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Analysis of antihypertensive drugs used of elderly hypertension in Beijing
Abstracts
Objective: To analyze the clinical characteristics of PA patients. Methods: 330 cases of PA from January 2006 to March 2010 in the Hypertension Department of the People's Hospital of Xinjiang Uygur autonomous region were recruited in the retrospective study. The characteristics of blood pressure and serum potassium were analyzed. Results: The common symptoms of patients with PA were hypertension (100%), headache (36.67%), dizziness (33.94%), palpitation (4.85%), and limb fatigue (4.24%). The prevalence of 1, 2 and 3 stage hypertension in these subjects was 3.64%, 20.91% and 75.45%, respectively. Of all PA patients, 89.09% were young adults and 81.82% were overweight and obese. There were more male patients with PA in the overweight and obese groups compared with that of normal weight groups (χ 2 = 22.82, P b 0.001). The incidence of hypokalemia was 32.12%. The concentration of serum potassium was not associated with the course (r = − 0.084, P N 0.05). Logistic regression showed that the concentration of plasma aldosterone was the independent risk factors of hypokalemia in PA patients (beta = 0.067, P b 0.001). The aldosterone-torenin activity ratio (ARR) was N20 in 94.24% of the patients with PA. Conclusions: The incidence of PA patients with hypokalemia is low. It is important to screen PA in moderate to severe hypertension of young adults with or without hypokalemia, in particular for males who are overweight and obese. ARR N 20 is a practical index for screening PA, which will help to reduce the rate of missed diagnosis of PA.
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Epidemiology of Hypertension and Metabolic Disorders 0014 Analysis of antihypertensive drugs used of elderly hypertension in Beijing LINA MA, ZHE TANG, XIAOLING ZHANG, SHAOCHEN GUAN Xuanwu Hospital, Beijing, China Objective: To analyze the trend of antihypertensive drugs used by elderly residents with hypertension in Beijing. Methods: A group of 2832, 1828, and 2277 elderly residents aged ≥60 in Beijing were chosen into this study in the year 2000, 2004, and 2007 by well-established statistical sampling techniques such as cluster, stratification and random selection, and trend of antihypertensive drugs used by elderly residents with hypertension was analyzed by χ2 analysis. Results: The proportion of CCB, ACEI, diuretics and β-RB increased, whereas that of compound reserpine decreased. Conclusion: The aim of hypertension treatment is not only to lower blood pressure, but also to decrease the complication, so as to improve the quality of life of people with hypertension. doi:10.1016/j.ijcard.2011.08.581 0017 Cardiac structure and function in relation to central blood pressure components in Chinese
doi:10.1016/j.ijcard.2011.08.579 0302 Comparison of diagnostic accuracy of catecholamine metabolite detection for diagnosis of pheochromocytoma SHENGNENG XUEa, JUAN LEIb, SHAOLING ZHANGa a Department of Endocrine Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China b Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China Objective: The comparison of the diagnostic accuracy of catecholamine metabolite detection for the diagnosis of pheochromocytoma. Methods: From 2005 to 2009, 340 cases (45 cases of pheochromocytoma, 111 cases of adrenal cortical adenoma, 145 patients with primary hypertension and 39 healthy subjects) were chosen to measure their 24-h urine vanillylmandelic acid (VMA), 5h urine VMA/Cr, normetanephrine (NMN) and metanephrine (MN) in blood and urine. Results: (1) The sensitivity of 24-h urine VMA in diagnosing pheochromocytoma was only 73.3%, which was lower than that of the blood NMN + MN, urinary NMN + MN and the joint detection of blood and urine NMN + MN (P b 0.05). The specificity of 5 h urine VMA/Cr in diagnosing pheochromocytoma was 84.1%, which was lower than that of the 24-h urine VMA, blood NMN + MN, urinary NMN + MN and the joint detection of blood and urine NMN + MN (P b 0.01). (2) Paired χ2 tests showed that the positive rate of urinary NMN + MN was higher than that of the 24-h urine VMA in diagnosing pheochromocytoma (χ2 = 9.091, P = 0.003). (3) The areas under the ROC curve of 24-h urine VMA, 5-h urine VMA/Cr, blood NMN + MN and urine NMN + MN were 0.884, 0.923, 0.972 and 0.985, respectively. Conclusions: Both the sensitivity and specificity of blood NMN+ MN and urine NMN + MN are high in diagnosing pheochromocytoma. They are ideal detection methods of pheochromocytoma in clinic. The diagnostic accuracy will be improved if the joint detection was done.
doi:10.1016/j.ijcard.2011.08.580
YI ZHANG, YAN LI, FENGHUA DING, CHANGSHENG SHENG, QIFANG HUANG, JIGUANG WANG Shanghai Institute of Hypertension, Shanghai, China Objective: Data are limited with regard to the association of central blood pressure components with cardiac structure and function. Methods: Our study was conducted in the framework of cardiovascular health examinations for the current and retired employees of a factory and their family members. We measured central blood pressures by SphygmoCor and cardiac structure and function by echocardiography. Results: The 826 participants (mean age: 43.0 years) included 285 (34.5%) women and 184 (22.3%) hypertensive patients, of whom 78 (42.4%) took antihypertensive drugs. After adjustment for age, gender, body weight, body height, antihypertensive treatment, current smoking and alcohol intake, left atrial volume (LAV) and left ventricular mass (LVM) were significantly associated with central blood pressure components (r: 0.09 to 0.21, P≤0.01), whereas left ventricular diastolic dysfunction, evaluated by E/A ratio and deceleration time of E wave (DTE), was only significantly associated with central systolic blood pressure (SBP, r=0.16 and r=0.14, Pb 0.001). Furthermore, in regression models with similar adjustments, with 1-SD increase in central SBP (16.7 mmHg), E/A ratio significantly decreased by 5.5±1.2 % and DTE significantly increased by 4.66±1.22 ms (Pb 0.001 for both). Sensitivity analyses in men and women separately and after exclusion of patients on antihypertensive medication were confirmatory. Conclusion: Cardiac structure was significantly and comparably associated with central blood pressure components, but left ventricular diastolic dysfunction was only significantly associated with central SBP. doi:10.1016/j.ijcard.2011.08.582 0022 Comparison of knowledge and understanding about hypertension in patients with controlled and uncontrolled hypertension: A multicenter study AYSHA ALMAS, SANIYA SERAJ, HALIMA TABANI, SAIMA LALANI, ZEHRA AZIZ SAMNI Aga Khan University, Karachi, Pakistan
Objective: To analyze the clinical characteristics of PA patients. Methods: 330 cases of PA from January 2006 to March 2010 in the Hypertension Department of the People's Hospital of Xinjiang Uygur autonomous region were recruited in the retrospective study. The characteristics of blood pressure and serum potassium were analyzed. Results: The common symptoms of patients with PA were hypertension (100%), headache (36.67%), dizziness (33.94%), palpitation (4.85%), and limb fatigue (4.24%). The prevalence of 1, 2 and 3 stage hypertension in these subjects was 3.64%, 20.91% and 75.45%, respectively. Of all PA patients, 89.09% were young adults and 81.82% were overweight and obese. There were more male patients with PA in the overweight and obese groups compared with that of normal weight groups (χ 2 = 22.82, P b 0.001). The incidence of hypokalemia was 32.12%. The concentration of serum potassium was not associated with the course (r = − 0.084, P N 0.05). Logistic regression showed that the concentration of plasma aldosterone was the independent risk factors of hypokalemia in PA patients (beta = 0.067, P b 0.001). The aldosterone-torenin activity ratio (ARR) was N20 in 94.24% of the patients with PA. Conclusions: The incidence of PA patients with hypokalemia is low. It is important to screen PA in moderate to severe hypertension of young adults with or without hypokalemia, in particular for males who are overweight and obese. ARR N 20 is a practical index for screening PA, which will help to reduce the rate of missed diagnosis of PA.
S35
Epidemiology of Hypertension and Metabolic Disorders 0014 Analysis of antihypertensive drugs used of elderly hypertension in Beijing LINA MA, ZHE TANG, XIAOLING ZHANG, SHAOCHEN GUAN Xuanwu Hospital, Beijing, China Objective: To analyze the trend of antihypertensive drugs used by elderly residents with hypertension in Beijing. Methods: A group of 2832, 1828, and 2277 elderly residents aged ≥60 in Beijing were chosen into this study in the year 2000, 2004, and 2007 by well-established statistical sampling techniques such as cluster, stratification and random selection, and trend of antihypertensive drugs used by elderly residents with hypertension was analyzed by χ2 analysis. Results: The proportion of CCB, ACEI, diuretics and β-RB increased, whereas that of compound reserpine decreased. Conclusion: The aim of hypertension treatment is not only to lower blood pressure, but also to decrease the complication, so as to improve the quality of life of people with hypertension. doi:10.1016/j.ijcard.2011.08.581 0017 Cardiac structure and function in relation to central blood pressure components in Chinese
doi:10.1016/j.ijcard.2011.08.579 0302 Comparison of diagnostic accuracy of catecholamine metabolite detection for diagnosis of pheochromocytoma SHENGNENG XUEa, JUAN LEIb, SHAOLING ZHANGa a Department of Endocrine Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China b Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China Objective: The comparison of the diagnostic accuracy of catecholamine metabolite detection for the diagnosis of pheochromocytoma. Methods: From 2005 to 2009, 340 cases (45 cases of pheochromocytoma, 111 cases of adrenal cortical adenoma, 145 patients with primary hypertension and 39 healthy subjects) were chosen to measure their 24-h urine vanillylmandelic acid (VMA), 5h urine VMA/Cr, normetanephrine (NMN) and metanephrine (MN) in blood and urine. Results: (1) The sensitivity of 24-h urine VMA in diagnosing pheochromocytoma was only 73.3%, which was lower than that of the blood NMN + MN, urinary NMN + MN and the joint detection of blood and urine NMN + MN (P b 0.05). The specificity of 5 h urine VMA/Cr in diagnosing pheochromocytoma was 84.1%, which was lower than that of the 24-h urine VMA, blood NMN + MN, urinary NMN + MN and the joint detection of blood and urine NMN + MN (P b 0.01). (2) Paired χ2 tests showed that the positive rate of urinary NMN + MN was higher than that of the 24-h urine VMA in diagnosing pheochromocytoma (χ2 = 9.091, P = 0.003). (3) The areas under the ROC curve of 24-h urine VMA, 5-h urine VMA/Cr, blood NMN + MN and urine NMN + MN were 0.884, 0.923, 0.972 and 0.985, respectively. Conclusions: Both the sensitivity and specificity of blood NMN+ MN and urine NMN + MN are high in diagnosing pheochromocytoma. They are ideal detection methods of pheochromocytoma in clinic. The diagnostic accuracy will be improved if the joint detection was done.
doi:10.1016/j.ijcard.2011.08.580
YI ZHANG, YAN LI, FENGHUA DING, CHANGSHENG SHENG, QIFANG HUANG, JIGUANG WANG Shanghai Institute of Hypertension, Shanghai, China Objective: Data are limited with regard to the association of central blood pressure components with cardiac structure and function. Methods: Our study was conducted in the framework of cardiovascular health examinations for the current and retired employees of a factory and their family members. We measured central blood pressures by SphygmoCor and cardiac structure and function by echocardiography. Results: The 826 participants (mean age: 43.0 years) included 285 (34.5%) women and 184 (22.3%) hypertensive patients, of whom 78 (42.4%) took antihypertensive drugs. After adjustment for age, gender, body weight, body height, antihypertensive treatment, current smoking and alcohol intake, left atrial volume (LAV) and left ventricular mass (LVM) were significantly associated with central blood pressure components (r: 0.09 to 0.21, P≤0.01), whereas left ventricular diastolic dysfunction, evaluated by E/A ratio and deceleration time of E wave (DTE), was only significantly associated with central systolic blood pressure (SBP, r=0.16 and r=0.14, Pb 0.001). Furthermore, in regression models with similar adjustments, with 1-SD increase in central SBP (16.7 mmHg), E/A ratio significantly decreased by 5.5±1.2 % and DTE significantly increased by 4.66±1.22 ms (Pb 0.001 for both). Sensitivity analyses in men and women separately and after exclusion of patients on antihypertensive medication were confirmatory. Conclusion: Cardiac structure was significantly and comparably associated with central blood pressure components, but left ventricular diastolic dysfunction was only significantly associated with central SBP. doi:10.1016/j.ijcard.2011.08.582 0022 Comparison of knowledge and understanding about hypertension in patients with controlled and uncontrolled hypertension: A multicenter study AYSHA ALMAS, SANIYA SERAJ, HALIMA TABANI, SAIMA LALANI, ZEHRA AZIZ SAMNI Aga Khan University, Karachi, Pakistan