Levels of Systolic and Diastolic Blood Pressure and Their Relation to Incident Metabolic Syndrome

Background: Elevated blood pressure (BP) is a component of the metabolic syndrome (MetS), and one third of individuals with hypertension simultaneously have MetS. However, the evidence is still unclear regarding the predictive ability of BP for incident MetS. Methods: In total, 5,809 Koreans without baseline MetS were grouped by baseline systolic (SBP) and diastolic BP (DBP) and monitored for 10 years to identify incident MetS. A Cox proportional hazards model was used to evaluate the HR and 95% CI for MetS according to SBP and DBP. Subgroup analysis was conducted in the normotensive population based on a new guideline of the American College of Cardiology and the American Heart Association. Results: High-BP groups tended to have worse metabolic profiles than the lowest-BP group in both SBP and DBP categories. In all of the participants, elevated SBP and DBP levels were significantly associated with the increased HR for MetS, even after adjusting for covariates. Subgroup analysis for normotensive participants indicated that the HR for MetS increased proportionally to both SBP (<110 mm Hg: reference, 110-119 mm Hg: HR = 1.60 [95% CI 1.40-1.84], and 120-129 mm Hg: HR = 2.12 [95% CI 1.82-2.48]) and DBP levels (<70 mm Hg: reference, 71-74 mm Hg: HR = 1.31 [95% CI 1.09-1.58], and 75-79 mm Hg: HR = 1.51 [95% CI 1.25-1.81]). Conclusion: The risk of incident MetS increased proportionally to baseline SBP and DBP, and this was identically observed even in normotensive participants.