Abstract
A new guideline on metabolic syndrome (MS) in Japanese was introduced in 2005. The purpose of this study was to evaluate the prevalence and lifestyle characteristics of Japanese hypertensive patients with MS. Subjects were 290 patients (mean age: 64±11 years) who had been followed at our hospital. The waist circumference (WC) and body mass index (BMI) were assessed. Subjects who had BMI ≥25 kg/m2 were defined as having BMI obesity, while abdominal obesity was defined as a WC ≥85 cm in men and ≥90 cm in women, respectively. Since all patients had hypertension, the definition of MS was made when the patient had abdominal obesity plus either dyslipidemia or glucose intolerance, or both. Among the subjects, 230 patients underwent 24-h home urine collection to measure urinary salt and potassium excretions. Dietary habits were also assessed by use of a questionnaire. Mean values of BMI and WC were 24.2±3.4 kg/m2 and 87.1±9.6 cm, respectively. Among the total subject group, 39% patients were classified as having BMI obesity, 49% as having abdominal obesity, and 27% as having MS. BMI was significantly correlated with WC both in men (r=0.86; p<0.01) and in women (r=0.79; p<0.01). More men than women belonged to the BMI obesity (46% vs. 33%, p<0.05), abdominal obesity (63% vs. 39%, p<0.01) and MS (39% vs. 18%, p<0.01) groups. There were no significant differences in blood pressure between patients with and without MS, while patients with MS needed a greater number of antihypertensive drugs than those without MS. Mean urinary salt and potassium excretions were 8.9±3.8 g/day and 1.9±0.7 g/day, respectively. Urinary salt excretion of <6 g (100 mmol of sodium)/day was achieved in 20% of the subjects. Urinary salt excretion in the patients with MS was significantly higher than that in the patients without (10.1±4.2 vs. 8.5±3.6 g/day; p<0.01). Only 16% of the patients with MS achieved salt restriction (<6 g/day). The patients with MS had a significantly greater the chance to eat out than the patients without MS. They were also less aware of the need to increase their vegetable consumption. The results suggested that MS is prevalent in Japanese hypertensive patients. Patients with MS showed higher urinary salt excretion and needed more antihypertensive drugs to manage their blood pressure. Dietary counseling focusing not only on sodium restriction but also on the need to increase fruit and vegetable consumption seems to be important.
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Kubo M, Kiyohara Y, Kato I, et al: Trends in the incidence, mortality, and survival rate of cardiovascular disease in a Japanese community: Hisayama study. Stroke 2003; 34: 2349–2354.
National Cholesterol Education Program (NCEP) Expert Panel : Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002; 106: 3143–3421.
Alberti KG, Zimmet PZ, for the WHO Consultation : Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998; 15: 539–553.
Committee to Evaluate Diagnostic Standards for Metabolic Syndrome : Definition and the diagnostic standard for metabolic syndrome. Nippon Naika Gakkai Zassi 2005; 94: 794–809 ( in Japanese).
Solymoss BC, Bourassa MG, Campeau L, et al: Effect of increasing metabolic syndrome score on atherosclerotic risk profile and coronary artery disease angiographic severity. Am J Cardiol 2004; 93: 159–164.
Lakka HM, Laaksonen DE, Lakka TA, et al: The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002; 288: 2709–2716.
Laaksonen DE, Lakka HM, Niskanen LK, Kaplan GA, Salonen JT, Lakka TA : Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am J Epidemiol 2002; 156: 1070–1077.
Isomaa B, Almgren P, Tuomi T, et al: Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683–689.
Malik S, Wong ND, Franklin SS, et al: Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults. Circulation 2004; 110: 1245–1250.
Takeuchi H, Saitoh S, Takagi S, et al: Metabolic syndrome and cardiac disease in Japanese men: applicability of the concept of metabolic syndrome defined by the National Cholesterol Education Program–Adult Treatment Panel III to Japanese Men—the Tanno and Sobetsu Study. Hypertens Res 2005; 28: 203–208.
Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi T, Azizi F : Beneficial effect of a dietary approaches to stop hypertension eating plan on features of the metabolic syndrome. Diabetes Care 2005; 28: 2823–2831.
Ford ES, Giles WH, Dietz WH : Prevalence of the metabolic syndrome among US adults: findings from the third national health and nutrition examination survey. JAMA 2002; 287: 356–359.
Grundy SM, Cleeman JI, Daniels SR, et al: Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Executive summary. Circulation 2005; 112: 2735–2740.
Ministry of Health, Labour and Welfare, Labour : The National Nutrition Survey in Japan, 2002. Tokyo, Dai-ichi Shuppan Press, 2004, p 182.
Ministry of Health, Labour and Welfare, Japan : Brachial-ankle pulse wave velocity and metabolic syndrome in a Japanese population: the Minoh study. Hypertens Res 2005; 28: 125–131.
Császar A, Kékes E, Abel T, Papp R, Kiss I, Balogh S : Prevalence of metabolic syndrome estimated by international diabetes federation criteria in a Hungarian population. Blood Press 2006; 15: 101–106.
Aizawa Y, Kamimura N, Watanabe H, et al: Cardiovascular risk factors are really linked in the metabolic syndrome: this phenomenon suggests clustering rather than coincidence. Int J Cardiol 2006; 109: 213–218.
Miyatake N, Kawasaki Y, Nishikawa H, Takenami S, Numata T : Prevalence of metabolic syndrome in Okayama prefecture, Japan. Intern Med 2006; 45: 107–108.
The Examination Committee of Criteria for ‘Obesity Disease’ in Japan, Society for the Study of Obesity : New criteria for ‘obesity disease’ in Japan. Circ J 2002; 66: 987–992.
Saito I, Murata K, Hirose H, Tsujioka M, Kawabe H : Relation between blood pressure control, body mass index, and intensity of medical treatment. Hypertens Res 2003; 26: 711–715.
Modan M, Almog S, Fuchs Z, Chetrit A, Lusky A, Halkin H : Obesity, glucose intolerance, hyperinsulinemia, and response to antihypertensive drugs. Hypertension 1991; 17: 565–573.
Ohta Y, Tsuchihashi T, Ueno M, et al: Relationship between the awareness of salt restriction and the actual salt intake in hypertensive patients. Hypertens Res 2004; 27: 243–246.
Ohta Y, Tsuchihashi T, Onaka U, Eto K, Tominaga M, Ueno M : Long-term compliance of salt restriction in Japanese hypertensive patients. Hypertens Res 2005; 28: 953–957.
Uzu T, Kimura G, Yamauchi A, et al: Enhanced sodium sensitivity and disturbed circadian rhythm of blood pressure in essential hypertension. J Hypertens 2006; 24: 1627–1632.
Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi F : Dairy consumption is inversely associated with the prevalence of the metabolic syndrome in Tehranian adults. Am J Clin Nutr 2005; 82: 523–530.
Vessby B : Dietary fat and insulin action in humans. Br J Nutr 2000; 83: S91–S96.
Connor WE : Importance of n-3 fatty acids in health and disease. Am J Clin Nutr 2000; 71: S171–S175.
Esposito K, Marfella R, Ciotola M, et al: Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 2004; 292: 1440–1446.
Riccardi G, Rivellese AA : Dietary treatment of the metabolic syndrome—the optimal diet. Br J Nutr 2000; 83: S143–S148.
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Ohta, Y., Tsuchihashi, T., Arakawa, K. et al. Prevalence and Lifestyle Characteristics of Hypertensive Patients with Metabolic Syndrome Followed at an Outpatient Clinic in Fukuoka, Japan. Hypertens Res 30, 1077–1082 (2007). https://doi.org/10.1291/hypres.30.1077
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DOI: https://doi.org/10.1291/hypres.30.1077
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