Cardiovascular Risk in Patients with Prehypertension and the Metabolic Syndrome

  • Sergey Kachur
  • Rebecca Morera
  • Alban De Schutter
  • Carl J. Lavie
Hypertension and the Kidney (RM Carey, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Hypertension and the Kidney


Prehypertension (pHTN) and metabolic syndrome (MetS) are both lifestyle diseases that are potentiated by increased adiposity, as both disease processes are closely related to weight. In the case of pHTN, increased adiposity causes dysregulation of the renin-angiotensin-aldosterone-system (RAAS) as well as adipokine- and leptin-associated increases in adrenergic tone. In MetS, excess weight potentiates hyperglycemia and insulin resistance which causes positive feedback into the RAAS system, activates an inflammatory cascade that potentiates atherosclerosis, and causes lipid dysregulation which together contribute to cardiovascular disease, especially coronary heart disease (CHD) and heart failure (HF). The relationship with all-cause mortality is not as clear-cut in part because of some protective effects associated with the obesity paradox in chronic diseases such as CHD and HF. However, in healthy populations, the absence of excess weight and its associated effects on prehypertension and MetS are associated with a longer absolute and disease-free lifespan.


Metabolic syndrome Obesity Prehypertension Heart failure Insulin resistance 



Body mass index


Blood pressure


Coronary heart disease


Cardiovascular disease


Diastolic blood pressure


European Society of Hypertension


European Society of Cardiology


Free fatty acid


Heart failure






Insulin resistance


Joint National Committee


Left ventricle/ventricular


The metabolic syndrome


National Cholesterol Education Program


National Health and Nutrition Examination Survey


Nitric oxide


Renin-angiotensin-aldosterone system


Reactive oxygen species


The Reasons for Geographic and Racial Differences in Stroke Study


Systolic blood pressure


Waist circumference


Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Sergey Kachur
    • 1
  • Rebecca Morera
    • 1
  • Alban De Schutter
    • 2
  • Carl J. Lavie
    • 3
  1. 1.Department of Graduate Medical EducationOcala Regional Medical CenterOcalaUSA
  2. 2.New York University School of MedicineNew YorkUSA
  3. 3.Department of Cardiovascular Diseases, John Ochsner Heart and Vascular InstituteOchsner Clinic School-the University of Queensland School of MedicineNew OrleansUSA

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