Prevalence and Clinical Profile of Metabolic Syndrome in Hypertensive Subjects.

OBJECTIVE: (1) To study the prevalence and clinical attributes of metabolic syndrome in hypertensive subjects (2) To identify the factors determining the high prevalence of metabolic syndrome in hypertensive subjects. METHODS: After ethical considerations, this prospective observational study was conducted on 151 non-pregnant essential hypertensive adults. Diagnosis of metabolic syndrome was made as per the NCEP - ATP III criteria. The parameters were compared with those of hypertensive subjects without metabolic syndrome. RESULTS: Amongst the 151 subjects enrolled, the prevalence of metabolic syndrome in hypertensive subjects was found to be 49.01% with a female preponderance (M: F =1: 1.39). The Metabolic Syndrome Score was 3, 4 and 5 in 52 (70.27%), 14 (18.91%) and 8 (10.81%), respectively in subjects positive for metabolic syndrome. Forty-six (62.16%) of the subjects with metabolic syndrome were in their sixth decade of life. Fifty-four subjects (73%) belonged to the lower socioeconomic strata. Sixty-three (85%) of the subjects were leading a sedentary lifestyle. The most common co-morbidity in these subjects was diabetes mellitus (66.21%, 49 subjects) followed by raised triglyceride levels (63.51%, 47 subjects). When compared with the hypertensive group not suffering from metabolic syndrome, statistical significance was noted with respect to central obesity (p<0.001), increased waist: height ratio (p<0.001) and BMI (p<0.001). No significant association was noted with the stage (p=0.163) or duration (p=0.850) of hypertension. CONCLUSIONS: The prevalence of metabolic syndrome is higher amongst hypertensive patients as compared to the general population. Increased waist: height ratio and BMI are important contributors to the high prevalence of this cardiac risk factor in hypertensive subjects.

Extreme Thrombocytosis.

A 55 years old female presented with hitherto abdominal pain and gangrenous changes of lower limbs. Patient was found to have extreme thrombocytosis. Approach to thrombocytosis is discussed here.