Mean and yearly changes in blood pressure with age in the metabolic syndrome: the DESIR study

Abstract

Systolic and diastolic blood pressure (SBP; DBP) increase with age, but after 45 years of age, the yearly change in DBP (ΔDBP) tends to be smaller in comparison with the yearly change in SBP (ΔSBP), which increases with age. The effect of the metabolic syndrome (MetS) on this yearly change has never been explored. In a 9-year longitudinal cohort Data from an Epidemiologic Study on the Insulin Resistance syndrome (DESIR) study, we examined 1308 men and 1325 women, aged 30-65 years, who had never been treated for hypertension. SBP and DBP were measured at four examinations 3 years apart, and pulse pressure (PP) and yearly changes (ΔSBP, ΔDBP and ΔPP) were calculated. SBP and PP increased with age to a higher degree in patients with the MetS. In men and women with the MetS, DBP remained nearly constant, but in those without the MetS, DBP increased. After adjusting for baseline values, ΔSBP and ΔPP increased by 0.5 mm Hg per year for every additional 10 years from baseline. These correlations with age were similar for men and women, and the yearly change was always higher than in those with the MetS. In contrast, ΔDBP increased very slowly until 50 years of age and then decreased similarly for those with and without the MetS. The increase in PP with age, a marker of vascular aging, was determined to begin earlier in the present study than has been shown in the past, and the MetS amplified this effect. This new aspect of the MetS might modify clinical management leading to earlier drug treatment, particularly in regard to both endothelial dysfunction and increased arterial stiffness.