The metabolic syndrome in hypertension: European society of hypertension position statement.

Details

Serval ID
serval:BIB_E5760A08472B
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
The metabolic syndrome in hypertension: European society of hypertension position statement.
Journal
Journal of Hypertension
Author(s)
Redon J., Cifkova R., Laurent S., Nilsson P., Narkiewicz K., Erdine S., Mancia G.
Working group(s)
Scientific Council of the European Society of Hypertension
Contributor(s)
Agabiti-Rosei E., Ambrosioni E., Burnier M., Coca A., Dominiczak AF., Kjeldsen S., Manolis AJ., Olsen MH., Schmieder R., Struijker-Boudier HA., Viigimaa M.
ISSN
0263-6352 (Print)
ISSN-L
0263-6352
Publication state
Published
Issued date
2008
Volume
26
Number
10
Pages
1891-1900
Language
english
Notes
Publication types: Journal Article ; Practice Guideline
Publication Status: ppublish
Abstract
The metabolic syndrome considerably increases the risk of cardiovascular and renal events in hypertension. It has been associated with a wide range of classical and new cardiovascular risk factors as well as with early signs of subclinical cardiovascular and renal damage. Obesity and insulin resistance, beside a constellation of independent factors, which include molecules of hepatic, vascular, and immunologic origin with proinflammatory properties, have been implicated in the pathogenesis. The close relationships among the different components of the syndrome and their associated disturbances make it difficult to understand what the underlying causes and consequences are. At each of these key points, insulin resistance and obesity/proinflammatory molecules, interaction of demographics, lifestyle, genetic factors, and environmental fetal programming results in the final phenotype. High prevalence of end-organ damage and poor prognosis has been demonstrated in a large number of cross-sectional and a few number of prospective studies. The objective of treatment is both to reduce the high risk of a cardiovascular or a renal event and to prevent the much greater chance that metabolic syndrome patients have to develop type 2 diabetes or hypertension. Treatment consists in the opposition to the underlying mechanisms of the metabolic syndrome, adopting lifestyle interventions that effectively reduce visceral obesity with or without the use of drugs that oppose the development of insulin resistance or body weight gain. Treatment of the individual components of the syndrome is also necessary. Concerning blood pressure control, it should be based on lifestyle changes, diet, and physical exercise, which allows for weight reduction and improves muscular blood flow. When antihypertensive drugs are necessary, angiotensin-converting enzyme inhibitors, angiotensin II-AT1 receptor blockers, or even calcium channel blockers are preferable over diuretics and classical beta-blockers in monotherapy, if no compelling indications are present for its use. If a combination of drugs is required, low-dose diuretics can be used. A combination of thiazide diuretics and beta-blockers should be avoided.
Keywords
Adrenergic beta-Antagonists/adverse effects, Angiotensin II Type 1 Receptor Blockers/therapeutic use, Angiotensin-Converting Enzyme Inhibitors/therapeutic use, Antihypertensive Agents/adverse effects, Antihypertensive Agents/therapeutic use, Calcium Channel Blockers/therapeutic use, Diet Therapy, Exercise Therapy, Humans, Hypertension/complications, Hypertension/drug therapy, Metabolic Syndrome X/complications, Metabolic Syndrome X/physiopathology, Risk Reduction Behavior, Sodium Chloride Symporter Inhibitors/adverse effects
Pubmed
Web of science
Create date
14/01/2009 13:41
Last modification date
20/08/2019 16:08
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