OBJECTIVETo study the clinical characteristics of hypertensive subjects with metabolic syndrome and its components in communities.

METHODSTotally 5628 subjects aged over 20 years were included. Measurement indicators included height, weight, waist circumference (W) , hip circumference, systolic pressure (SP) , diastolic pressure (DP) , total cholesterol ( TC) , triglyceride (TG) , high-density lipoprotein cholesterol (HDL-C) , low-density lipoprotein cholesterol (LDL-C) , fasting plasma glucose (FPG) , 2 h postprandial plasma glucose (2hPG) , fasting serum insulin (FIN) , and 2 h postprandial serum insulin (2hIN). Body mass index (BMI) , waist to hip ratio (WHR), and homeostatic model approach-insulin resistance index (HOMA-IR) were calculated. According to 1999 WHO definition of metabolic syndrome, these individuals were divided into 4 groups: non-metabolic disorder group, isolated hypertension group, hypertension with one component of metabolic syndrome group, hypertension with two components of metabolic syndrome group, and hypertension with three components of metabolic syndrome group.

RESULTSAmong subjects with hypertension, 15. 37% were patients with isolated hypertension, 32. 40% with one component of metabolic syndrome, 33. 36% with two components of metabolic syndrome, and 18. 87% with three components of metabolic syndrome. BMI, W, WHR, TC, TG, LDL-C, FPG, 2hPG, FIN, 2hIN and HOMA-IR in three groups (hypertension with one component of metabolic syndrome group, hypertension with two components of metabolic syndrome group, and hypertension with three components of metabolic syndrome group) significantly increased than those in isolated hypertension group (P < 0. 01 ). The hypertensive patients showed a higher insulin resistance, despite other metabolic disorders. Furthermore, the hypertensive patients with more components of metabolic syndrome showed a higher chance to get insulin resistance. Multiple stepwise regression analysis showed FPG, 2hPG, FIN, 2hIN, BMI, SP and TC were risk factors of HOMA-IR.

CONCLUSIONSPatients with isolated hypertension are rare in community-based population. About 85% of hypertensive patients have more than one metabolic disorders, more than half of were metabolic syndrome. The percentage of total body fat, levels of plasma glucose, serum insulin, total cholesterol and systolic blood pressure are independent risk factors of insulin resistance.