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Submitted on August 2, 2005
Accepted on November 4, 2005
Department of Medical and Surgical Sciences (F.F., P.D.M., G. F.), Department of Statistical Sciences (N.S.), and Department of Neurosciences, Biostatistical Section (M.E.), University of Padova, 35128 Padova, Italy; and Department of Medicine and Experimental Oncology, Hypertension Unit (F.V., C.B., F.R., P.M.), University of Torino, 10133 Torino, Italy
* To whom correspondence should be addressed. E-mail: francesco.fallo{at}unipd.it.
Context: Patients with hypertension have a high prevalence of concurrent metabolic abnormalities including obesity, dyslipidemia and hyperglycaemia. Clustering of these cardiovascular risk factors, defined as metabolic syndrome, causes a more pronounced target organ damage. Aldosterone excess has been found to be associated with glucose disorders, and may contribute to cardiovascular damage.
Objective: The aim of our study was to assess the prevalence and the characteristics of metabolic syndrome in a group of patients with hypertension due to primary aldosteronism, compared with essential hypertension.
Methods: The NCEP ATP-III definition of metabolic syndrome was used. Eighty-five patients with primary aldosteronism and 381 patients with essential hypertension were studied. Most patients were off antihypertensive therapy during investigation.
Results: Blood glucose and systolic blood pressure were higher (P < 0.05 and P < 0.01, respectively) and duration of hypertension was longer (P < 0.05) in primary aldosteronism than in essential hypertension. The prevalence of metabolic syndrome was higher in primary aldosteronism than in essential hypertension (41.1% vs. 29.6%, P < 0.05). Distribution of single components of the metabolic syndrome other than hypertension showed a higher prevalence of hyperglycaemia in primary aldosteronism than in essential hypertension (27.0% vs. 15.2%, P < 0.05).
Conclusions: Our findings confirm a negative effect of aldosterone excess on glucose metabolism, and suggest that the recently reported higher rates of cardiovascular events in primary aldosteronism than in essential hypertension might be due to increased prevalence of metabolic syndrome in the former condition.
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