Background and Aims:
Metabolic syndrome (MetS) is a multi-complex risk of stroke and cardiovascular disease. Hypertension with MetS had at least three- folds higher risk for developed stroke. Most of the previous studies examined MetS in obese, few studies in none-obese, but not in a population of hypertension. We determined the prevalence of MetS and metabolic components in normal weight (BMI < 23.0 kg/m2) hypertension.

Methods:
Among 1,461 hypertensions attended 11 rural health care units in southern Thailand, 571 (39%) were normal weight. Data were obtained by structure interview, medical records, and by measurements of anthropometric, blood pressure, fasting plasma glucose, and lipid profiles. MetS was defined according to NCEP-ATP III criteria. Weight circumference was defined based on NCEP-APC criteria, a cut-off points of 80 cm in women and 90 cm in men indicated abdominal obesity.

Results:
Prevalence of MetS was 54.8% in normal weight hypertension. Components of MetS were hypertension co-existed with hypertriglyceridemia (47.8%), HDL (47.3%), hyperglycemia (42.6%), and abdominal obesity (33.6%). All of these components were significantly attributed of MetS. Based on logistic Wald values, MetS was strongly attributed by low HDL (Wald 190.52, RR 27.99, 95%CI 17.44-44.94), hypertriglyceridemia (Wald 183.81, RR 22.41, 95%CI 14.30-35.14), abdominal obesity (Wald 70.18, RR 4.81, 95%CI 3.33- 6.95), and hyperglycemia (Wald 70.81, RR 4.81, 95%CI 3.33-6.95), respectively.

Conclusions:
Over a half of normal weight hypertension had MetS. Common co-existed components were low HDL, hypertriglyceridemia, and hyperglycemia. This finding warrants further research explored cardiovascular event in this patient group, and clinical practice to prevent MetS in normal weight person.

METABOLIC SYNDROME AS A COMMON RISK FOR STROKE IN NORMAL WEIGHT HYPERTENSION: A MULTI-SITE SURVEY FROM 11 PRIMARY CARE SETTINGS IN THAILAND