Metabolic syndrome in relation to structure and function of large arteries:: A predominant effect of blood pressure -: A report from the SU.VI.MAX. vascular study

Background: Metabolic syndrome (MetS) is associated with increased risk of cardiovascular disease. However, the contribution of MetS to intermediate cardiovascular endpoints such as structure and function alterations of large arteries is still unclear. Methods: A total of 917 middle-aged French men and women participating to the SUpplementation en VItamines et Mineraux AntioXydants (SU.VI.MAX) Vascular study were included. Carotid-femoral pulse wave velocity was used to assess aortic stiffness. Carotid ultrasound examination included measurements (at sites free of plaques) of intima-media thickness (IMT) at the common carotid arteries (CCA) and assessment of atherosclerotic plaques in the extracranial carotid arteries. Results: Prevalence of the MetS defined by the National Cholesterol Education Program was 8.7%. Compared with subjects without MetS, subjects with MetS had significant higher mean values of CCA-IMT (P = .02) and pulse wave velocity (P = .0001). We found that MetS was not significantly related to the presence of carotid plaques. Blood pressure was the only MetS component associated with all vascular parameters. Addition of other MetS components in the multivariate models contributed poorly to the explained variance of these parameters. Conclusions: The MetS is adversely associated with markers of early arterial dysfunction, such as CCA-IMT and arterial stiffness. Although the associations between MetS and these arterial parameters are related to insulin resistance, blood pressure was shown to be the most important MetS component in relation to structure and function of large arteries.