Características clínicas, metabólicas y vasculares de pacientes prehipertensos Artículo original

Background: The appearance of the prehypertension group in the classification of the JNC-VII has been justified on the basis of not considering these subjects as normal but evaluating its cardiovascular risk in an integral way. Objetive: To determine the clinical, metabolic and vascular characteristics of the prehypertensive (PH) subjects in comparison with normotensive (NT) ones. Patients and method: Seventy-one PH and 83 NT were detected and they were featured for: sex, age, weight, height, BMI, record of cardiovascular risk factors, comorbidities and their treatments, clinical chemistry, fasting and postprandial glycemia, fasting insulin, lipid profile, microalbuminuria and waist perimeter. The insulin resistance was calculated by means of the Homeostatic Method Assessment (HOMA). They were measured with vascular ultrasound the carotid intima-media thickness to a centimeter of their bifurcation and the endothelial function was evaluated through measuring the caliber of the humeral artery before and after mechanic stimulation of the endothelium. Results: Fourty-one percent of the PH and 34.6% of the NT were men, the main differences between PH and NT were: age 51.4±13.7 and 44.6±14.2, BMI 28.3±4.5 and 26.8±4.9, waist 95.8±10.9 and 89.7±12.6 cm, HOMA 3.51±2.1 and 2.6±2.2, uric acid 5.65±6.09 and 3.6±1.5 mg/dL, C-HDL 48.2±15.3 and 55.1±25.5 mg/dL, C-LDL 113.4±33.4 and 127.7±43 mg/dL, all significant ones (p < 0.05). The PH regarding the NT had resistance to the insulin (RI) 65.2 vs 44.8%, hypertriglyceridemia 46 vs 41.7%, hypoalphalipoproteinemia 34 vs 29.4%, microalbuminuria 13.5 vs 10%, metabolic syndrome for the criteria of the NCEP 21.7 vs 13.7% all significant ones (p < 0.05). The BMI was of 0.67 mm in PH and of 0.53 mm in NT (p < 0.05), the endothelium-dependent dilation of the humeral was of 16.05% in PH and of 20.2% in NT (p < 0.05). Conclusions: The group of PH seems to be an interim statement in the road toward the diabetes mellitus and cardiovascular events via the metabolic syndrome, with RI and endothelial dysfunction.