Metabolic syndrome linked to BP variability

By Eleanor McDermid, Senior medwireNews Reporter

Blood pressure (BP) variability is increased in patients with the metabolic syndrome, shows an analysis of NHANES III data.

Moreover, Mohammed Faramawi (University of Arkansas for Medical Sciences, Little Rock, USA) and team found that systolic (S)BP variability increased in line with the number of metabolic syndrome components people had.

“Arterial stiffness has been postulated as an important cause for systolic arterial blood pressure variability”, they write in Hypertension Research. “Therefore, we hypothesize that the noticed significant relationship between the [metabolic syndrome] and visit-to-visit blood pressure variability in this study may be explained by arterial stiffness.”

The findings arise from an analysis of 9140 participants in NHANES (National Health And Nutrition Examination Survey) III. Their BP was measured at a home visit and a mobile clinic visit, and the average of the standard deviation of SBP between these visits was 6.82 mmHg.

This value was significantly higher in participants with than without the metabolic syndrome, at 8.95 versus 5.62 mmHg, and rose with increasing number of metabolic syndrome components, from 5.37 mmHg in participants with no components to 10.07 mmHg in those with all five.

“Each component of the [metabolic syndrome] enhances the pathophysiological changes, for example, arterial stiffness, that are intermediate steps between the [metabolic syndrome] components and systolic blood pressure variability”, explain the study authors.

Of the metabolic syndrome components, hypertension and hyperglycaemia were associated with the largest increases in SBP variability. These two components remained significantly associated with increased SBP variability on multivariate analysis, as did an increased waist circumference.

Despite being statistically significant, Faramawi and team note that the increases in SBP variability associated with the metabolic syndrome and its components were small.

“However, it is important to distinguish between the implications of individual and population changes in blood pressure”, they say. “At the population level, even a small upward shift in blood pressure would be expected to result in a substantial increase in [cardiovascular] disease and vice versa.”

They conclude: “The findings of this study are important because the [metabolic syndrome] is becoming a pandemic in Western societies.”

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