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LIPID PROFILE AND LP(A) IN FIT AND HEALTHY ELDERLY
Poster Sessions PO27 Lifestyle modification PO27-431
THE EFFECTS OF A COMMUNITY- BASED LIFESTYLE MODIFICATION PROGRAM ON SERUM LIPIDS –
H.S. Englert 1 , H.A. Diehl 2 , R.L. Greenlaw 3 , S. Willich 4 . 1 University of Applied Sciences Muenster, Germany; 2 Lifestyle Medicine Institute, Loma Linda, CA, USA; 3 Center for Complementary Medicine, Swedish American Health System Rockford, IL, USA; 4 Charité - University Medical Center Berlin, Germany
PO27-432
EUROASPIRE III: LIFESTYLE AND RISK FACTOR MANAGEMENT AND USE OF DRUG THERAPIES IN CORONARY PATIENTS FROM 22 COUNTRIES IN EUROPE
K. Kotseva 1 , U. Keil 2 , C. Jennings 1 , D. De Bacquer 3 , G. De Backer 3 , D. Wood 1 . 1 Department of Cardiovascular Medicine, NHLI, Imperial College London, UK; 2 Institut of Epidemiology and Public Health, University of Munster, Germany; 3 Department of Public Health, University of Ghent, Belgium Objectives: To determine in patients with CHD whether the 2003 Joint European Societies’ guidelines on cardiovascular prevention are being followed in clinical practice. Methods: EUROASPIRE III survey was undertaken in 2006-2007 in 22 European countries. Data collection took place at least six months after index event or procedure and was based on a review of medical records and a prospective interview and standardised examination. Results: A total of 13,935 medical records (27.4% women) were reviewed and 8,966 patients were interviewed on average 1.24 years following their index event (participation rate 73.0%). At interview, 17.2% of patients smoked cigarettes, 35.3% were obese (BMI ≥30 kg/m2 ), 52.7% had central obesity (waist circumference ≥102 cm in men or ≥88 cm in women), 56.0% had raised blood pressure (≥140/90 mmHg for non-diabetes patients and ≥130/80 mmHg for patients with diabetes), 34.2% had total cholesterol ≥5mmol/l, 33.8% had LDL-cholesterol ≥3mmol/l, 34.7% had triglycerides ≥1.7mmol/l and 34.8% had diabetes. The use of prophylactic drug therapies was as follows: aspirin or other anti-platelets drugs 90.5%, beta-blockers 79.8%, ACE inhibitors 59.9%, AT II receptor blockers 12.0%, statins 78.1%, anticoagulants 5.6%. 27.7% patients on lipid-lowering medication had not achieved the total cholesterol goal of < 5 mmol/l. Conclusions: EUROASPIRE III shows that a large majority of coronary patients have adverse lifestyles and many do not achieve the blood pressure, lipid and diabetes goals. A wide gap continues to exist in the implementation of evidence-based medicine in cardiological practice.
THE VALUE OF SMOKING CESSATION IN PRENENTING CARDIOVASCULAR DISEASE. THE LINEAR CORRELATION BETWEEN SMOKING INTRNSITY AND ARTERIAL STIFFNESS
D. Levisianou 1 , A. Melidonis 1 , E. Adamopoulou 3 , A. Koutsovasilis 1 , A. Manolis 3 , I. Skoularigis 4 , G. Koukoulis 4 , S. Foussas 2 , F. Triposkiadis 4 . 1 Diabetes outpatient clinic, Tzanio General Hospital, Piraeus Greece; 2 Cardiology department, Tzanio General Hospital, Piraeus Greece; 3 Hypertension outpatient clinic, Tzanio General Hospital, Piraeus Greece; 4 Cardiology department, Faculty of Medical, University of Thessaly Background and aims: Correlation between smoking, a very well established and independent risk factor for cardiovascular disease, and arterial stiffness, marker of atherosclerosis, is well known. The aim of our study was to find a reliable indicator of smoking intensity in predicting the grade of arterial stiffness. Methods: Seventy nine (79) current smokers (81.3% male, mean age 62.77±9.24 years), patients of Diabetes and Hypertension outpatient clinic, were enrolled in our study. Years of smoking, cigarettes per day, pac-years were registered as indicators of smoking intensity. Carotid-femoral pulse wave velocity (PWV) was measured in all patients using Complior device. Results: Forty one (51.9%) of the patients were diabetics, 50 (63.3%) hypertensive, 42 (53.2%) had dyslipidaemia, 26 (32,9%) with known CHD and 49 (61,9%) with Metabolic Syndrome (MetS). NCEP ATPIII criteria were used for the definition of MetS. Using linear regression analysis, with PWV as dependent variable, and after adjustment to sex, age, waist, BMI, serum lipids profile, hypertension, diabetes mellitus, presence of MetS and history of CHD, only pac-years indicator was correlated with PWV, β=0.012 (p=0.027). On the contrary smoking years or cigarettes per day weren’t correlated with PWV β=0.050 (p=0.057) and β=0.018 (p=0.215) respectively. Conclusions: Pac-years is a reliable indicator of smoking intensity strongly predicting the grade of arterial stiffness. The linear correlation between this indicator and aortic stiffness justify the need for physicians to be very persistent in smoking cessation for prevent cardiovascular disease. PO27-434
LIPID PROFILE AND LP(A) IN FIT AND HEALTHY ELDERLY
L. Zlatohlavek, K. Zidkova, M. Snejdrlova, M. Vrablik, R. Ceska. 3rd Department of Internal Medicine, General Faculty Hospital, 1st Medical Faculty, Charles University, Prague Objective: Dyslipidemia including lipoprotein(a) are risk factors for atherosclerosis. The objectives of this study were to determine lipid and Lp(a) levels (including gene control regions: repetitions of STR locus and variability of +121A/A) in healthy elderly individuals. Methods: In a group of 136 patients (42% men, age 89±6 years, in good condition according to Spirdus: independent and fit, without hypolipidemic therapy) Lp(a) levels were assayed by LEIA, lipids using enzyme methods on automated analyzer, gene control regions by methods of molecular biology. Control group consisted of 550 lipid clinic patients (48% men, 55±16 years). Results: In study subjects there were following lipids parametres: TCHOL 4,6±1,07mmol/l, LDL 2,76±0,83 mmol/l, HDL 1,27±0,46 mmol/l, TG 1,34±0,82 mmol/l, apo B 0,9±0,24 mmol/l, apo A 1,22±0,39 mmol/l, Lp(a) 0,31±0,31g/l, median 0,16 g/l. There was a significantly higher frequency of +121A/A and 9 repetitions of the STR locus then in controls (0,185 vs. 0,030, p>0,001, X2 15,36 and 0,222 vs. 0,120, X2 13,45, p>0,001, respectively). Conclusion: The octogenarians have favourable lipid profile. The Lp(a) levels were not elevated. The higher frequency of +121A/A and 9 repetitions of the STR locus are associated with the medium-long and long isoforms of Lp(a), witch are associated with longevity. Supported by grant NR/8328-3 and MSM 0021620807. PO27-435
HOW TO DO LIFESTYLE CHANGES IN TURKISH IMMIGRANTS
A. Bader, M. Hochleitner. Innsbruck Medical University The Women’s Health Center for Tyrol focuses on cardiac prevention. On average, 90% of the patients estimate that they exercise enough. At our Out-Patient Clinic for Female Turkish Immigrants we encounter special problems with physical activity. During two of our prevention cam77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
POSTER SESSIONS
Aims: The aim of this study was to assess the clinical effects of a community-based lifestyle intervention program in reducing coronary risk, especially in a high risk group. Methods: The 40-hour educational curriculum of the Coronary Health Improvement Project (CHIP) delivered over a 30 day period with clinical and nutritional assessments before and after, was offered in the spring and fall of 2000 to 2002 through the Center for Complementary Medicine of the SwedishAmerican Health System in Rockford, IL to its employees and the general public. The participants were instructed to optimize their diet, quit smoking and exercise daily (walking 30 min/day). Results: The data of the 5 CHIP programs were pooled and analyzed. 544 men and 973 women (almost all Caucasian; mean age 55 years) were eligible for analysis. At the end of the 30-day intervention period, stratified analyses of total cholesterol (TC), LDL, triglycerides, blood glucose, blood pressure and weight showed highly significant reductions with the greatest improvements among those at highest risk. Those in the highest TC category (≥260mg%) had mean reductions of 27% and 14% for men and women, respectively. Conclusions: Well-designed community-based intervention programs can improve lifestyle choices and health habits. They can also markedly and rather quickly reduce the level of coronary risk factors in a non-randomized population.
PO27-433
123
THE EFFECTS OF A COMMUNITY- BASED LIFESTYLE MODIFICATION PROGRAM ON SERUM LIPIDS –
H.S. Englert 1 , H.A. Diehl 2 , R.L. Greenlaw 3 , S. Willich 4 . 1 University of Applied Sciences Muenster, Germany; 2 Lifestyle Medicine Institute, Loma Linda, CA, USA; 3 Center for Complementary Medicine, Swedish American Health System Rockford, IL, USA; 4 Charité - University Medical Center Berlin, Germany
PO27-432
EUROASPIRE III: LIFESTYLE AND RISK FACTOR MANAGEMENT AND USE OF DRUG THERAPIES IN CORONARY PATIENTS FROM 22 COUNTRIES IN EUROPE
K. Kotseva 1 , U. Keil 2 , C. Jennings 1 , D. De Bacquer 3 , G. De Backer 3 , D. Wood 1 . 1 Department of Cardiovascular Medicine, NHLI, Imperial College London, UK; 2 Institut of Epidemiology and Public Health, University of Munster, Germany; 3 Department of Public Health, University of Ghent, Belgium Objectives: To determine in patients with CHD whether the 2003 Joint European Societies’ guidelines on cardiovascular prevention are being followed in clinical practice. Methods: EUROASPIRE III survey was undertaken in 2006-2007 in 22 European countries. Data collection took place at least six months after index event or procedure and was based on a review of medical records and a prospective interview and standardised examination. Results: A total of 13,935 medical records (27.4% women) were reviewed and 8,966 patients were interviewed on average 1.24 years following their index event (participation rate 73.0%). At interview, 17.2% of patients smoked cigarettes, 35.3% were obese (BMI ≥30 kg/m2 ), 52.7% had central obesity (waist circumference ≥102 cm in men or ≥88 cm in women), 56.0% had raised blood pressure (≥140/90 mmHg for non-diabetes patients and ≥130/80 mmHg for patients with diabetes), 34.2% had total cholesterol ≥5mmol/l, 33.8% had LDL-cholesterol ≥3mmol/l, 34.7% had triglycerides ≥1.7mmol/l and 34.8% had diabetes. The use of prophylactic drug therapies was as follows: aspirin or other anti-platelets drugs 90.5%, beta-blockers 79.8%, ACE inhibitors 59.9%, AT II receptor blockers 12.0%, statins 78.1%, anticoagulants 5.6%. 27.7% patients on lipid-lowering medication had not achieved the total cholesterol goal of < 5 mmol/l. Conclusions: EUROASPIRE III shows that a large majority of coronary patients have adverse lifestyles and many do not achieve the blood pressure, lipid and diabetes goals. A wide gap continues to exist in the implementation of evidence-based medicine in cardiological practice.
THE VALUE OF SMOKING CESSATION IN PRENENTING CARDIOVASCULAR DISEASE. THE LINEAR CORRELATION BETWEEN SMOKING INTRNSITY AND ARTERIAL STIFFNESS
D. Levisianou 1 , A. Melidonis 1 , E. Adamopoulou 3 , A. Koutsovasilis 1 , A. Manolis 3 , I. Skoularigis 4 , G. Koukoulis 4 , S. Foussas 2 , F. Triposkiadis 4 . 1 Diabetes outpatient clinic, Tzanio General Hospital, Piraeus Greece; 2 Cardiology department, Tzanio General Hospital, Piraeus Greece; 3 Hypertension outpatient clinic, Tzanio General Hospital, Piraeus Greece; 4 Cardiology department, Faculty of Medical, University of Thessaly Background and aims: Correlation between smoking, a very well established and independent risk factor for cardiovascular disease, and arterial stiffness, marker of atherosclerosis, is well known. The aim of our study was to find a reliable indicator of smoking intensity in predicting the grade of arterial stiffness. Methods: Seventy nine (79) current smokers (81.3% male, mean age 62.77±9.24 years), patients of Diabetes and Hypertension outpatient clinic, were enrolled in our study. Years of smoking, cigarettes per day, pac-years were registered as indicators of smoking intensity. Carotid-femoral pulse wave velocity (PWV) was measured in all patients using Complior device. Results: Forty one (51.9%) of the patients were diabetics, 50 (63.3%) hypertensive, 42 (53.2%) had dyslipidaemia, 26 (32,9%) with known CHD and 49 (61,9%) with Metabolic Syndrome (MetS). NCEP ATPIII criteria were used for the definition of MetS. Using linear regression analysis, with PWV as dependent variable, and after adjustment to sex, age, waist, BMI, serum lipids profile, hypertension, diabetes mellitus, presence of MetS and history of CHD, only pac-years indicator was correlated with PWV, β=0.012 (p=0.027). On the contrary smoking years or cigarettes per day weren’t correlated with PWV β=0.050 (p=0.057) and β=0.018 (p=0.215) respectively. Conclusions: Pac-years is a reliable indicator of smoking intensity strongly predicting the grade of arterial stiffness. The linear correlation between this indicator and aortic stiffness justify the need for physicians to be very persistent in smoking cessation for prevent cardiovascular disease. PO27-434
LIPID PROFILE AND LP(A) IN FIT AND HEALTHY ELDERLY
L. Zlatohlavek, K. Zidkova, M. Snejdrlova, M. Vrablik, R. Ceska. 3rd Department of Internal Medicine, General Faculty Hospital, 1st Medical Faculty, Charles University, Prague Objective: Dyslipidemia including lipoprotein(a) are risk factors for atherosclerosis. The objectives of this study were to determine lipid and Lp(a) levels (including gene control regions: repetitions of STR locus and variability of +121A/A) in healthy elderly individuals. Methods: In a group of 136 patients (42% men, age 89±6 years, in good condition according to Spirdus: independent and fit, without hypolipidemic therapy) Lp(a) levels were assayed by LEIA, lipids using enzyme methods on automated analyzer, gene control regions by methods of molecular biology. Control group consisted of 550 lipid clinic patients (48% men, 55±16 years). Results: In study subjects there were following lipids parametres: TCHOL 4,6±1,07mmol/l, LDL 2,76±0,83 mmol/l, HDL 1,27±0,46 mmol/l, TG 1,34±0,82 mmol/l, apo B 0,9±0,24 mmol/l, apo A 1,22±0,39 mmol/l, Lp(a) 0,31±0,31g/l, median 0,16 g/l. There was a significantly higher frequency of +121A/A and 9 repetitions of the STR locus then in controls (0,185 vs. 0,030, p>0,001, X2 15,36 and 0,222 vs. 0,120, X2 13,45, p>0,001, respectively). Conclusion: The octogenarians have favourable lipid profile. The Lp(a) levels were not elevated. The higher frequency of +121A/A and 9 repetitions of the STR locus are associated with the medium-long and long isoforms of Lp(a), witch are associated with longevity. Supported by grant NR/8328-3 and MSM 0021620807. PO27-435
HOW TO DO LIFESTYLE CHANGES IN TURKISH IMMIGRANTS
A. Bader, M. Hochleitner. Innsbruck Medical University The Women’s Health Center for Tyrol focuses on cardiac prevention. On average, 90% of the patients estimate that they exercise enough. At our Out-Patient Clinic for Female Turkish Immigrants we encounter special problems with physical activity. During two of our prevention cam77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
POSTER SESSIONS
Aims: The aim of this study was to assess the clinical effects of a community-based lifestyle intervention program in reducing coronary risk, especially in a high risk group. Methods: The 40-hour educational curriculum of the Coronary Health Improvement Project (CHIP) delivered over a 30 day period with clinical and nutritional assessments before and after, was offered in the spring and fall of 2000 to 2002 through the Center for Complementary Medicine of the SwedishAmerican Health System in Rockford, IL to its employees and the general public. The participants were instructed to optimize their diet, quit smoking and exercise daily (walking 30 min/day). Results: The data of the 5 CHIP programs were pooled and analyzed. 544 men and 973 women (almost all Caucasian; mean age 55 years) were eligible for analysis. At the end of the 30-day intervention period, stratified analyses of total cholesterol (TC), LDL, triglycerides, blood glucose, blood pressure and weight showed highly significant reductions with the greatest improvements among those at highest risk. Those in the highest TC category (≥260mg%) had mean reductions of 27% and 14% for men and women, respectively. Conclusions: Well-designed community-based intervention programs can improve lifestyle choices and health habits. They can also markedly and rather quickly reduce the level of coronary risk factors in a non-randomized population.
PO27-433
123