Purpose: Metabolic syndrome is related to increased inflammatory status. Arterial stiffness is an important determinant of cardiovascular performance and a predictor of the corresponding risk. The aim of the present study was to investigate the association of low-grade inflammation with arterial stiffness and wave reflections in hypertensive patients with metabolic syndrome.

Methods: We studied 106 consecutive patients with never treated essential hypertension and metabolic syndrome, defined according to the Adult Treatment Panel III criteria. Arterial stiffness was assessed by measuring carotid-femoral (PWVc-f) and carotid-radial pulse wave velocity (PWVc-r). Heart rate corrected augmentation index (AIx₇₅) was studied as a measure of wave reflections and arterial stiffness. High-sensitivity C-reactive protein (hsCRP), serum amyloid A (SAA) and fibrinogen were measured as inflammatory indices using immunonephelometry.

Results: In univariate analysis, PWVc-f was correlated with both loghsCRP (r=0.28, p=0.003) and fibrinogen (r=0.29, p=0.003) whereas PWVc-r was associated with loghsCRP (r=0.21, p=0.03) and logSAA (r=0.22, p=0.05). No correlation was found between AIx₇₅ and any of the measured biomarkers. After adjustment for several confounders, an independent association was observed between PWVc-f and loghsCRP (β=0.24, p=0.01) and fibrinogen (β=0.16, p=0.04) whereas an independent correlation was also emerged between PWVc-r and loghsCRP (β=0.22, p=0.02).

Conclusion: In hypertensive patients with metabolic syndrome both hsCRP and fibrinogen are related to arterial stiffness but not to wave reflections. This finding elucidates the potential role of inflammation in arterial stiffening in patients with hypertension and metabolic syndrome and may have important clinical implications.