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We sought to determine the prognostic significance of the metabolic syndrome in hypertension.

Increased cardiovascular risk in hypertensive patients might be partially attributable to metabolic disturbances.

We prospectively followed for up to 10.5 years (mean 4.1 years) a total of 1,742 hypertensive patients without cardiovascular disease (55% men; blood pressure [BP] 154/95 mm Hg; age 50 ± 12 years). A modified National Cholesterol Education Program definition for metabolic syndrome was used, with body mass index in place of waist circumference.

During follow-up, 162 patients developed cardiovascular events (2.28 events/100 patient-years). Event rates in the groups with one to five characteristics of the metabolic syndrome were 1.54, 1.96, 2.97, 3.35, and 5.27 per 100 patient-years, respectively (p < 0.001). A total of 593 patients (34%) had the metabolic syndrome …