Blood Pressure Management in Metabolic Syndrome

Yuichiro      Yano; Satoshi      Hoshide; Kazuyuki      Shimada; Kazuomi      Kario

Abstract

To assess 24-hour BP levels in subjects with metabolic syndrome is essential, because hypertension, which is the most prevalent component in the syndrome, makes the major contribution to cardiovascular risk. Because BP levels in subjects with metabolic syndrome are prone to be elevated in an out-of-office setting (i.e., nocturnal hypertension, morning hypertension), measurement of home and/or ambulatory BP levels is a promising method for managing the syndrome. The best treatment approach for this complex condition is a multifactorial one, much emphasis has been placed on RAAS inhibition, which is one of the most important factors in the disease, although there has been no clear evidence that RAAS inhibitors are more effective than other drugs for treatment of metabolic syndrome. However, previous trials for treating hypertension have generally enrolled non-obese patients, and have enrolled more complicated high-risk patients, in whom the most important issue is BP lowering itself. here is thus a need to assess how to treat relatively younger subjects withmilder and/or high-normal hypertension, because the prevalence of such patients is expected to increase dramatically along with burgeoning obesity rates.

Keywords: Metabolic syndrome, morning hypertension, masked hypertension, prehypertension, renin-angiotensinaldosterone system

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