{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T02:16:17Z","timestamp":1784945777791,"version":"3.55.0"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Hypertension is a relevant cardiovascular comorbidity. Adipose tissue represents a metabolically active tissue involved in the regulation of blood pressure and metabolic alterations. In recent decades, several classifications for the metabolic syndrome (MS) have been proposed. Recently, a new syndrome called the \u201cCardiovascular-kidney-metabolic\u201d (CKM) syndrome was identified, to determine patients at high cardiovascular and metabolic risk. The aim of the study was to compare different classifications in a large population of hypertensive patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Between September 2022 and August 2023, we consecutively enrolled 772 hypertensive patients (407 men; 365 women; mean age 52.2\u2009\u00b1\u200915.1 years), evaluating anthropometric, biochemical, and instrumental parameters (transthoracic echocardiogram, carotid echo-Doppler, 24-h ambulatory blood pressure monitoring, fundus oculi).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using different classifications we found MS prevalence: Adult Treatment Panel III (ATP-III) 28.8%, International Diabetes Federation (IDF) 31.5%, CKM 40.7%. CKM Classes 3 and 4 showed higher body mass index and waist circumference compared with other groups. Compared with ATP-III and IDF, CKM Class 4 showed higher 24-h systolic blood pressure, lower percentage of controlled hypertension, increased interventricular septum and posterior wall, reduced ejection fraction, and greater prevalence of hypertensive arterial retinal damage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Visceral obesity and MS are frequent conditions with healthy impact, becoming an important trigger for the development of cardiovascular and metabolic complications. The different MS classifications allow the early identification of patients at high risk of cardiometabolic complications. The new CKM syndrome proves useful to identify individuals at high risk for CKM morbidity and mortality.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2024.1369090","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T13:31:23Z","timestamp":1711632683000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Relevance of obesity-related organ damage and metabolic syndrome classification in cardiovascular and renal risk stratification in patients with essential hypertension"],"prefix":"10.3389","volume":"11","author":[{"given":"Luigi","family":"Petramala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonietta","family":"Gigante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Sarlo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Servello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Circosta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Marino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonello","family":"Ciccarelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Cavallaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Letizia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1874","DOI":"10.1097\/HJH.0000000000003480","article-title":"2023 ESH Guidelines for the management of arterial hypertension the Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA)","volume":"41","author":"Mancia","year":"2023","journal-title":"J Hypertens"},{"key":"B2","doi-asserted-by":"publisher","first-page":"S74","DOI":"10.3109\/07853890.2012.663928","article-title":"Obesity-related hypertension: epidemiology, pathophysiology, treatments, and the contribution of perivascular adipose tissue","volume":"44","author":"Aghamohammadzadeh","year":"2012","journal-title":"Ann Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"48","DOI":"10.7326\/0003-4819-67-1-48","article-title":"The relation of adiposity to blood pressure and development of hypertension","volume":"67","author":"Kannel","year":"1967","journal-title":"Ann Intern Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fcvm.2023.1187735","article-title":"Visceral adipose tissue and residual cardiovascular risk: a pathological link and new therapeutic options","volume":"10","author":"Cesaro","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1661","DOI":"10.1161\/CIRCULATIONAHA.108.821181","article-title":"Local inflammation and hypoxia abolish the protective anticontractile properties of perivascular fat in obese patients","volume":"119","author":"Greenstein","year":"2009","journal-title":"Circulation"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0248716","article-title":"Expression of adipocytokines in heart fat depots depending on the degree of coronary artery atherosclerosis in patients with coronary artery disease","volume":"16","author":"Gruzdeva","year":"2021","journal-title":"PLoS One"},{"key":"B7","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1159\/000488829","article-title":"Metabolic syndrome severity and risk of CKD and worsened GFR: the Jackson heart study","volume":"43","author":"Deboer","year":"2018","journal-title":"Kidney Blood Press Res"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1016\/S0140-6736(05)67402-8","article-title":"The metabolic syndrome\u2014a new worldwide definition","volume":"366","author":"Alberti","year":"2005","journal-title":"Lancet"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; 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