Abstract

Hypertension as a part of the chronic metabolic syndrome has a multiplicative and devastating cardiovascular risk effect that advises an aggressive intervention over all the risk factors in order to preserve the amount and quality of life in this high-risk population. 23 patients with hypertension, type 2 diabetes, dislipemia and central obesity (Chronic Metabolic Syndrome) had macrovascular affectation as consequence of a poor control over their diseases (see below table) secondary to lack of treatment adherence and sub-optimal selection of the available therapeutic options following the JNC-VI, WHO/ISH; ADA recommendations. None of them where receiving ARA-II, biguanides or statins. Medium age was 62,4 years (+/- 9,3), hypertension was known for 9,9 years (+/- 2,36) and diabetes for 8,1 years (+/- 3,2). All received educative interventions by the nurses plus candesartan 16 mgr per day, metformin 850 mgr twice a day and pravastatin 20 mgr per day. The high prevalence of non-compliance with diet, exercise and other healthy non-pharmacological interventions supports the intensive drug therapy in this high-risk patient's subpopulation. Associating candesartan as the second or third antihipertensive drug permits to control the blood pressure fulfilling the ADA, WHO and JNC-VI criteria. The pravastatin and butformin association significatively improves the lipids profile, atherogenic index and the abnormalities of the coagulation/fibrinolytic system that predispose to a procoagulant state.

Baseline StdFollow-up Stdt-test
HbA1c (%)8.571.938.211.78n.s.
BMI32.74.8132.814.18n.s.
SBP (mm Hg)155.7814.36134.0613.560.0029
DBP (mm Hg)88.6810.5271.568.100.0000
Triglycerides (mg/dL)155.3766.74140.6354.96n.s.
T-chol (mg/dL)252.5240.88215.0826.870.0300
HDL (mg/dL)49.0511.6150.3810.770.0902
LDL (mg/dL)166.3629.82133.2727.180.0392
T-c/HDL5.401.614.460.940.0062
LDL/HDL3.601.422.830.920.0133
Fibrinogen (mg/dL)383.6276.93335.7352.64n.s.
Leukocytes8,4262,0747,0901,3850.0836
Platelets 10*3238.466.4194.544.10.0609
Baseline StdFollow-up Stdt-test
HbA1c (%)8.571.938.211.78n.s.
BMI32.74.8132.814.18n.s.
SBP (mm Hg)155.7814.36134.0613.560.0029
DBP (mm Hg)88.6810.5271.568.100.0000
Triglycerides (mg/dL)155.3766.74140.6354.96n.s.
T-chol (mg/dL)252.5240.88215.0826.870.0300
HDL (mg/dL)49.0511.6150.3810.770.0902
LDL (mg/dL)166.3629.82133.2727.180.0392
T-c/HDL5.401.614.460.940.0062
LDL/HDL3.601.422.830.920.0133
Fibrinogen (mg/dL)383.6276.93335.7352.64n.s.
Leukocytes8,4262,0747,0901,3850.0836
Platelets 10*3238.466.4194.544.10.0609
Baseline StdFollow-up Stdt-test
HbA1c (%)8.571.938.211.78n.s.
BMI32.74.8132.814.18n.s.
SBP (mm Hg)155.7814.36134.0613.560.0029
DBP (mm Hg)88.6810.5271.568.100.0000
Triglycerides (mg/dL)155.3766.74140.6354.96n.s.
T-chol (mg/dL)252.5240.88215.0826.870.0300
HDL (mg/dL)49.0511.6150.3810.770.0902
LDL (mg/dL)166.3629.82133.2727.180.0392
T-c/HDL5.401.614.460.940.0062
LDL/HDL3.601.422.830.920.0133
Fibrinogen (mg/dL)383.6276.93335.7352.64n.s.
Leukocytes8,4262,0747,0901,3850.0836
Platelets 10*3238.466.4194.544.10.0609
Baseline StdFollow-up Stdt-test
HbA1c (%)8.571.938.211.78n.s.
BMI32.74.8132.814.18n.s.
SBP (mm Hg)155.7814.36134.0613.560.0029
DBP (mm Hg)88.6810.5271.568.100.0000
Triglycerides (mg/dL)155.3766.74140.6354.96n.s.
T-chol (mg/dL)252.5240.88215.0826.870.0300
HDL (mg/dL)49.0511.6150.3810.770.0902
LDL (mg/dL)166.3629.82133.2727.180.0392
T-c/HDL5.401.614.460.940.0062
LDL/HDL3.601.422.830.920.0133
Fibrinogen (mg/dL)383.6276.93335.7352.64n.s.
Leukocytes8,4262,0747,0901,3850.0836
Platelets 10*3238.466.4194.544.10.0609

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