831</sourcerecordid><originalsourceid>FETCH-LOGICAL-c444t-28539f5c7c05e55a489b82786862ecdcb2f8481c91d814664d1b5451461508a63</originalsourceid><addsrcrecordid>eNqNksGO1DAMhiMEYoeFV0C5IHHYDnGbtOkBJLSCBWkRB-AcpYmrzdA2Q9yO6NuTahYOe-LiRPbv3_InM_YKxB4E1G8OezvfYYrkhi0G2pcCVK7tRds-YjvQTVuA1PIx2wlRQtGCEhfsGdFBCCEb0E_ZRVkrLUHCjv3-grPt4hAcp3XyKY54xcPk8Yg5TDOPPQ8zcRfHY5xygq647Xt0OWf9CRPhsHJnkw_xZMktg018jKkLPsxrduJIlNuCHfjdesQ040ThhPScPentQPji_r1kPz5--H79qbj9evP5-v1t4aSUc1FqVbW9co0TCpWyUredLhtd67pE511X9lpqcC14DbKupYdOSZW_eW1t6-qSvT77HlP8tSDNZgzkcBjshHEhA42qykroCrL07VnqMlhK2JtjCqNNqwFhNvjmYB7ANxv8rZzh5_6X96OWbkT_r_sv7Sy4OQswL3wKmAy5gJNDH1ImanwM_z3q3QMnN4QpODv8xBXpEJc0ZaoGDJVGmG_bJWyHAKoSoCtR_QF8S7bS</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1753230831</pqid></control><display><type>article</type><title>Metabolic syndrome, independent of its components, affects adversely cardiovascular morbidity in essential hypertensives</title><source>Elsevier</source><creator>Georgiopoulos, George ; Tsioufis, Costas ; Tsiachris, Dimitrios ; Dimitriadis, Kyriakos ; Kasiakogias, Alexandros ; Lagiou, Fotini ; Andrikou, Eirini ; Ioannidis, Ioannis ; Hatziagelaki, Erifili ; Tousoulis, Dimitris</creator><creatorcontrib>Georgiopoulos, George ; Tsioufis, Costas ; Tsiachris, Dimitrios ; Dimitriadis, Kyriakos ; Kasiakogias, Alexandros ; Lagiou, Fotini ; Andrikou, Eirini ; Ioannidis, Ioannis ; Hatziagelaki, Erifili ; Tousoulis, Dimitris</creatorcontrib><description>Abstract Background The metabolic syndrome (MS) is widespread among hypertensive patients. However, the net impact of MS on major atherosclerotic events beyond the cardiovascular risk imposed by its individual components remains controversial in this group. We sought to assess both the independent and incremental prognostic role of MS for unfavorable cardiovascular events in a cohort of essential hypertensives. Methods We followed up 2176 essential hypertensives free of cardiovascular disease for a median period of 40 months. All subjects had at least one annual visit. MS was defined according to the updated NCEP III criteria. Endpoint of interest was the incidence of stroke, coronary artery disease (CAD) and their composite. Results MS was present at baseline in 819 hypertensives (37.6%). MS group presented increased prevalence of resistant hypertension in comparison to MS free group (18.4% versus 10.6%, p < 0.001). The incidence of the composite end-point was 3.1% (69 events) across the follow-up period. Patients with MS were more likely to experience major adverse cardiovascular events (MACE) in comparison to reference category (3.7% versus 1.9%, log rank p = 0.024). While MS was an independent predictor for MACE, none of the individual components of the syndrome was associated independently with the endpoint. MS provided incremental discriminative value (Harrell's c, p < 0.05 for all) over individual risk factors for the incidence of MACE. Conclusions MS predicts adverse cardiovascular events in hypertensives incrementally of its individual components. Early identification of MS in this population may enable more accurate prediction of future cardiovascular risk and could implement more efficient strategies in terms of primary prevention.</description><identifier>ISSN: 0021-9150</identifier><identifier>EISSN: 1879-1484</identifier><identifier>DOI: 10.1016/j.atherosclerosis.2015.10.099</identifier><identifier>PMID: 26584141</identifier><language>eng</language><publisher>Ireland: Elsevier Ireland Ltd</publisher><subject>Cardiovascular ; Cardiovascular Diseases - epidemiology ; Cardiovascular risk ; Essential Hypertension ; Female ; Follow-Up Studies ; Greece - epidemiology ; Humans ; Hypertension ; Hypertension - epidemiology ; Hypertension - etiology ; Male ; Metabolic syndrome ; Metabolic Syndrome - complications ; Metabolic Syndrome - epidemiology ; Middle Aged ; Morbidity - trends ; Prognosis ; Retrospective Studies ; Risk Assessment - methods ; Risk Factors ; Survival Rate - trends ; Time Factors</subject><ispartof>Atherosclerosis, 2016-01, Vol.244, p.66-72</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2015 Elsevier Ireland Ltd</rights><rights>Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c444t-28539f5c7c05e55a489b82786862ecdcb2f8481c91d814664d1b5451461508a63</citedby><cites>FETCH-LOGICAL-c444t-28539f5c7c05e55a489b82786862ecdcb2f8481c91d814664d1b5451461508a63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26584141$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Georgiopoulos, George</creatorcontrib><creatorcontrib>Tsioufis, Costas</creatorcontrib><creatorcontrib>Tsiachris, Dimitrios</creatorcontrib><creatorcontrib>Dimitriadis, Kyriakos</creatorcontrib><creatorcontrib>Kasiakogias, Alexandros</creatorcontrib><creatorcontrib>Lagiou, Fotini</creatorcontrib><creatorcontrib>Andrikou, Eirini</creatorcontrib><creatorcontrib>Ioannidis, Ioannis</creatorcontrib><creatorcontrib>Hatziagelaki, Erifili</creatorcontrib><creatorcontrib>Tousoulis, Dimitris</creatorcontrib><title>Metabolic syndrome, independent of its components, affects adversely cardiovascular morbidity in essential hypertensives</title><title>Atherosclerosis</title><addtitle>Atherosclerosis</addtitle><description>Abstract Background The metabolic syndrome (MS) is widespread among hypertensive patients. However, the net impact of MS on major atherosclerotic events beyond the cardiovascular risk imposed by its individual components remains controversial in this group. We sought to assess both the independent and incremental prognostic role of MS for unfavorable cardiovascular events in a cohort of essential hypertensives. Methods We followed up 2176 essential hypertensives free of cardiovascular disease for a median period of 40 months. All subjects had at least one annual visit. MS was defined according to the updated NCEP III criteria. Endpoint of interest was the incidence of stroke, coronary artery disease (CAD) and their composite. Results MS was present at baseline in 819 hypertensives (37.6%). MS group presented increased prevalence of resistant hypertension in comparison to MS free group (18.4% versus 10.6%, p < 0.001). The incidence of the composite end-point was 3.1% (69 events) across the follow-up period. Patients with MS were more likely to experience major adverse cardiovascular events (MACE) in comparison to reference category (3.7% versus 1.9%, log rank p = 0.024). While MS was an independent predictor for MACE, none of the individual components of the syndrome was associated independently with the endpoint. MS provided incremental discriminative value (Harrell's c, p < 0.05 for all) over individual risk factors for the incidence of MACE. Conclusions MS predicts adverse cardiovascular events in hypertensives incrementally of its individual components. Early identification of MS in this population may enable more accurate prediction of future cardiovascular risk and could implement more efficient strategies in terms of primary prevention.</description><subject>Cardiovascular</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular risk</subject><subject>Essential Hypertension</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Greece - epidemiology</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - epidemiology</subject><subject>Hypertension - etiology</subject><subject>Male</subject><subject>Metabolic syndrome</subject><subject>Metabolic Syndrome - complications</subject><subject>Metabolic Syndrome - epidemiology</subject><subject>Middle Aged</subject><subject>Morbidity - trends</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Survival Rate - trends</subject><subject>Time Factors</subject><issn>0021-9150</issn><issn>1879-1484</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNqNksGO1DAMhiMEYoeFV0C5IHHYDnGbtOkBJLSCBWkRB-AcpYmrzdA2Q9yO6NuTahYOe-LiRPbv3_InM_YKxB4E1G8OezvfYYrkhi0G2pcCVK7tRds-YjvQTVuA1PIx2wlRQtGCEhfsGdFBCCEb0E_ZRVkrLUHCjv3-grPt4hAcp3XyKY54xcPk8Yg5TDOPPQ8zcRfHY5xygq647Xt0OWf9CRPhsHJnkw_xZMktg018jKkLPsxrduJIlNuCHfjdesQ040ThhPScPentQPji_r1kPz5--H79qbj9evP5-v1t4aSUc1FqVbW9co0TCpWyUredLhtd67pE511X9lpqcC14DbKupYdOSZW_eW1t6-qSvT77HlP8tSDNZgzkcBjshHEhA42qykroCrL07VnqMlhK2JtjCqNNqwFhNvjmYB7ANxv8rZzh5_6X96OWbkT_r_sv7Sy4OQswL3wKmAy5gJNDH1ImanwM_z3q3QMnN4QpODv8xBXpEJc0ZaoGDJVGmG_bJWyHAKoSoCtR_QF8S7bS</recordid><startdate>20160101</startdate><enddate>20160101</enddate><creator>Georgiopoulos, George</creator><creator>Tsioufis, Costas</creator><creator>Tsiachris, Dimitrios</creator><creator>Dimitriadis, Kyriakos</creator><creator>Kasiakogias, Alexandros</creator><creator>Lagiou, Fotini</creator><creator>Andrikou, Eirini</creator><creator>Ioannidis, Ioannis</creator><creator>Hatziagelaki, Erifili</creator><creator>Tousoulis, Dimitris</creator><general>Elsevier Ireland Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160101</creationdate><title>Metabolic syndrome, independent of its components, affects adversely cardiovascular morbidity in essential hypertensives</title><author>Georgiopoulos, George ; Tsioufis, Costas ; Tsiachris, Dimitrios ; Dimitriadis, Kyriakos ; Kasiakogias, Alexandros ; Lagiou, Fotini ; Andrikou, Eirini ; Ioannidis, Ioannis ; Hatziagelaki, Erifili ; Tousoulis, Dimitris</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c444t-28539f5c7c05e55a489b82786862ecdcb2f8481c91d814664d1b5451461508a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Cardiovascular</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular risk</topic><topic>Essential Hypertension</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Greece - epidemiology</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - epidemiology</topic><topic>Hypertension - etiology</topic><topic>Male</topic><topic>Metabolic syndrome</topic><topic>Metabolic Syndrome - complications</topic><topic>Metabolic Syndrome - epidemiology</topic><topic>Middle Aged</topic><topic>Morbidity - trends</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Survival Rate - trends</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Georgiopoulos, George</creatorcontrib><creatorcontrib>Tsioufis, Costas</creatorcontrib><creatorcontrib>Tsiachris, Dimitrios</creatorcontrib><creatorcontrib>Dimitriadis, Kyriakos</creatorcontrib><creatorcontrib>Kasiakogias, Alexandros</creatorcontrib><creatorcontrib>Lagiou, Fotini</creatorcontrib><creatorcontrib>Andrikou, Eirini</creatorcontrib><creatorcontrib>Ioannidis, Ioannis</creatorcontrib><creatorcontrib>Hatziagelaki, Erifili</creatorcontrib><creatorcontrib>Tousoulis, Dimitris</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Atherosclerosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Georgiopoulos, George</au><au>Tsioufis, Costas</au><au>Tsiachris, Dimitrios</au><au>Dimitriadis, Kyriakos</au><au>Kasiakogias, Alexandros</au><au>Lagiou, Fotini</au><au>Andrikou, Eirini</au><au>Ioannidis, Ioannis</au><au>Hatziagelaki, Erifili</au><au>Tousoulis, Dimitris</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Metabolic syndrome, independent of its components, affects adversely cardiovascular morbidity in essential hypertensives</atitle><jtitle>Atherosclerosis</jtitle><addtitle>Atherosclerosis</addtitle><date>2016-01-01</date><risdate>2016</risdate><volume>244</volume><spage>66</spage><epage>72</epage><pages>66-72</pages><issn>0021-9150</issn><eissn>1879-1484</eissn><abstract>Abstract Background The metabolic syndrome (MS) is widespread among hypertensive patients. However, the net impact of MS on major atherosclerotic events beyond the cardiovascular risk imposed by its individual components remains controversial in this group. We sought to assess both the independent and incremental prognostic role of MS for unfavorable cardiovascular events in a cohort of essential hypertensives. Methods We followed up 2176 essential hypertensives free of cardiovascular disease for a median period of 40 months. All subjects had at least one annual visit. MS was defined according to the updated NCEP III criteria. Endpoint of interest was the incidence of stroke, coronary artery disease (CAD) and their composite. Results MS was present at baseline in 819 hypertensives (37.6%). MS group presented increased prevalence of resistant hypertension in comparison to MS free group (18.4% versus 10.6%, p < 0.001). The incidence of the composite end-point was 3.1% (69 events) across the follow-up period. Patients with MS were more likely to experience major adverse cardiovascular events (MACE) in comparison to reference category (3.7% versus 1.9%, log rank p = 0.024). While MS was an independent predictor for MACE, none of the individual components of the syndrome was associated independently with the endpoint. MS provided incremental discriminative value (Harrell's c, p < 0.05 for all) over individual risk factors for the incidence of MACE. Conclusions MS predicts adverse cardiovascular events in hypertensives incrementally of its individual components. Early identification of MS in this population may enable more accurate prediction of future cardiovascular risk and could implement more efficient strategies in terms of primary prevention.</abstract><cop>Ireland</cop><pub>Elsevier Ireland Ltd</pub><pmid>26584141</pmid><doi>10.1016/j.atherosclerosis.2015.10.099</doi><tpages>7</tpages></addata></record> |
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| subjects | Cardiovascular Cardiovascular Diseases - epidemiology Cardiovascular risk Essential Hypertension Female Follow-Up Studies Greece - epidemiology Humans Hypertension Hypertension - epidemiology Hypertension - etiology Male Metabolic syndrome Metabolic Syndrome - complications Metabolic Syndrome - epidemiology Middle Aged Morbidity - trends Prognosis Retrospective Studies Risk Assessment - methods Risk Factors Survival Rate - trends Time Factors |
| title | Metabolic syndrome, independent of its components, affects adversely cardiovascular morbidity in essential hypertensives |
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