Different Impact of the Metabolic Syndrome on Left Ventricular Structure and Function in Hypertensive Men and Women

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Abstract
Metabolic syndrome (MS) is increasingly recognized as an important cardiovascular risk factor in hypertension, but its influence on left ventricular (LV) mass and function in the 2 genders has not been specifically addressed. Among 618 nondiabetic, untreated hypertensive subjects, echocardiographically detected LV mass was significantly greater in subjects with MS. A significant interaction was observed between sex and the MS ( P −2.7 ; P −2.7 ; P =0.003). A greater prevalence of LV hypertrophy was found in women (37% versus 14%; P P =0.09) with the MS. After adjustment for the effect of age, body mass index, 24-hour systolic blood pressure, and several confounders, the MS was independently associated with a greater LV mass index in women (regression coefficient, 4.80; P P =0.004) and a depressed afterload-corrected midwall fractional shortening (94.0±12% versus 101.0±13%; P <0.001) than women without the syndrome, whereas no differences emerged in men. We conclude that, in untreated hypertension, MS has a different impact on LV hypertrophy and function in men and women. The effect of MS is more pronounced in women and is partly independent from the effect of several hemodynamic and nonhemodynamic determinants of LV mass.