Association of metabolic syndrome with cardiovascular outcomes in hypertensive patients: a systematic review and meta-analysis

Purpose The association between metabolic syndrome (MetS) and cardiovascular outcomes in patients with hypertension is still controversial. This meta-analysis sought to evaluate the association of MetS with cardiovascular outcomes in hypertensive patients. Methods Two authors comprehensively searched PubMed and Embase databases from their inception to April 18, 2020 for the longitudinal studies that evaluated the association of MetS with cardiovascular outcomes in patients with hypertension. The main outcomes were major adverse cardiovascular events (myocardial infarction, revascularization, stroke, hospitalization due to heart failure, etc.) and stroke. Results Eight studies consisting of 36,614 hypertensive patients were identified and analyzed. Meta-analysis indicated that MetS was associated with an increased risk of major adverse cardiovascular events (risk ratio [RR] 1.55; 95% confidence intervals [CI] 1.28–1.87), cardiovascular mortality (RR 1.44; 95%CI 1.13–1.82), and stroke (RR 1.46; 95%CI 1.22–1.75), respectively. Sensitivity analysis further confirmed the robustness of the prognostic value of MetS. Conclusions MetS is associated with higher risk of major adverse cardiovascular events, cardiovascular mortality, and stroke in patients with hypertension. Determination of MetS may contribute to improving cardiovascular risk stratification in hypertension.