Blood pressure at rest, during 24 h monitoring and in response to sympathetic stimulation in hypertensive patients with metabolic syndrome.

OBJECTIVE: As subjects with metabolic syndrome have an increased sympathetic activity regardless of the presence of arterial hypertension, this study aimed at evaluating in hypertensives whether this condition has repercussions on differences in resting, ambulatory and under sympathetic stimulation blood pressure levels.
METHODS: Blood pressure (BP) was measured at rest and in response to isometric exercise and cold pressure test by zero-random sphygmomanometer. Moreover 24 h BP monitoring was performed by using Spacelabs 90207.
RESULTS: Of the 340 hypertensive patients entering the study, 110 (32%) had metabolic syndrome. They were older (47 vs. 42 years, p<0.01) than those without MS and, by definition, had increased body mass index, fasting blood glucose and triglycerides and lower HDL-cholesterol. Also BP at rest (148/95 vs. 140/90 mm Hg, p<0.01), during 24 h (138/89 vs. 129/84 mm Hg, p<0.001) as well as during daytime and nighttime were significantly increased in this group. No difference, on the other hand, was detected in the response to tests stimulating sympathetic nervous system and in the clinic-daytime BP difference.
CONCLUSIONS: In the present study hypertensive patients with MS have higher BP, both at rest and during ambulatory monitoring in comparison to hypertensives without MS. The BP response to the stimulation of the sympathetic system seems, on the other hand, similar probably because the presence of hypertension in both groups masks during maximal stress the differences evident in less stressing conditions.