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P343 Prevalence of obesity and its association with blood pressure
Posters / International Journal of Cardiology 125 Suppl. 1 (2008) S51–S73 P341 Conduction disturbances in acute myocardial infarction Ahmadali Shirafkan1 *, Ali Shirafkan2 , M. Mehrad2 , A. Gholamrezanezhad3 . 1 Department of Cardiology, Golestan Medical University, Iran, 2 Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Iran, 3 Young Researchers Club, Azad University of Tehran, Iran Objectives of the study: Heart blocks may occur as complications of acute myocardial infarction (AMI) and are accompanied with increased in-hospital mortality. The objective of this investigation was to study heart blocks in patients with AMI to assess their association with clinical features and therapeutic measures. Methods: Four hundred consecutive patients [263M, 137F, mean age: 59.6±8.4 yrs] who were admitted with the diagnosis of acute myocardial infarction were assessed. The initial ECG, which was recorded immediately after admitting the patient to the emergency department, was considered as the base ECG. Thereafter, by comparing the electrocardiograms of the following days with this base ECG, development of heart blocks in the 3−5 following days were screened. Results: The overall prevalence of heart blocks was 15.8%. There was not any significant statistical correlation between the incidence of heart blocks and the patients’ age and gender (both p values >0.05). Although the prevalence of cigarette smoking, hypertension? hypercholestrolemia and diabetes mellitus, in patients with heart block was more than patients without such complications, the differences were not statistically significant. The development of heart blocks was more common among those patients treated with trombolytic therapy (21.1% v.s 12%, p = 0.01). Also it was shown that the development of heart blocks is accompanied with a significant reduction in left ventricular ejection fraction. It was found that 25% of those patients who died following MI but only 13.6% of those who remained alive had experienced heart blocks after MI (P < 0.01). Conclusions: Development of heart blocks has important prognostic significance. As it is confirmed by the higher prevalence of heart blocks in anterior wall or Q-wave infarctions, increased morbidity following heart block development is probably not entirely related to the conduction disturbance itself, but also to the relatively larger infarcted area. P342 Ambulatory blood pressure, lipids and obesity with hypertension G. Simonyi1 *, J.R. Bedros1 , M. Medvegy2 . 1 Lipid Dept./Flor Ferenc County Hospital, Kistarcsa, Central Hospital, Budapest, Hungary, 2 Cardiology/National Health Center, Budapest, Hungary Obesity and hypertension are the most pronounced risk factors for cardiovascular morbidity and mortality. The correlations between obesity and abnormal lipid parameters well known, but we know fewer about the relationship in obese patients between blood pressure and lipid parameters. The purpose of the present study was to determine the relationship between serum lipids (cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride) and parameters derived from 24-hour ambulatory blood pressure monitoring including mean 24-hour, daytime, nighttime systolic and diastolic blood pressures, 24-hour daytime and nighttime pulse pressure, mean 24-hour daytime and nighttime heart rate in obese hypertensive patients. Patients and Method: 86 patients suffering from obesity and hypertension were investigated. All of patients was hypertensive (determined by 24 hour ambulatory blood pressure earlier). We measured the fasting cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride level and blood pressure parameters. The correlation analysis was made between the investigated parameters by SPSS. Results: The age was 45.68±6.66 years, BMI was 32.69±1.91 kg/m2 (obesity = BMI 30 kg/m2 ). Male/female: 47/39. The average 24-hour systolic blood pressure was 136.87±10.97 mmHg and the diastolic was 88.62±6.84 mmHg. The serum cholesterol level was 7.26±1.86,
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the LDL-cholesterol level was 4.49±2.15, HDL-cholesterol level was 1.39±0.63 and triglyceride level was 4.19±2.15 mmol/l. With correlation analysis we found significant correlations between LDL-cholesterol and mean systolic blood pressure (r = 0.76, P < 0.05), mean diastolic blood pressure (r = 0.64, P < 0.02), the daytime systolic blood pressure (r = 0.65, P < 0.02) and daytime diastolic blood pressure (r = 0.69, P < 0.01). Conclusion: The abnormal level of LDL-cholesterol closely related to blood pressure in obese hypertensive patients. P343 Prevalence of obesity and its association with blood pressure G. Simonyi1 *, J.R. Bedros1 , L. Halmy1 , M. Medvegy2 . 1 Hypertension and Lipid Center/Flor Ferenc County Hospital, Kistarcsa, Hungary, 2 Cardiology/National Health Center, Budapest, Hungary Obesity and hypertension are the most important risk factor for cardiovascular diseases. They spread epidemically in the world. With the significant rise in obesity in this last decade comes a corresponding increase in the prevalence of hypertension. Previous studies showed that almost 29 percent of the population is hypertensive (having a blood pressure (BP) greater than 140/90 mmHg or using hypertensive medications). We investigated the prevalence of obesity and hypertension, and its association in Hungarian Policemen. Patients and Method: 20,499 policemen were involved in this study. The investigations were performed before they regular yearly exercise testing. We measured the blood pressure, heart rate, waist circumference, and hip circumference, body weight, body height and calculated body mass index (BMI). The criteria of obesity were: BMI 30 kg/m2 . We made correlation analysis between body weight, BMI, waist circumference and blood pressure by SPSS 15.0. Results: The age was 32.52±7.74 (range: 18−61) years, body weight was 82.54±14.72 (range:42–170) kg, BMI was 26.34±4.04 (range: 15.43−48.85) kg/m2 . Male/female: 7.75/1. The waist circumference was 91.81±9.01 (range: 54–158) cm, hip circumference was 101.43±9.01 (range: 61–160) cm. The systolic blood pressure was 130.29±15.17 (range: 80–220) mmHg and the diastolic was 80.87±9.85 (range: 40–140) mmHg. In women we found 17.3%, in male 36.4% we found hypertensive. Obesity was found in women 7.9% and 18.8% in men. With correlation analysis we found significant correlations between BMI and systolic (P < 0.0001) and diastolic (P < 0.0001) blood pressure. The body weight correlated significantly with systolic (P < 0.0001) and diastolic (P < 0.0001) blood pressure. The waist circumference also correlated significantly with systolic (P < 0.0001) and diastolic (P < 0.0001) blood pressure. Conclusions: In our investigation we found significant proportion of obesity and untreated hypertension in both gender. We found significant correlation between BMI and blood pressure therefore it is important to maintain normal body weight to prevent developing hypertension. P344 Risk stratification in heart failure B.B. Siswanto *, Sunanto, M. Munawar, D. Kusmana, A. Hanafiah, S. Waspadji, A. Bachtiar. Department of Cardiology & Vascular Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia Objective: To look for predictors of mortality and rehospitalization, we conducted a prospective study using fifty variables from history, physical examination, EXG, CXR, Echocardiography and blood tests (e.g. N terminal pro BNP, hsCRP, and Lactate level) that suspected as predictors for mortality and readmission in heart failure. Methods: Blinded prospective cohort study at Emergency room NCVC Jakarta as entry site, with ICCU, wards and OPD for evaluation. All consecutive patients with Acute Decompensated Heart Failure that need hospitalization (Functional Class III and IV NYHA). Exclusion criteria were other concomitant severe diseases. Results: Of 97 patients enrolled, variables were measured using standard protocols. During follow up period of six months, 11
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the LDL-cholesterol level was 4.49±2.15, HDL-cholesterol level was 1.39±0.63 and triglyceride level was 4.19±2.15 mmol/l. With correlation analysis we found significant correlations between LDL-cholesterol and mean systolic blood pressure (r = 0.76, P < 0.05), mean diastolic blood pressure (r = 0.64, P < 0.02), the daytime systolic blood pressure (r = 0.65, P < 0.02) and daytime diastolic blood pressure (r = 0.69, P < 0.01). Conclusion: The abnormal level of LDL-cholesterol closely related to blood pressure in obese hypertensive patients. P343 Prevalence of obesity and its association with blood pressure G. Simonyi1 *, J.R. Bedros1 , L. Halmy1 , M. Medvegy2 . 1 Hypertension and Lipid Center/Flor Ferenc County Hospital, Kistarcsa, Hungary, 2 Cardiology/National Health Center, Budapest, Hungary Obesity and hypertension are the most important risk factor for cardiovascular diseases. They spread epidemically in the world. With the significant rise in obesity in this last decade comes a corresponding increase in the prevalence of hypertension. Previous studies showed that almost 29 percent of the population is hypertensive (having a blood pressure (BP) greater than 140/90 mmHg or using hypertensive medications). We investigated the prevalence of obesity and hypertension, and its association in Hungarian Policemen. Patients and Method: 20,499 policemen were involved in this study. The investigations were performed before they regular yearly exercise testing. We measured the blood pressure, heart rate, waist circumference, and hip circumference, body weight, body height and calculated body mass index (BMI). The criteria of obesity were: BMI 30 kg/m2 . We made correlation analysis between body weight, BMI, waist circumference and blood pressure by SPSS 15.0. Results: The age was 32.52±7.74 (range: 18−61) years, body weight was 82.54±14.72 (range:42–170) kg, BMI was 26.34±4.04 (range: 15.43−48.85) kg/m2 . Male/female: 7.75/1. The waist circumference was 91.81±9.01 (range: 54–158) cm, hip circumference was 101.43±9.01 (range: 61–160) cm. The systolic blood pressure was 130.29±15.17 (range: 80–220) mmHg and the diastolic was 80.87±9.85 (range: 40–140) mmHg. In women we found 17.3%, in male 36.4% we found hypertensive. Obesity was found in women 7.9% and 18.8% in men. With correlation analysis we found significant correlations between BMI and systolic (P < 0.0001) and diastolic (P < 0.0001) blood pressure. The body weight correlated significantly with systolic (P < 0.0001) and diastolic (P < 0.0001) blood pressure. The waist circumference also correlated significantly with systolic (P < 0.0001) and diastolic (P < 0.0001) blood pressure. Conclusions: In our investigation we found significant proportion of obesity and untreated hypertension in both gender. We found significant correlation between BMI and blood pressure therefore it is important to maintain normal body weight to prevent developing hypertension. P344 Risk stratification in heart failure B.B. Siswanto *, Sunanto, M. Munawar, D. Kusmana, A. Hanafiah, S. Waspadji, A. Bachtiar. Department of Cardiology & Vascular Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia Objective: To look for predictors of mortality and rehospitalization, we conducted a prospective study using fifty variables from history, physical examination, EXG, CXR, Echocardiography and blood tests (e.g. N terminal pro BNP, hsCRP, and Lactate level) that suspected as predictors for mortality and readmission in heart failure. Methods: Blinded prospective cohort study at Emergency room NCVC Jakarta as entry site, with ICCU, wards and OPD for evaluation. All consecutive patients with Acute Decompensated Heart Failure that need hospitalization (Functional Class III and IV NYHA). Exclusion criteria were other concomitant severe diseases. Results: Of 97 patients enrolled, variables were measured using standard protocols. During follow up period of six months, 11