The metabolic syndrome in hypertensive and normotensive subjects: the Isfahan Healthy Heart Programme

There are numerous correlations between hypertension and the metabolic syndrome, although this is not always the case. The objective of this study was to compare the prevalence of the metabolic syndrome and its different phenotypes among hypertensive and normotensive subjects. This cross-sectional study was performed on a representative sample of adults living in 3 cities in Iran. Among the 12,514 subjects selected by multi-stage random sampling, 1736 (13.9%) were hypertensive. The prevalence of the metabolic syndrome [according to the Adult Treatment Panel (ATP) III criteria] was significantly higher in hypertensive than normotensive subjects (51.6% versus 12.9%, respectively; OR, 7.15; 95% CI, 6.4 to 7.9). The metabolic syndrome was more prevalent in normotensive and hypertensive subjects living in urban areas than those living in rural areas (14.2% and 53.9% versus 9.5% and 45.6%, respectively, P < 0.05). The mean age of hypertensive subjects, with or without the metabolic syndrome, was not significantly different (55.7 +/- 12 years versus 55.4 +/- 15.5 years, P = 0.6). Hypertension with the metabolic syndrome was more prevalent in women than men (72% versus 28% respectively, P < 0.000), and in subjects living in urban areas than those in rural areas (75.1% versus 24.9%, respectively, P = 0.002). The findings of this study indicate the need for metabolic screening in all hypertensive patients, and emphasise the importance of promoting primary and secondary prevention of high blood pressure and associated modifiable risk factors in order to counter the upcoming epidemic of non-communicable disease in developing countries.