Background: Arterial hypertension (AH), metabolic syndrome (MS) and diabetes mellitus type 2 (DM2) are interrelated metabolic disorders. The aim of our study was to evaluate how the coexistence of MS or DM2 with AH influences arterial reactivity during cold pressor test (CPT). Methods: We studied 102 patients, 32 with AH (Group A), 38 with AH and MS (Group B) and 32 with AH and DM2 (Group C). All patients underwent full laboratory evaluation and measurement of systolic and diastolic blood pressure (SBP and DBP), heart rate (HR) and carotid-femoral pulse wave velocity (PWVc-f) before and during CPT. Results: During CPT PWVc-f, SBP, DBP and HR were increased significantly in all studied groups, but the change of PWVc-f and HR during CPT was significantly greater in group A compared to group C. On the contrary, the coexistence of MS or DM2 with AH does not alter the response of BP to CPT. Conclusion: The increase of CV risk resulting from the coexistence of MS or DM2 with AH, is best expressed by PWVc-f, while the change of the former and HR during CPT possibly reflects dysfunction of the autonomic nervous system. 1. Introduction Cardiovascular disease (CVD) is the principal cause of death globally [1], and arterial hypertension (AH) is the most common and the most serious cardiovascular (CV) risk factor. ΑΗ usually coexists with metabolic disorders, such as metabolic syndrome (MS) and diabetes mellitus type 2 (DM2). AH is one of the diagnostic criteria of MS; the prognostic value of the existence of MS in patients with AH is significant. PIUMA study [2], PAMELA study [3], and the study of Pierdomenico et al. [4] showed that MS is an independent risk factor of coronary disease and stroke in patients with essential AH without obvious CVD. Furthermore, AH occurs twice as often in diabetics than the general population. The prevalence of AH in DM patients reaches up to 70–80% [5]. When these two entities coexist, the risk of stroke or CVD (coronary heart disease, cardiac failure, peripheral arterial disease), increases 5 to 6 times compared to hypertensives without DM2. Large artery stiffness is an independent prognostic factor of both total and CV mortality. The gold standard for evaluating arterial stiffness is pulse wave velocity (PWV) [6], which has been shown to predict CV risk [7]. Specifically, PWV has been established as a powerful and independent prognostic factor of CVD and mortality, especially in patients with end stage kidney disease [8], AH [7], DM2 [9], in the elderly [10], but also in the general population [11], independently of confounding
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