THE ROLE OF OUT-OF-OFFICE BLOOD PRESSURE MEASUREMENTS ON THE DIAGNOSIS OF METABOLIC SYNDROME

Objective: Metabolic syndrome (MetS) is considered as a global epidemic, affecting around one-quarter of people worldwide and being a significant cause of morbidity and mortality. As so, the diagnosis of MetS is crucial, as it allows early intervention and management. Hence, the main aim of this study was to examine any possible BP differences, based on ambulatory BP (ABPM), home BP (HBPM) and office BP (OBPM) measurements, on those with and without MetSa and investigate if any of these measurements better correlate with Mets. Design and method: The study population is consisted of 282 individuals attending the Hypertension Clinic. ABPM, OBPM, HBPM performed in all patients, as well as cardiovascular risk assessment and pulse wave velocity. Results: A total of 282 (39.9% men) subjects, aged 56.8±15.8 years were analysed, 60.8% of the study population had metabolic syndrome according to the IDF criteria. The group with metabolic syndrome had statistically significant higher SBP, in all BP measurements (p<0.05), significantly higher LV hypertrophy prevalence (49.2% vs. 22.7%, p=0.005), ASCVD (9.8 vs. 9, p=0.016) and Framingham risk scores (6.8 vs. 3.7, p=0.002). In the univariate analysis, metabolic syndrome showed significant correlation only with the average 24 h SBP, SBP during daytime and nighttime, the mean office SBP and the average home SBP in the morning (p<0.05). No statistically significant differences were observed for any of the DBP measurements. Finally, 50.5% of metabolic syndrome patients had sustained hypertension, while 15.2% presented masked and 11.5% white coat hypertension. Furthermore, most of the patients presented non-dipping hypertension (56.4%). Conclusions: The results show the importance of out-of-office BP measurements in the diagnosis of Mets, as SBP not only from office but also from out-of –office is a significant determinant and the no importance of DBP. The need of out-of-office measurements are revealed also from the high rates of different phenotypes (masked, white-coat, non-dipping status).