Pulse pressure and the metabolic syndrome in patients with hypertension.

The authors examined the clinical profile of the hypertensive population with the metabolic syndrome (MetS) and elevated pulse pressure (PP) in a sample of 5866 patients (3291 women and 2575 men) included in a large hypertension survey performed in primary care setting. Elevated PP was defined as >or=80 mm Hg in women and >or=75 mm Hg in men; 92.7% of women and 87.6% of men had normal PP values. Patients with higher PP levels were older, were more commonly diabetic, and exhibited more frequently target organ damage and associated clinical conditions. Blood pressure was less well controlled in the subgroup of patients with elevated PP: control rates were 4.1% vs 19.2%, P<.001; men, 3.9% vs 19.0%, P<.001; P=NS between sexes. Low-density lipoprotein cholesterol was similarly controlled regardless of PP: control rates were, 17.0% vs 17.8%; in women with high PP vs normal PP and 25.2% vs 25.1% in men with high PP vs normal PP, both P=NS; P<.001 between sexes with high PP. In the patients with high PP, the female subgroup was older, was more obese, and had more left ventricular hypertrophy and fewer associated clinical conditions than did men. The odds ratio of having high PP in women with MetS vs no MetS was 3.13 and in men was 1.9 (both P<.01).