Metabolic syndrome and cardiometabolic risk: An update

Figures & data

Figure 1. Prevalence of the metabolic syndrome in the PAMELA population, accordingly to the subjects' gender and age decades. Data from ref. [23].

Figure 2. Prevalence of the various compounds of the metabolic syndrome in the PAMELA population. BP, Blood pressure; TG, Triglycerides; IFG, Impaired fasting glucose. ↑: Increase. Data from ref. [23].

Figure 3. Kaplan‐Meier survival curves for cardiovascular death and all‐cause death in subjects without (MS–) and with (MS+) metabolic syndrome. p‐values refer to the statistical difference between the two curves. Modified from ref. [23].

Table I. Intermediate (surrogate) endpoints of prognostic relevance in hypertension and in metabolic syndrome.

Left ventricular hypertrophy	Arterial stiffness
Diastolic dysfunction	Small arteries media‐to‐lumen ratio
Pulse pressure	Large arteries intima/media thickness
Silent myocardial ischaemia	Endothelial dysfunction
Silent cerebral ischaemia	Insulin resistance
Microalbuminuria/proteinuria	Sympathetic activation
Carotid plaques	Central pressure

Figure 4. Prevalence (%) of left ventricular hypertrophy (LVH) in the subjects of the PAMELA study without (blue bars) and with (grey bars) metabolic syndrome in the whole population samples and in males and females, after exclusion of hypertensive patients or adjustment for 24‐h systolic blood pressure values and in different age decades. Asterisks (*p,0.05) refer to the statistical significance between groups. Data are shown as mean ± SEM. Modified from ref. [23].

Figure 5. Left ventricular mass index (LVMI) and prevalence of left ventricular hypertrophy (LVH) in the subjects of the PAMELA study with metabolic syndrome examined in 1991–1992 and reassessed 10 years later. Data are shown as absolute (LVMI) or percentage (LVH) mean values. Data from ref. [40].

Figure 6. Values of muscle sympathetic nerve activity (MSNA) in obesity. Panel A, data in controls (C) and in obese (O) subjects; Panel B in visceral (CO) and peripheral (PO) overweight; Panel C, in the obese state (O+ HT); panel D, in the metabolic syndrome state (MS). Asterisks (*p<0.05, **p< 0.01) refer to the statistical significance between groups. Data from refs [61–64].

Mancia G, Bombelli M, Corrao G, Facchetti R, Madotto F, Giannattasio C, et al. Metabolic syndrome in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study: daily life blood pressure, cardiac damage, and prognosis. Hypertension 2007; 49: 40–47

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Mancia G, Bombelli M, Facchetti R, Madotto F, Corrao G, Quarti‐Trevano F, et al. Long‐term risk of diabetes, hypertension and left ventricular hypertrophy associated with the metabolic syndrome in a general population. J Hypertens 2008; 26: 1602–1611

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