Prevalence of metabolic syndrome and associated cardiovascular risk profiles among prehypertensive adults

Background Metabolic syndrome (MS) is associated with high cardiovascular risk (CVR). Its prevalence increases significantly with blood pressure levels. Purpose Our work aimed to evaluate the prevalence of MS during prehypertension (PHT), according to the CVR of these patients. Methods Our cross-sectional study included 399 patients with PHT (defined by JNC VII as a systolic pressure between 120–139mmhg and a diastolic pressure between 80-89 mmHg). MS has been defined according to the criteria of ATPIII (Adult Treatment Panel III) and IDF (International Diabetes Federation). All patients benefited from waist circumference measurement, lipid and renal assessment, oral glucose tolerance test (OGTT), ambulatory blood pressure monitoring (ABPM), pulse wave velocity (PWV) measurement and measurement of the carotid intima media thickness (IMT). Results We included 156 men and 243 women, average age: 42.3 ± 13.9 years. Overweight and obesity affected respectively 35.8% and 31.8% of patients, dyslipidemia 17.3% of cases, and diabetes 13% of cases. Android obesity was noted in 26.31% of patients according to ATPIII, and 49.9% according to the IDF. Twenty-five % of the pre-hypertensive patients had an MS according to ATPIII, with high prevalence in the high CVR groups, including the presence of a masked hypertension (42%), a high PWV (26.4%), prediabetes (34.6%) or a high Framingham score (63%). According to the IDF, the prevalence of MS was 36.3% in pre-hypertensive patients; also, higher in the different risk groups (44%, 32%, 52% and 71.7% respectively). Conclusion MS is common during PHT. Screening and early management of metabolic risk factors associated with this new blood pressure category should reduce the risk of subsequent cardiovascular mortality.