Presion Arterial

Cardiovascular Diabetology
Original investigation

BioMed Central

Open Access

Blood pressure control and components of the metabolic syndrome: the GOOD survey
Walter Zidek*1, Lisa Naditch-Brûlé2, Stefano Perlini3, Csaba Farsang4 and Sverre E Kjeldsen5
Address: 1Medizinische Klinik IV (Endocrinology and Nephrology), Charité, Berlin, Germany, 2Sanofi Aventis, Paris, France, 3Departmentof Internal Medicine, Fondazione IRCCS San Matteo, Università di Pavia, Pavia, Italy, 4The Cardiometabolic Centre, St Imre Hospital, Budapest, Hungary and 5Department of Cardiology, Ullevaal Hospital, Norway Email: Walter Zidek* - walter.zidek@charite.de; Lisa Naditch-Brûlé - Lisa.Naditch-Brule@sanofi-aventis.com; Stefano Perlini - sperlini@unipv.it; Csaba Farsang - hunghyp@t-online.hu; Sverre EKjeldsen - s.e.kjeldsen@medisin.uio.no * Corresponding author

Published: 15 September 2009 Cardiovascular Diabetology 2009, 8:51 doi:10.1186/1475-2840-8-51

Received: 5 June 2009 Accepted: 15 September 2009

This article is available from: http://www.cardiab.com/content/8/1/51 © 2009 Zidek et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of theCreative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract
Background: The GOOD (Global Cardiometabolic Risk Profile in Patients with Hypertension Disease) survey showed that blood pressure control was significantly worse in hypertensivepatients with metabolic syndrome and/or diabetes mellitus than in those with essential hypertension only. This analysis aimed to investigate which components of the metabolic syndrome are primarily associated with poor blood pressure control. Methods: The GOOD survey was designed as an observational cross-sectional survey in 12 European countries to assess the cardiometabolic risk profile in patientswith essential hypertension. Investigators were randomly selected from a list of general practitioners (70% of investigators) and a list of specialists such as internists, cardiologists and hypertension specialists (30% of investigators). Data from 3,280 outpatients with hypertension, aged at least 30 years who were receiving antihypertensive treatment or had newly diagnosed hypertensionaccording to the European Society of Hypertension and the European Society of Cardiology criteria, were included in the analyses. Blood pressure control, body mass index (BMI), waist circumference, serum triglycerides, total and high density lipoprotein (HDL) cholesterol measurements were compared in patients with diabetes mellitus and metabolic syndrome, with diabetes mellitus only, with metabolicsyndrome only, and with neither metabolic syndrome nor diabetes mellitus. Results: The highest blood pressure values were found in patients with metabolic syndrome with or without diabetes mellitus. Blood pressure was significantly lower in patients with diabetes mellitus only. The highest BMI, waist circumference and serum triglycerides, and the lowest HDL cholesterol levels among the groups studiedoccurred in patients with metabolic syndrome, either with or without diabetes mellitus. Conclusion: Among the components of the metabolic syndrome, it is not impaired glucose tolerance which is associated with the poor response to antihypertensive treatment. Instead, visceral obesity and dyslipidemia components of the metabolic syndrome, i.e. hypertriglyceridemia and low HDL cholesterol levels, areassociated with resistance to antihypertensive treatment.

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Cardiovascular Diabetology 2009, 8:51

http://www.cardiab.com/content/8/1/51

Background
In a previous paper, in which the principal results of the Global Cardiometabolic Risk Profile in Patients with Hypertension Disease (GOOD) survey were reported, the main finding was...