Each component of the
metabolic syndrome is not necessarily clustered coincidentally. Thus, subjects who have
obesity,
dyslipidemia or
impaired glucose tolerance may be at high risk for the development of
hypertension. We studied the predictive value of the following for the development of
hypertension:
obesity (body mass index > or =25.0 kg/m2),
dyslipidemia (
high-density lipoprotein-cholesterol <40 mg/dL,
triglyceride > or =150 mg/dL, or use of anti-dyslipidemic drugs), high normal blood pressure (130 mmHg < or = systolic <140 mmHg, or 85 mmHg < or = diastolic <90 mmHg), and
impaired glucose tolerance (fasting plasma
glucose > or =110 mg/dL or use of anti-diabetic agents). This observational study included 5,785 subjects without
hypertension recruited from participants in our health checkup program. They were followed up for 1,097+/-365 d, with the endpoint being the development of
hypertension. During the follow-up,
hypertension developed in 1,168 subjects (74.1 per 1,000 person-years). The incidence of
hypertension was higher in subjects who had
obesity (106.2 vs. 67.8),
dyslipidemia (96.1 vs. 69.0), high normal blood pressure (166.0 vs. 40.1), or
impaired glucose tolerance (130.5 vs. 65.3 per 1,000 person-years) than in those without these disorders at baseline. The risk of
hypertension was increased as the number of metabolic disorders in an individual increased. Multiple regression analysis indicated that
obesity, high normal blood pressure, and
impaired glucose tolerance remained independent predictors of the onset of
hypertension. Thus, the presence of individual components of the
metabolic syndrome predicts the development of
hypertension. Prediction of the development of
hypertension may lead to effective prevention of both
hypertension and resulting
cardiovascular diseases.