Journal of the American Society of Hypertension
Volume 1, Issue 2 , Pages 120-134 , March 2007

Understanding essential hypertension from the perspective of the cardiometabolic syndrome

  • Poorna R. Karuparthi, MD

      Affiliations

    • Department of Internal Medicine, University of Missouri, Columbia, Missouri, USA
    • Corresponding Author InformationCorresponding author: Poorna R. Karuparthi, MD, Department of Internal Medicine, University of Missouri, Columbia, Missouri 65201. Tel: 573-529-6638.
  • ,
  • Preethi Yerram, MD

      Affiliations

    • Department of Internal Medicine, University of Missouri, Columbia, Missouri, USA
    • Veteran Affairs Medical Center, Columbia, Missouri, USA
  • ,
  • Guido Lastra, MD

      Affiliations

    • Department of Internal Medicine, University of Missouri, Columbia, Missouri, USA
    • Veteran Affairs Medical Center, Columbia, Missouri, USA
  • ,
  • Melvin R. Hayden, MD

      Affiliations

    • Department of Internal Medicine, University of Missouri, Columbia, Missouri, USA
    • Division of Endocrinology Diabetes and Metabolism, University of Missouri, Columbia, Missouri, USA
  • ,
  • James R. Sowers, MD

      Affiliations

    • Division of Endocrinology Diabetes and Metabolism, Diabetes Center, Arizona Health Sciences, Tucson, Arizona, USA

Received 16 December 2006 ,Accepted 19 January 2007.

References 

  1. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560–2572
  2. Hajjar I, Kotchen T. Trends in prevalence, awareness, treatment and control of hypertension in the United States, 1988–2000. JAMA. 2003;290:199–206
  3. Sowers J. Update on the cardiometabolic syndrome. Clin Cornerstone. 2001;4:17–23
  4. Vasan R, Beiser A, Seshadri S, Martin G, Larson M, Kannel W, et al. Residual lifetime risk for developing hypertension in middle-aged women and men: the Framingham Heart Study. JAMA. 2002;287:1003–1010
  5. Stamler J, Stamler R, Neaton J. Blood pressure, systolic and diastolic, and cardiovascular risks: US population data. Arch Intern Med. 1993;153:598–615
  6. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903–1913
  7. MacMahon S, Peto R, Cutler J, Collins R, Sorlie P, Neaton J, et al. Blood pressure, stroke, and coronary heart disease, part 1; prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet. 1990;335:765–774
  8. Wilson P, D’Agostino R, Levy D, Belanger A, Silbershatz H, Kannel W. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:1837–1847
  9. Ford E, Giles W, Dietz W. Prevalence of metabolic syndrome among adults. JAMA. 2002;287:356–359
  10. Wang Y, Wang Q. The prevalence of prehypertension and hypertension among US adults according to the new joint national committee guidelines: new challenges of the old problem. Arch Intern Med. 2004;164:21–26
  11. Sowers J. Insulin resistance and hypertension. Am J Physiol Heart Circ Physiol. 2004;286:H1597–H1602
  12. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26(suppl 1):S5–S20
  13. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–2497
  14. McFarlane S, Banerji M, Sowers J. Insulin resistance and cardiovascular disease. J Clin Endocrinol Metab. 2001;86:713–718
  15. Cheng Z, Vaskonen T, Tikkanen I, Nurminen K, Ruskoaho H, Vapaatalo H, et al. Endothelial dysfunction and salt-sensitive hypertension in spontaneously diabetic Goto-Kakizaki rats. Hypertension. 2001;37:433–439
  16. Standley P, Rose K, Sowers J. Increased basal arterial smooth muscle glucose transport in the Zucker rat. Am J Hypertens. 1995;8:48–52
  17. Kannel W. Risk stratification in hypertension: new insights from the Framingham Study. Am J Hypertens. 2000;13(suppl 1):S3–S10
  18. Reaven G. Banting Lecture 1988: role of insulin resistance in human disease. Diabetes. 1998;37:1595–1607
  19. Hayden M, Stump C, Sowers J. Introduction: organ involvement in the cardiometabolic syndrome. J CardioMetabolic Syndr. 2006;1:16–24
  20. Hayden M, Tyagi S. Myocardial redox stress and remodeling in metabolic syndrome, type 2 diabetes mellitus, and congestive heart failure. Med Sci Monit. 2003;9:SR35–SR52
  21. Grundy S, Brewer H, Cleeman J, Smith S, Lenfant C. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition. Circulation. 2004;109:433–483
  22. Galassi A, Renolds K, He J. Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med. 2006;119:812–819
  23. Ahima R, Flier J. Adipose tissue as an endocrine organ. Trends Endocrinol Metab. 2000;11:327–332
  24. Sharma A. Adipose tissue: a mediator of cardiovascular risk. Int J Obes Relat Metab Disord. 2002;26(suppl 4):S5–S7
  25. Scott M. Metabolic complication of obesity. Endocrine. 2000;13:155–165
  26. Jeppesen J, Facchini F, Reaven G. Individuals with high total cholesterol/HDL cholesterol ratios are insulin resistant. J Intern Med. 1998;243:293–298
  27. Kern W, Peters A, Born J, Fehm H, Schultes B. Changes in blood pressure and plasma catecholamine levels during prolonged hyperinsulinemia. Metabolism. 2005;54:391–396
  28. Baum M. Insulin stimulates volume absorption in the rabbit proximal convoluted tubule. J Clin Invest. 1987;79:1104–1109
  29. DeFronzo R, Cooke C, Andres R, Faloona G, Davis P. The effect of insulin in renal handling of sodium, potassium, calcium, and phosphate in man. J Clin Invest. 1975;55:845
  30. Hayden M, Sowers J. Hypertension in type 2 diabetes mellitus. Insulin. 2006;1:22–37
  31. Nickenig G, Roling J, Strehlow K, Schnabel P, Bohm M. Insulin induces upregulation of vascular AT1 receptor gene expression by posttranscriptional mechanisms. Circulation. 1998;98:2453–2460
  32. Sharma A, Jürgen J, Kerstin G, Stefan E, Friedrich C. Angiotensin blockade prevents type 2 diabetes by formation of fat cells. Hypertension. 2002;40:609–611
  33. Sharma A. The obese patient with diabetes mellitus: from research targets to treatment options. Am J Med. 2006;119:S17–S23
  34. Hanspeter B, John R, John D. Endothelial function and dysfunction (Part II: association with cardiovascular risk factors and diseases. A statement by the Working Group on Endothelins and Endothelial Factors of the European Society of Hypertension). J Hypertens. 2005;23:233–246
  35. Safar M, Levy B, Striker-Boudier H. Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation. 2003;107:2864–2869
  36. Lastra G, Manrique C, Whaley-Connell A, Sowers J. Hypertension and the cardiometabolic syndrome. J Clin Hypertens. 2005;7:471–476
  37. Fesler P, du Cailar G, Ribstein J, Mimran A. Heterogeneity of cardiorenal characteristics in normotensive subjects. Hypertension. 2004;43:219–223
  38. Villarreal F, MacKenna D, Omens J, Dillmann W. Myocardial remodeling in hypertensive Ren-2 transgenic rats. Hypertension. 1995;25:98–104
  39. Hayden M, Chowdhury N, Govindarajan G, Karuparthi P, Habibi J, Sowers J. Myocardial myocyte remodeling and fibrosis in the cardiometabolic syndrome. J Cardiometabolic Syndr. 2006;1:326–332
  40. Hayden M, Chowdhury N, Witte L, Sowers J. Microalbuminuria and proximal tubule remodeling in the cardiometabolic syndrome. J Cardiometabolic Syndr. 2006;1:107–114
  41. Hayden M, Kolb L, Chowdhury N, Karuparthi P, Khanna R, Sowers JR. Detecting microalbuminuria and taking action in the cardiometabolic syndrome and type 2 diabetes mellitus. Mo Med. 2006;103:533–538
  42. Hayden M, Whaley-Connell A, Sowers J. Renal redox stress and remodeling in metabolic syndrome, type 2 diabetes mellitus, and diabetic nephropathy: paying homage to the podocyte. Am J Nephrol. 2005;25:553–569
  43. Hayden M, Chowdhury N, Cooper S, Whaley-Connell A, Habibi J, Witte L, et al. Proximal tubule microvilli remodeling and albuminuria in the Ren2 transgenic rat. Am J Physiol Renal Physiol. 2007;292:861–867
  44. Giles T, Berk B, Black H, Cohn J, Kostis J, Izzo J, et al. Expanding the definition and classification of hypertension (on behalf of the Hypertension Writing Group). J Clin Hypertens (Greenwich). 2005;7:505–512
  45. Lane J. Microalbuminuria as a marker of cardiovascular and renal risk in type 2 diabetes mellitus: a temporal perspective. Am J Physiol Renal Physiol. 2004;286:F442–F450
  46. Chen J, Muntner P, Hamm L, Jones D, Batuman V, Fonseca V, et al. The metabolic syndrome and chronic kidney disease in U.S. adults. Ann Intern Med. 2004;104:167–174
  47. Maclsaac RJ, Jerums G, Cooper ME. New insights into significance of microalbuminuria. Curr Opin Nephrol Hypertens. 2004;13:83–91
  48. Hillege H, Filder V, Diercks G, van Gilst WH, de Zeeuw D, van Veldhuisen DJ, et al. Prevention of Renal and Vascular End Stage Disease (PREVEND) Study Group Urinary albumin excretion predicts cardiovascular and non cardiovascular mortality in general population. Circulation. 2002;106:1777–1782
  49. Isomaa B, Almgren P, Tumi R, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001;24:683–689
  50. Rion F, Waeber B, Graf H, et al. Utility of ambulatory blood pressure recording in therapeutic trials of antihypertensive drugs. Schweiz Med Wochenscr. 1985;115:1829–1831
  51. Kailasam M, Parmer R, Tyrell E, et al. Circulating amylin in human essential hypertension: heritability and early increase in individuals at genetic risk. J Hypertens. 2000;18:1611–1620
  52. American Diabetes Association. Treatment of hypertension in adults with diabetes. Diabetes Care. 2003;26(suppl 1):S80–S82
  53. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification (Kidney Disease Outcome Quality Initiative). Am J Kidney Dis. 2002;39(suppl 2):S1–S246
  54. Black H, Elliott W, Neaton J, et al. Baseline characteristics and elderly blood pressure control in the CONVINCE Trial. Hypertension. 2001;37:12–18
  55. Cushman WC, Ford CE, Cutler JA, et al. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). J Clin Hypertens (Greenwich). 2002;4:393–404
  56. Sowers J. Recommendations for special populations: diabetes mellitus and the metabolic syndrome. Am J Hypertens. 2003;16:S41–S45
  57. The Trials of Hypertension Collaborative Research Group. Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. The trials of hypertension prevention, phase II. Arch Intern Med. 1997;157:657–667
  58. He J, Whelton P, Appel L, et al. Long term effects of weight loss and dietary sodium reduction on incidence of hypertension. Hypertension. 2000;35:544–549
  59. Sacks FM, Svetkey LP, Vollmer WM, et al. DASH-Sodium Collaborative Research Group Effects on blood pressure of reduced sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med. 2001;344:3–10
  60. ALLHAT. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288:2981–2997
  61. Zillich AJ, Garg J, Basu S, et al. Thiazide diuretics, potassium, and the development of diabetes: a quantitative review. Hypertension. 2006;48:219–224
  62. Siscovick D, Raghunathan T, Psaty B, Koepsell T, Wicklund K, Lin X, et al. Diuretic therapy for hypertension and the risk of primary cardiac arrest. N Engl J Med. 1994;330:1899–1900
  63. Braunwald E, Antman E, Beasley J. ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction—summary article: a report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on the Management of Patients With Unstable Angina). J Am Coll Cardiol. 2002;40:1366–1374
  64. Hunt S, Abraham W, Chin M, et al. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005;112:e154–e235
  65. Khan N, McAlister F. Re-examining the efficacy of beta-blockers for the treatment of hypertension: a meta-analysis. Can Med Assoc J. 2006;174:1737–1742
  66. The National Collaborating Centre for Chronic Conditions. Hypertension: management of hypertension in adults in primary care (partial update of NICE Clinical Guideline 18, published August 2004). June 2006. Accessed from http://www.nice.org.uk/full guideline on October 16, 2006.
  67. Zanella MT, Kohlmann OJ, Ribeiro AB. Treatment of obesity hypertension and diabetes syndrome. Hypertension. 2001;38:705–708
  68. Bell D. Advantages of a third-generation beta-blocker in patients with diabetes mellitus. Am J Cardiol. 2004;93:49B–52B
  69. The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting-enzyme inhibitor, ramipril on cardiovascular events in high-risk patients. N Engl J Med. 2000;342:145–153
  70. The Heart Outcomes Prevention Evaluation Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet. 2000;355:253–259
  71. Niklason A, Hedner T, Niskanen L, et al. Development of diabetes is retarded by ACE inhibition in hypertensive patients — a subanalysis of the Captopril Prevention Project (CAPPP). J Hypertens. 2004;22:645–652
  72. Niskanen L, Hedner T, Hansson L, et al. Reduced cardiovascular morbidity and mortality in hypertensive diabetic patients on first-line therapy with an ACE inhibitor compared with a diuretic/beta-blocker-based treatment regimen: a subanalysis of the Captopril Prevention Project. [see comment] Diabetes Care. 2001;24:2091–2096
  73. The DREAM Trial Investigators. Effect of ramipril on the incidence of diabetes. N Engl J Med. 2006;355:1551–1562
  74. Bakris GL, Weir MR. Angiotensin-converting enzyme inhibitor-associated elevations in serum creatinine: is this a cause for concern?. Arch Intern Med. 2000;160:685–688
  75. Bakris GL, Weir MR, Shanifar S, Zhang Z, Douglas J, van Dijk DJ, et al. Effects of blood pressure level on progression of diabetic nephropathy: results from the RENAAL study. [see comment] Arch Intern Med. 2003;163:1555–1565
  76. Dahlof B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction (LIFE) in hypertension study: a randomized trial against atenolol. Lancet. 2002;359:995–1003
  77. Julius S, Kjeldsen SE, Weber M, et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet. 2004;363:2022–2031
  78. Pfeffer MA, Swedberg K, Granger CB, et al. Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall programme. [see comment] Lancet. 2003;362:759–766
  79. Whaley-Connell A, Sowers J. Hypertension management in type 2 diabetes mellitus: recommendations of the Joint National Committee VII. Endocrinol Metab Clin North Am. 2005;34:63–75
  80. Black HR. Calcium channel blockers in the treatment of hypertension and prevention of cardiovascular disease: results from major clinical trials. Clin Cornerstone. 2004;6:53–66
  81. National High Blood Pressure Education Program (The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure). Arch Intern Med. 1997;157:2413–2446
  82. Anderson PE, Lithell H. Metabolic effects of doxazosin and enalapril in hypertriglyceridemic, hypertensive men: relationship to changes in skeletal muscle blood flow. Am J of Hypertens. 1996;9:323–333
  83. Lithell H. Hyperinsulinemia, insulin resistance, and the treatment of hypertension. Am J Hypertens. 1996;9:S150–S154
  84. ALLHAT. Diuretic versus α-blocker as first-step antihypertensive therapy. Final results from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). 2003;2:239–246
  85. Gradman AH, Schmeider RE, Lins RL, et al. Aliskerin, a novel orally effective renin inhibitor, provides dose-dependent antihypertensive efficacy and placebo-like tolerability in hypertensive patients. Circulation. 2005;111:1012–1018
  86. Stanton A, Jensen C, Nussberger J, et al. Blood pressure lowering in essential hypertension with an oral renin inhibitor, aliskiren. Hypertension. 2003;42:1137
  87. Gradman AH, Vivas Y. New drugs for hypertension: what do they offer?. Curr Hypertens Rep. 2006;8:425–432
  88. Sarafidis P, Lasaridis A. Actions of peroxisome proliferators—activated receptors-agonists explaining a possible blood pressure-lowering effect. Am J Hypertens. 2006;19:646–653
  89. The DREAM Trial Investigators. Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial. Lancet. 2006;368:1096–1205
  90. Lebovitz H, Banerji M. Insulin resistance and its treatment by thiazolidinediones. Recent Prog Horm Res. 2001;56:265–294
  91. Kaplan N. Trial of Preventive Hypertension (TROPHY): design and 2-year progress report. Hypertension. 2004;44:146–151

 Conflict of interest: none.

PII: S1933-1711(07)00018-6

doi: 10.1016/j.jash.2007.01.006

Journal of the American Society of Hypertension
Volume 1, Issue 2 , Pages 120-134 , March 2007