DOI: http://dx.doi.org/10.18203/2349-3933.ijam20193261

Prevalance and clinical profile of metabolic syndrome in hypertensive patients and its correlation with insulin resistance

Gurinder Mohan, Tanish Dhir, Manish Chandey

Abstract


 

Background:Metabolic syndrome (MS) is a collection of cardiometabolic risk factors that includes obesity, insulin resistance, hypertension, and dyslipidaemia. Insulin resistance lies at the heart of the metabolic syndrome. The purpose of this study is to study the prevalence, clinical attributes of metabolic syndrome in hypertensive subjects and to find out the correlation between prevalence, clinical attributes of metabolic syndrome and insulin resistance.

Methods: About 200 diagnosed cases of hypertension as per Joint national committee 8 guidelines were included in this cross sectional single centric study. All patients were examined, history enquired and laboratory tests like lipid profile, fasting plasma glucose were done and diagnosis of metabolic syndrome made as per the National Cholesterol Education Program- Adult Treatment Panel III criteria. Insulin resistance was calculated by Homeostatic model assessment method.

Results: Amongst the 200 subjects enrolled, the prevalence of metabolic syndrome in hypertensive subjects was found to be 65%. 93.07% of patients with metabolic syndrome were having blood pressure >150/90 mm hg. The prevalence of metabolic syndrome among smoker males was 54.25%. The most common co-morbidity in these subjects was raised triglycerides (96.29% in males, 90.78% in females) followed by low HDL levels (87.03% in males, 90.78% in females). Insulin resistance was found in 75 out of 130 patients who fulfilled the criteria of metabolic syndrome (57.69%), implying increased correlation of metabolic syndrome in hypertensive patients with insulin resistance (p value <0.05).

Conclusions: It was found that there is increased prevalence of metabolic syndrome in hypertensive patients and it correlates with insulin resistance. 


Keywords


Insulin resistance, Metabolic syndrome, Obesity

Full Text:

PDF

References


Reaven GM. Role of insulin resistance in human disease. Diabetes. 1988;37(12):1595-607.

Executive summary: The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) JAMA. 2001;285(19):2486-97.

Cornier M, Dabelea D, Hernandez TL, Lindstrom RC, Steig AJ, Stob NR, et al. The metabolic syndrome. Endocr Rev. 2008;29:777-822.

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation. 2005;112(17):2735-52.

Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007;49(4):403-14.

Wolf-Maier K, Cooper RS, Banegas JR, Giampaoli S, Hense HW, Joffres M, et al. Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA. 2003;289(18):2363-9.

Meigs JB, D'Agostino RB, Wilson PW, Cupples LA, Nathan DM, Singer DE. Risk variable clustering in the insulin resistance syndrome: the Framingham offspring study. Diabetes. 1997;46(10):1594-600.

Working Group Report on Primary Prevention of Hypertension: National High Blood Pressure Education Program, Bethesda, Md: National Institutes of Health. National Institutes of Health, National Heart, Lung and Blood Institute document number 93-2669. 1993. Available at: https://www.nhlbi.nih.gov/.

Kannel WB. Risk stratification in hypertension: new insights from the Framingham Study. Am J Hypertens. 2000;13(S1):3S-10S.

Govindula A, Vlupadas C, Panchagiri S. Prevalence of metabolic syndrome in hypertensive de novo patients at a tertiary care hospital. IJOPP. 2016;9(2):131.

Thakur S, Raina S, Thakur S, Negi PC, Verma BS. Prevalence of metabolic syndrome among newly diagnosed hypertensive patients in the hills of Himachal Pradesh, India. Ind J Endocrinol Metab. 2013;17(4):723-6.

Tachebele B, Abebe M, Addis Z, Mesfin N. Metabolic syndrome among hypertensive patients at University of Gondar Hospital, North West Ethiopia: a cross sectional study. BMC Cardiovasc Dis. 2014;14(1):177.

Sawant A, Mankeshwar R, Shah S, Raghavan R, Dhongde G, Raje H, et al. Prevalence of metabolic syndrome in urban India. Cholesterol. 2011;2011.

Zhan Y, Yu J, Chen R, Gao J, Ding R, Fu Y, et al. Socioeconomic status and metabolic syndrome in the general population of China: a cross-sectional study. BMC Pub Heal. 2012;12(1):921.

Matthews KA, Räikkönen K, Gallo L, Kuller LH. Association between socioeconomic status and metabolic syndrome in women: testing the reserve capacity model. Health Psychol. 2008;27(5):576-83.

Slagter SN, van Vliet-Ostaptchouk JV, Vonk JM, Boezen HM, Dullaart RP, Kobold AC, et al. Associations between smoking, components of metabolic syndrome and lipoprotein particle size. BMC Med. 2013;11(1):195.

Oh SW, Yoon YS, Lee ES, Kim WK, Park C, Lee S, et al. Association between cigarette smoking and metabolic syndrome: the Korea National Health and Nutrition Examination Survey. Diabetes Care. 2005;28(8):2064-6.

Misra A, Khurana L. The metabolic syndrome in South Asians: epidemiology, determinants, and prevention. Metab Syndr Relat Disord. 2009;7:497-514.

Lind L, Berne C, Lithell H. Prevalence of insulin resistance in essential hypertension. J Hypertens. 1995;13(12Pt1):1457-62.

Tunçkale A, Aran SN, Karpuz H, Dirican A. Relationship between insulin resistance and end-organ damage in white coat hypertension. Am J Hypertens. 2004;17(11):1011-6.

Cheal KL, Abbasi F, Lamendola C, McLaughlin T, Reaven GM, Ford ES. Relationship to insulin resistance of the adult treatment panel III diagnostic criteria for identification of the metabolic syndrome. Diabetes. 2004;53(5):1195-200.

Abel N, Contino K, Jain N, Grewal N, Grand E, Hagans I, et al. Eighth joint national committee (JNC-8) guidelines and the outpatient management of hypertension in the African-American population. North Am J Med Sci. 2015;7(10):438.