고혈압 신환 및 구환에서 대사증후군과 고혈압성 표적장기 손상과의 관계에 대한 다기관 공동연구

Abstract

Background: The metabolic syndrome (MS) is associated with increased hypertension-related target organ damage. We analyzed the prevalence and the relationship between the MS and cardio-renal changes in a large number of hypertensive patients.

Methods: Three hundred and seventy seven untreated and 677 treated patients without cardiovascular disease, alleged diabetes, and medication for dyslipidemia were enrolled. Albuminuria was measured by a spot urine albumin-to-creatinine ratio. Left ventricular hypertrophy (LVH) was assessed by an ECG.

Results: The prevalence of MS was higher in the treated patients than in the untreated patients (60.0 vs. 50.4%, p=0.003). The treated patients had a higher number of the MS components, except for hypertension, than the untreated patients (1.8±1.1 vs. 1.6±1.2, p=0.001). In the untreated patients, the prevalence of an increased serum creatinine (s-Cr) or low eGFR was similar to those with or without the MS (2.6 vs. 5.4%, p=NS). The prevalence of microalbuminuria (MA) and clinical albuminuria (CA) was also similar (MA, 21.6 vs. 16.4%; CA, 4.0 vs. 2.3%; both, p=NS). In the treated patients, however, those with the MS showed a higher prevalence of increased s-Cr or low eGFR (11.9 vs. 4.8%, p<0.01) and the MA (19.5 vs. 9.0%, p<0.001) than those without the MS. The prevalence of CA was not different (1.6 vs. 1.6%, p=NS). The prevalence of LVH was increased when the MS was present in untreated patients (6.1 vs. 1.7%, p<0.05), while it was similar in the treated patients (3.0 vs. 2.6%, p=NS).

Conclusion: The impact of the MS on renal changes was more noticeable in treated patients, while the impact of the MS on LVH was more noticeable in untreated patients