Homocysteine confounders in arterial hypertension

Tseng

discordant. In 88 cases ATP III and ADA suggested treatment whereas EAS did not. All the patients had LDL-0130 mg/dL or LDL-C loo&129 mg/dL and HDL-Cc40 mg/dL. In 57 cases, EAS suggested treatment whereas ATP III and ADA did not. All these patients had associated non lipid risk factors (smoke and hypertension) and LDL-Cc130 mg/dL and HDL-040 mg/dL. In conclusion, more than 65% of type 2 diabetic patients needs lipid lowering therapy according to one or the other guideline. However, recent intervention studies suggest that more patients may benefit from lipid lowering therapy.

I7 15 HOMOCYSTEINE

CONFOUNDERS

IN ARTERIAL

HYPERTENSION

A.N. Arapogianni, G.F! Vyssoulis, E.A. Karpanou, F!I. Kloufetos, J.K. Rizos, M.A. Toutouza, A.G. Marinakis, D.V. Cokkinos, F!K. Toutouzas. Cardiology Department, Uniuersify ofAthens, Greece Elevated plasma homocysteine levels (HOM) are considered an independent cardiovascular risk factor. Arterial hypertension is often accompanied by increased plasma HOM. We studied 1260 consecutive untreated patients with chronic uncomplicated essential hypertension and 175 matched healthy controls to evaluate HOM confounders in arterial hypertension according to gender. All patients underwent complete clinical, biochemical and echocardiographic examination. HOM values were higher in hypertensives (13,2 vs 10,9 micromol/L p=O,OOOOl) with no gender differentiation (p=NS). In controls, HOM values were strongly related to pulse pressure (r=O,552), left atria1 index (r=O,556), isovolumic index (r=O,566), mildly related to PAI- (r=O,326), weakly related to serum creatinine (r=O,278), without significant relation to cholesterol and triglycerides (r=O,O64, r=O,O89) and were independent of rennin (r=-0,009). There was no gender differentiation (p=NS) with the exception of total peripheral resistances (r=O,527 vs,156, p=O,OOS). In hypertensive patients HOM levels were significantly related to pulse pressure (r=O,495), ejection fraction (LVEF) (r=O,495), aortic stiffness index (r=O,553), mildly to serum creatinine (r=O,359) and fibrinogen (r=O,308), weakly to PAI- (r=O,239) and with no significant relation to cholesterol and triglycerides (~0,078, r=O,182).In hypertensives women, HOM had better correlation to LVEF (~-0,584 vs 0,428 p=O,OOO2), arterial-ventricular coupling (r=O,539 vs,376 p=O,OOO3) and LV midwall mechanics (r=-0,524 vs 0,62 p=O,OOO4). Overall, in hypertensives, HOM was weaker correlated to heart rate than controls (~-0,136 vs 0,376 p=O,OOl),as was to diastolic blood pressure (~-0,199 vs 0,350 p=O,O4), with better relation of HOM to midwall fractional shortening (~-0,427 vs 0,156 p=O,OOO2). It is concluded that in hypertensives, HOM levels are high and depend on age, blood pressure values, cardiovascular hypertrophy and function, while lipids effect are minimal with stronger relations in women.

I716 CUTANEOUS WITH

VASOMOTOR RESPONSE IN DIABETICS AND WITHOUT ATHEROSCLEROSIS

I7 17 NEW METHOD POSSESSING

Tretiakovs’,A. Lacis’, A.

Jurka’ ,

Experimental And Clinical Medicine: Hospital, Riga, Latvia

V Pirags’. ‘Latvian Institute of ‘F? Stradins Clinical Uniuersify

Aim: to evaluate changes in the cutaneous vasomotor response in diabetics with and without peripheral arterial occlusive disease (PAOD). Subjects: 20 healthy controls (C); 18 diabetic (NIDDM) patients without complications (D); 18 diabetics with peripheral neuropathy and microalbuminuria (N); 16 diabetics with coronary artery disease (CA); 14 patients with PAOD (P) and 14 diabetics with PAOD (PD) who underwent infraiguinal reconstruction were examined the day before and 34 days after surgery. Patient groups were matched for age, sex, and body mass index. We recorded changes in laser Doppler flux (LDF) (PeriFlux 4001, Perimed) induced by 3 min arterial occlusion on the pulp of the big toe, and estimated: resting LDF (r-LDF), the percent increase of r-LDF (d-LDF) and time to peak LDF (t-LDF). Comparing PAOD patient groups: t-LDF was significantly shorter in diabetics (P 185*51 vs. PD 139*43 s, piO.05). Diabetics without PAOD (N group) had a shorter t-LDF (piO.05) in comparison to the controls, but the t-LDF was prolonged in CA patients (piO.05). Both PAOD patient groups improved by surgery according to the ankle-bra&al index. They had a reduced t-LDF (p
OF COMPOUNDS ACTIVITY

Y.A. Troshkin’, V.V Tertov’, L.A. Medvedeva’, T.A. Scalbe’, A.N. 0rekhov2. ‘Institute ofEqwimental Cardiology: ‘Institute Atherosclerosis Research, Moscow, Russia

for

One of the most effective ways for cardiovascular risk lowering is the use of GMG-CoA reductase inhibitors. Initially the statins raised from products of fungi. It turned out that many fungi cultures might be the potent producers of compounds with statin-like activity. The search of effective and promising cholesterol lowering agents demands for the development of rapid and inexpensive screening method. The use of deuterium incorporation for the assessment of cholesterol synthesis rate seems to be inappropriate. Other methods are based on measurement of cholesterol precursors, such as desmosterol, lathosterol and squalene. The most accurate way to estimate the rate of cholesterol synthesis is the estimation of lathosterol level in blood serum. We have developed the rapid and reliable method for lathosterol extraction and HPLC measurement. It employs the hydrolysis of esterified lipids from plasma followed by extraction of unesterified sterols. Under these conditions, lathosterol release accounted for 92%. Using this method, we have studied the effectiveness of more than 40 extracts from different Streptomyces cultures in comparison with well-known GMG-CoA reductase inhibitor, Lovastatin. Lathosterol plasma level was measured before single dose administration of the drug and 4 hours later in 10 men and women aged 28-55 with serum cholesterol level above 220 mg/dl. Due to screening results, three compounds possessing cholesterol-lowering activity similar to that of Lovastatin were selected for further investigation. They lowered serum lathosterol level by 25-30% (piO,O5) at 4 hours after oral intake, and decreased serum cholesterol level by S-15% (p
CORRELATION INDICES AND TARGET HYPERTENSION

BETWEEN AORTIC FUNCTION ORGAN DAMAGE IN UNTREATED

W.-C. Tsai, Y.-Y. Huang, T.-H. Chao, P.-Y. Liu, J.-H. Chen. National Cheng Kung Uniuersify Hospital, Tainan, Taiwan Objective: This study was undertaken to investigate whether aortic function indices derived from M-mode echocardiography were associated with target organ damage in hypertension. Methods: Thirty-two non-diabetic men (Mean age 39 years) with untreated hypertension were included in this study. Two functional indices of aortic compliance, stiffness index (SI) and distensibility (DI), were derived from measurements of aortic diameters at 3 cm above aortic valve by M-mode echocardiography and sphygmomanometric bra&al blood pressure. DI and SI were calculated from the following formulas: DI = Z(clm1ges

F!

FOR RAPID SCREENING GMG-CoA REDUCTASE-LIKE

221

in aortic

diameterj/(diastolic

di~=eter)(plllsepre~~~~);

SI = ln(systolic

blood

pressure/

Left VCntI’iCLIhr mass index (LVMI) was measured by M-mode echocardiography and body surface area. Indirect fundoscopy was used for assessment of retinopathy. Blood urea nitrogen (BUN) and creatinine were examined in each patient. Results: SI was significantly correlated with LVMI (r=O.546, p=O.OOl), BUN (r=O.506, p=O.O12), and creatinine (r=O.501, p=O.O07). DI was inversely correlated with LVMI (~-0.365, p=O.O40), BUN (~-0.403, p=O.O51), and creatinine (~-0.366, p=O.O55). SI was higher (p=O.O68) and DI was lower (p=O.O3 1) among patients (N=19) with hypertensive retinopathy. Conclusions: SI and DI had good correlation with target organ damage in untreated hypertensive men. Aortic function indices derived simply from M-mode echocardiography can be used for assessment of target organ damage in hypertension.

/diastolic

blood

pmsm)/(clmges

I719 PREVALENCE VASCULAR PATIENTS

h aortic diameter/diastolic

aortic diamter).

AND RISK FACTORS OF PERIPHERAL DISEASE IN TAIWANESE TYPE 2 DIABETIC

C.-H. Tseng. Department Hospital, Taipei, Taiwan

ofInternal Medicine, National Taiwan Uniuersify

This study was to evaluate the prevalence and risk factors of peripheral vascular disease (PVD) in Taiwanese type 2 diabetic patients. A total

73rd EAS Congress