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Gender differences in blood pressure and electrocardiography parameters in response to antihypertensive treatment
Abstracts / Maturitas 81 (2015) 191–236
disease although favourite effects on lipid parameters have been shown. In the present study the combination of estrogen/progestin plus statin therapy was investigated in comparison to a statin monotherapy. Patients and methods: Twenty postmenopausal women with known coronary heart disease were included in this study. The patients received either fluvastatin combined with oral estradiol/norethisterone or fluvastatin alone in a randomised cross-over study design. Blood flow measurement was conducted before, after 6 weeks’ and after 12 weeks of treatment. Urinay vasoactive parameters (cGMP, metabolites of prostacyclin and thromboxane) and serum parameters (lipids, P-selectin, ICAM-1, MCP-1 and homocysteine) were also measured basal and after 6 and 12 weeks of treatment. Results: Mean age of the patients was 62.3 years (SD 6.6). In the intention-to-treat analysis no significant difference was found in terms of blood flow measurements. A significant difference in totalChol and LDL was found between both treatment groups favouring the hormone/statin group (p < 0.001), whereas no significant differences were found for LDL, HDL and Lp(a). For the vasoactive surrogate marker in serum and urine no significant differences between both treatment groups were observed. Conclusions: Combined hormone/statin therapy may have beneficial effects on cardiovascular risk factors beyond the effect of a statin monotherapy. However it is very difficult to assess as to whether the observed benefits of a hormone/statin therapy elicit a significant influence on the risk of coronary heart desease. http://dx.doi.org/10.1016/j.maturitas.2015.02.332 P192 Gender differences in blood pressure and electrocardiography parameters in response to antihypertensive treatment Marina M.J. Romero-Prado 1,∗ , J. Aarón Curiel Beltrán 2 , Maria Viviana Miramontes Espino 3 , ˜ 1 Ernesto G. Cardona Munoz 1
Universidad de Guadalajara, Fisiología, Guadalajara, Mexico 2 Universidad de Guadalajara, Puerto Vallarta, Mexico 3 Hospital General Morelia, Morelia, Mexico Introduction: Previously we shown that dietary flavonoids (DF) administrated to antihypertensive pharmacological therapy (AHT) have additional benefits on blood pressure, lipid profile, inflammation and obesity in hypertensive young people. Differences in cardiovascular disease development as well in the treatments response has been related to the gender of the patient. In the present work we compared the efficacy of this approach with DF on blood pressure (BP) electrocardiography parameters on both gender patients from 20 to 50 years. Material and methods: 37 male and 42 female patients with hypertension grade I (n = 27) or II (n = 52) received 425.8 ± 13.9 mg gallic acid equivalents (GAE) from dietary flavonoids were added to AHT based on captopril (50 mg/day) or telmisartan (40 mg/day) during 6 months. The Standard electrocardiogram (ECG) 12-lead was recorded at 25 mm/s and 1 mV/cm measured at 0,3 and 6 months of treatment. ECGs were defined according two Criteria: The Cornell Voltage combination (CV) = (RaVL + SV3 ) (LVH: >28 mm in men and > 20 mm in women); the Cornell product (CP) is considered as the product of QRS duration times the CV (LVH: >2440 mm/ms in both sexes). The media changes between baseline
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to the end of the study were considered as significant at P < 0.05 (6,7). Results: By gender, the SBP diminution was significantly lower in women that received AHT + DF vs AHT (−40.5 ± 8.4 vs. −30.65 ± 9.2 mmHg) (P = 0.002). DBP reduction was different in women with ATH (−18.3 ± 8.4 mmHg) vs ATH + DF (−20.6 ± 5.1 mm Hg) (P = 0.049); while men with AHT showed (−17.9 ± 4.6) vs ATH + DF (−21 ± 5) (P = 0.03). The ECG activity for Tms vs Cpr was different: CP = −178.4 ± 282.1 vs. 49.2 ± 151.1 (P = 0.002). By gender, male were the most favored than women in the CP diminution and there were differences when each group of women was compared with male without DF (P = 0.03 and P = 0.049). Conclusion: The response to DF added to AHT in BP and ECG parameters is different depending on patient gender. http://dx.doi.org/10.1016/j.maturitas.2015.02.333 P193 The association of carotid artery intima-media thickness and atherosclerosis-related factors, and the effects of interventions in postmenopausal Japanese women Yoshiaki Somekawa ∗ , Aya Osonoi, Atsushi Fusegi, Chiaki Okamoto, Mikiko Tsugata, Hidenori Umeki Toride Medical Center, Obstetrics & Gynecology, Toride, Japan Objective: The purpose of this study was to investigate the relationships among carotid artery intima-media thickness (IMT) and lipid profile, blood glucose, blood pressure (BP), habit of tobacco smoking, and physical and age-related factors of atherosclerotic risk, and the effects of interventions in postmenopausal women. Design and methods: The subjects were 216 postmenopausal Japanese women aged 46–82 years (mean age 64.7 ± 0.5 yr) who visited our menopause clinic. IMTs were measured by the ultrasonography at intervals of three years. Age, anthropometric factors, menses-related factors, alcohol ingestion, and habit of tobacco smoking were investigated. Levels of serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), highdensity lipoprotein cholesterol (HDL-C), blood glucose (BG), HbA1c, and blood pressure (BP) were measured at initial visit and 3 years later. LDL-C/HDL-C ratios were calculated. The relationships among initial IMTs and these atherosclerosis-related factors, and the effects of treatment interventions on changes of IMTs were analyzed. Results: Significant correlations were found between inital IMTs and age, years since menopause (YSM), HbA1c, habit of tobacco smoking, and BP. Correlations among IMTs and BG, or other lipid parameters were not significant. After 3 years measurement, significant increase in IMTs were found in the untreated group compared with treated group of lipids. Conclusion: Age and YSM are associated with thickening of IMT, and high blood pressure, habit of tobacco smoking, and hyperglycemia may be responsible for the atherosclerosis. Early intervention treatments on lipids are effective to prevent the deterioration of atherosclerosis in these postmenopausal women. http://dx.doi.org/10.1016/j.maturitas.2015.02.334
disease although favourite effects on lipid parameters have been shown. In the present study the combination of estrogen/progestin plus statin therapy was investigated in comparison to a statin monotherapy. Patients and methods: Twenty postmenopausal women with known coronary heart disease were included in this study. The patients received either fluvastatin combined with oral estradiol/norethisterone or fluvastatin alone in a randomised cross-over study design. Blood flow measurement was conducted before, after 6 weeks’ and after 12 weeks of treatment. Urinay vasoactive parameters (cGMP, metabolites of prostacyclin and thromboxane) and serum parameters (lipids, P-selectin, ICAM-1, MCP-1 and homocysteine) were also measured basal and after 6 and 12 weeks of treatment. Results: Mean age of the patients was 62.3 years (SD 6.6). In the intention-to-treat analysis no significant difference was found in terms of blood flow measurements. A significant difference in totalChol and LDL was found between both treatment groups favouring the hormone/statin group (p < 0.001), whereas no significant differences were found for LDL, HDL and Lp(a). For the vasoactive surrogate marker in serum and urine no significant differences between both treatment groups were observed. Conclusions: Combined hormone/statin therapy may have beneficial effects on cardiovascular risk factors beyond the effect of a statin monotherapy. However it is very difficult to assess as to whether the observed benefits of a hormone/statin therapy elicit a significant influence on the risk of coronary heart desease. http://dx.doi.org/10.1016/j.maturitas.2015.02.332 P192 Gender differences in blood pressure and electrocardiography parameters in response to antihypertensive treatment Marina M.J. Romero-Prado 1,∗ , J. Aarón Curiel Beltrán 2 , Maria Viviana Miramontes Espino 3 , ˜ 1 Ernesto G. Cardona Munoz 1
Universidad de Guadalajara, Fisiología, Guadalajara, Mexico 2 Universidad de Guadalajara, Puerto Vallarta, Mexico 3 Hospital General Morelia, Morelia, Mexico Introduction: Previously we shown that dietary flavonoids (DF) administrated to antihypertensive pharmacological therapy (AHT) have additional benefits on blood pressure, lipid profile, inflammation and obesity in hypertensive young people. Differences in cardiovascular disease development as well in the treatments response has been related to the gender of the patient. In the present work we compared the efficacy of this approach with DF on blood pressure (BP) electrocardiography parameters on both gender patients from 20 to 50 years. Material and methods: 37 male and 42 female patients with hypertension grade I (n = 27) or II (n = 52) received 425.8 ± 13.9 mg gallic acid equivalents (GAE) from dietary flavonoids were added to AHT based on captopril (50 mg/day) or telmisartan (40 mg/day) during 6 months. The Standard electrocardiogram (ECG) 12-lead was recorded at 25 mm/s and 1 mV/cm measured at 0,3 and 6 months of treatment. ECGs were defined according two Criteria: The Cornell Voltage combination (CV) = (RaVL + SV3 ) (LVH: >28 mm in men and > 20 mm in women); the Cornell product (CP) is considered as the product of QRS duration times the CV (LVH: >2440 mm/ms in both sexes). The media changes between baseline
215
to the end of the study were considered as significant at P < 0.05 (6,7). Results: By gender, the SBP diminution was significantly lower in women that received AHT + DF vs AHT (−40.5 ± 8.4 vs. −30.65 ± 9.2 mmHg) (P = 0.002). DBP reduction was different in women with ATH (−18.3 ± 8.4 mmHg) vs ATH + DF (−20.6 ± 5.1 mm Hg) (P = 0.049); while men with AHT showed (−17.9 ± 4.6) vs ATH + DF (−21 ± 5) (P = 0.03). The ECG activity for Tms vs Cpr was different: CP = −178.4 ± 282.1 vs. 49.2 ± 151.1 (P = 0.002). By gender, male were the most favored than women in the CP diminution and there were differences when each group of women was compared with male without DF (P = 0.03 and P = 0.049). Conclusion: The response to DF added to AHT in BP and ECG parameters is different depending on patient gender. http://dx.doi.org/10.1016/j.maturitas.2015.02.333 P193 The association of carotid artery intima-media thickness and atherosclerosis-related factors, and the effects of interventions in postmenopausal Japanese women Yoshiaki Somekawa ∗ , Aya Osonoi, Atsushi Fusegi, Chiaki Okamoto, Mikiko Tsugata, Hidenori Umeki Toride Medical Center, Obstetrics & Gynecology, Toride, Japan Objective: The purpose of this study was to investigate the relationships among carotid artery intima-media thickness (IMT) and lipid profile, blood glucose, blood pressure (BP), habit of tobacco smoking, and physical and age-related factors of atherosclerotic risk, and the effects of interventions in postmenopausal women. Design and methods: The subjects were 216 postmenopausal Japanese women aged 46–82 years (mean age 64.7 ± 0.5 yr) who visited our menopause clinic. IMTs were measured by the ultrasonography at intervals of three years. Age, anthropometric factors, menses-related factors, alcohol ingestion, and habit of tobacco smoking were investigated. Levels of serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), highdensity lipoprotein cholesterol (HDL-C), blood glucose (BG), HbA1c, and blood pressure (BP) were measured at initial visit and 3 years later. LDL-C/HDL-C ratios were calculated. The relationships among initial IMTs and these atherosclerosis-related factors, and the effects of treatment interventions on changes of IMTs were analyzed. Results: Significant correlations were found between inital IMTs and age, years since menopause (YSM), HbA1c, habit of tobacco smoking, and BP. Correlations among IMTs and BG, or other lipid parameters were not significant. After 3 years measurement, significant increase in IMTs were found in the untreated group compared with treated group of lipids. Conclusion: Age and YSM are associated with thickening of IMT, and high blood pressure, habit of tobacco smoking, and hyperglycemia may be responsible for the atherosclerosis. Early intervention treatments on lipids are effective to prevent the deterioration of atherosclerosis in these postmenopausal women. http://dx.doi.org/10.1016/j.maturitas.2015.02.334