Metabolic syndrome using national cholesterol education program criteria in black patients with arterial hypertension

ABSTRACT

Objective: to assess the prevalence and correlates of the metabolic syndrome (MS) in black patients with essential hypertension. Methods: A total of 100 consecutive essential hypertensives (53 men and 47 women, mean age 49 ± 10 years, BMI 27 ± 5 Kg/m², SBP 155 ± 19 mmHg, DBP 101 ± 11 mmHg) attending the University of Kinshasa outpatient hypertension clinic and included in a case-control study of lipids and lipoproteins were considered for the present cross sectional analysis. All patients underwent clinical, laboratory and electrocardiographic investigations searching for lipid and lipid cardiovascular risk factors. NCEP-ATP III criteria were used to define the MS. Between group comparisons were made with the Student t test, Mann Whitney U test or Chi square as appropriate. Results: 31 hypertensive patients (33%), 23 men and 8 women, fulfilled the NCEP-ATP III criteria of the MS. In univariate analysis, aside the variables defining the MS, patients with the MS had a significantly higher TC/HDL-c ratio (4.44 ± 2.40 vs 3.79 ± 1.82; p ≤ 0.05) and proportion (13% vs 3%, p ≤ 0.05) of smokers; they paradoxically showed lower proportion (39% vs 52%, p ≤ 0.05) of left ventricular hypertrophy (LVH) in comparison to those without the MS. The two groups were similar for age, sex distribution, duration of hypertension, physical activity, treatment status, BP and other biological variables. Multivariate logistic regression analysis was used to determine the independent contribution of risk factors to the risk of MS. Conclusion: MS is common among Congolese patients with essential hypertension and seems to be paradoxically associated with less pronounced cardiac damage probably due to the phenomenon of reverse epidemiology of traditional cardiovascular risk factors