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Cardiovascular Risk in Patients with Prehypertension and the Metabolic Syndrome

  • Sergey Kachur
  • Rebecca Morera
  • Alban De Schutter
  • Carl J. Lavie
Hypertension and the Kidney (RM Carey, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Hypertension and the Kidney

Abstract

Prehypertension (pHTN) and metabolic syndrome (MetS) are both lifestyle diseases that are potentiated by increased adiposity, as both disease processes are closely related to weight. In the case of pHTN, increased adiposity causes dysregulation of the renin-angiotensin-aldosterone-system (RAAS) as well as adipokine- and leptin-associated increases in adrenergic tone. In MetS, excess weight potentiates hyperglycemia and insulin resistance which causes positive feedback into the RAAS system, activates an inflammatory cascade that potentiates atherosclerosis, and causes lipid dysregulation which together contribute to cardiovascular disease, especially coronary heart disease (CHD) and heart failure (HF). The relationship with all-cause mortality is not as clear-cut in part because of some protective effects associated with the obesity paradox in chronic diseases such as CHD and HF. However, in healthy populations, the absence of excess weight and its associated effects on prehypertension and MetS are associated with a longer absolute and disease-free lifespan.

Keywords

Metabolic syndrome Obesity Prehypertension Heart failure Insulin resistance 

Abbreviations

BMI

Body mass index

BP

Blood pressure

CHD

Coronary heart disease

CVD

Cardiovascular disease

DBP

Diastolic blood pressure

ESH

European Society of Hypertension

ESC

European Society of Cardiology

FFA

Free fatty acid

HF

Heart failure

HTN

Hypertension

pHTN

Prehypertension

IR

Insulin resistance

JNC

Joint National Committee

LV

Left ventricle/ventricular

MetS

The metabolic syndrome

NCEP

National Cholesterol Education Program

NHANES

National Health and Nutrition Examination Survey

NO

Nitric oxide

RAAS

Renin-angiotensin-aldosterone system

ROS

Reactive oxygen species

REGARDS

The Reasons for Geographic and Racial Differences in Stroke Study

SBP

Systolic blood pressure

WC

Waist circumference

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Sergey Kachur
    • 1
  • Rebecca Morera
    • 1
  • Alban De Schutter
    • 2
  • Carl J. Lavie
    • 3
  1. 1.Department of Graduate Medical EducationOcala Regional Medical CenterOcalaUSA
  2. 2.New York University School of MedicineNew YorkUSA
  3. 3.Department of Cardiovascular Diseases, John Ochsner Heart and Vascular InstituteOchsner Clinic School-the University of Queensland School of MedicineNew OrleansUSA

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