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PM305 Atherosclerosis, Target Organ Damage in Patients with Metabolic Syndrome and Hypertension
POSTER ABSTRACTS
generated curcumin dispersed with colloidal nano-particle, TheracurminÒ which increases its oral bioavailability 30-fold higher that curcumin powder in both rats and humans. However, the comparative study to measure plasma curcumin levels taking TheracurminÒ and other commercially available curcumin beverages has not been reported. Objectives: In this study, to evaluate the absorption efficiency of this type of curcumin, we performed a double-blind, single-dose, randomized, 4-way crossover study. Methods: Twenty-four volunteers (male/female¼13/11, age 23-32) were divided into four groups and administrated TheracurminÒ beverage (30 mg) and other 3 drinkable types of curcumin (Drink A: 30 mg, B: 40 mg, and C: 30 mg) at interval of 1 week. Blood specimens were obtained immediately at 0.5, 1, 2, 4, and 8 hours after taking them. Results: At all point, plasma levels of curcumin were higher in TheracurminÒ than Drink A, B, and C. Plasma maximum concentration values (Cmax) of TheracurminÒ (25.512.2 ng/ml) were higher than those of Drink A (14.95.4 ng/ml), Drink B (8.64.9 ng/ml), and Drink C (6.73.0 ng/ml), respectively. The calculated AUC at 0-8 hours was significantly higher in TheracurminÒ (121.265.6 ng/ml) than Drink A (79.531.4 ng/ml), Drink B (40.924.9 ng/ml), and Drink C (30.114.4 ng/ml). Individual differences in pharmacokinetics of curcumin are shared by all 4 types of curcumin beverages. Conclusion: These findings indicate that our newly prepared TheracurminÒ beverage exhibits the highest bioavailability among currently available preparations of curcumin. Thus, TheracurminÒ may be useful to exert its benefits for cardiovascular diseases in humans at low dosage. Disclosure of Interest: S. Hirano: None Declared, Y. Sunagawa: None Declared, Y. Katanasaka: None Declared, O. Doi: None Declared, T. Yokoji: None Declared, H. Wada: None Declared, A. Imaizumi Employee from: Theravalues Corporation, T. Hashimoto Employee from: Theravalues Corporation, A. Shimatsu: None Declared, H. Kakeya: None Declared, K. Hasegawa: None Declared, T. Morimoto: None Declared PM305 Atherosclerosis, Target Organ Damage in Patients with Metabolic Syndrome and Hypertension Sang-Hyun Kim*1, Hyang-Lim Lee2, Yeon Lee2, Young-Joon Seong1, Hack-Lyoung Kim1, Jae-Bin Seo1, Woo-Young Chung1, Joo-Hee Zo1, Myung-A. Kim1 1 Cardiology, Internal Medicine, Seoul Boramae Hospital, Seoul National University College of Medicine, 2Internal Medicine, Seoul Bukbu Hospital, Seoul, Korea, Republic Of Introduction: Metabolic syndrome is the constellation of risk factors of cardiovascular disease. Objectives: The metabolic syndrome consists of abdominal obesity, insulin resistance, glucose intolerance, hypertension, and dyslipidemia. The prevalence of metabolic syndrome (MS) in Korea is continuously increasing. Hypertension is a component of metabolic syndrome and has intimate relations with pathophysiology and clinical importance. The aim of this study is to evaluate clinical and chemical characters in hypertensive patients with MS. Methods: We reviewed medical records of patients with hypertension in BORAMAE Medical center. Only the patients with metabolic syndrome were included. Anti-hypertension medications were classified according to their action mechanism. The prevalence of target-organ damage was evaluated, including left ventricular hypertrophy, heart failure, coronary artery disease, albuminuria, renal failure, carotid atheroma, arterial stiffness, cerebrovascular disease. Results: Of 155 patients with MS, 66% was obese, 46% had high triglyceride, 61% had low HDL-cholsterol, 62% was glucose intolerance. ACE inhibitor and angiotension II receptors blocker (ARB) were used in 86 patients, beta blocker in 34 patients, calcium channel blocker in 86 patients, diuretics in 25 patients. The prevalence of disease related with target-organ was 31, 28, 15, 16 events respectively for heart, kidney, peripheral vessels, brain. 5% of total patients showed left ventricular hypertrophy, 7% showed heart failure, 10% showed coronary artery disease. 9% of total patients showed microalbuminuria, 14% showed decrease of glomerular filtation rate.
Conclusion: The hypertensive patients with MS showed multiple target-organ damage and need proper management on hypertension, diabetes, dyslipidemia, obesity. Disclosure of Interest: None Declared PM306 A User-Centred Design Process Informs The Development of A Web-Based Cardiovascular Prevention Program Lis Neubeck*1,2, David Peiris1,3, Genevieve Coorey1, Fred Hersch4, Bindu Patel1, Marilyn Lyford1, Jax Wechsler5, Lauren Tan5, Julie Redfern1,3 1 Cardiovascular, The George Institute for Global Health, 2Sydney Nursing School, 3Sydney Medical School, The University of Sydney, Sydney, Australia, 4Essential Healthcare, The George Institute for Global Health, Oxford, United Kingdom, 5Sticky Design Studio, Sydney, Australia Introduction: Cardiovascular disease (CVD) is the leading killer globally and secondary prevention substantially reduces risk. However access to preventive programs is low, leading to development of alternative models of care. Objectives: To inform the development of a web-based preventive program integrated with general practitioner (GP) record systems, we undertook a collaborative user-centred design process to understand the needs of patients with prior CVD event and those at high risk of CVD. Methods: A five stage iterative process was utilised involving seven multidisciplinary clinicians and academics (GP, public health nurses and allied health professionals), two strategic design consultants and nine proposed end-users. The two-month process included (i) literature search and competitor review; (ii) face-to-face interviews, (iii) enduser diary studies, (iv) user experience strategy workshops and (v) co-design and prototype validation activities with prospective users. This work enabled deep understanding of user contexts, specifying the user and organisational requirements, and producing increasingly detailed designs and prototypes. Results: We reviewed ten related apps/websites and 15 observational and interventional studies in a half-day workshop and derived a set of core components and ideal features for the system. These included the need for interactivity, visual appeal, credible information, virtual rewards and need for emotional and physical support. Four ‘personas’ and two customer journey frameworks were consequently developed. These personas were used as a starting point and were then iteratively refined based on user research. The following three features were identified as essential: (i) both mobile and web-enabled ‘apps’, (ii) an emphasis on medication management, and (iii) strong psychosocial support component. Subsequent workshops (n¼6; 2 x 1.5 hours) informed the development of functionality and lo-fidelity sketches of interfaces for the tool. These ideas were next tested in focus groups with patients (n¼9; 3 x 1.5 hours). Finally, prototypes of increasing fidelity were developed emphasising workflow of the application, including language, navigation and labels, and specifics features e.g. tracking bio-metric data. Conclusion: End-users of web-based CVD preventive programs have complex needs including physical and psychosocial support. A user-centred design process aided the integration of these needs into the development and refinement of our web-based application for prevention of CVD. Disclosure of Interest: None Declared PM307 Higher Adherence to a Western Type of Diet is Associated With Higher Probability of Severe Coronary Artery Disease Eleni Kokkou1, Dimitris Tousoulis*2, Gerasimos Siasos2, Evangelos Oikonomou1, Stamatios Kioufis1, Marina Zaromitidou1, Konstantinos Maniatis1, Savvas Mazaris1, Nikolaos Gouliopoulos1, Theodosia Konsola1, Konstantinos Zisimos1, Panagiotis Tourikis1, Vasiliki Genimata3, Christodoulos Stefanadis1 1 1st Cardiology Department, University of Athens Medical School, “Hippokration” Hospital, 2 1st Cardiology Department, University of Athens Medical School, “Hippokration” Hospital, Athens, Greece, 3University of Athens Medical School, “Hippokration” Hospital, Athens, Greece Introduction: The association of dietary pattern with cardiovascular disease is well established. Objectives: In this study we examined the association between different dietary patterns and the severity of coronary artery disease (CAD). Methods: The study population consisted of 188 consecutive symptomatic CAD patients recruited from the outpatient clinic of our Hospital. All patients underwent coronary angiography and they were categorized in subjects with one, two or three vessel disease (1VD, 2VD, 3VD respectively) and in subjects with LM disease. Accordingly, patients with LM disease (stenosis50%), 3VD, or 2VD marked by stenosis of the proximal left anterior descending artery 70% were characterized as having angiographically severe CAD. Among several other demographics and clinical characteristics all subjects were tested with a validated semi quantitative food frequency questionnaire. Univariate and multivariate (principal components analysis) analyses were used in order to evaluate the relationship between dietary habits and the severity of CAD, adjusting for potential confounders. Results: There was no statistically significant difference in the presence of diabetes mellitus, hypertension, hyperlipidemia, family history of CAD and smoking habits between patients with severe and non-severe CAD. Body mass index did not differ between patients with severe and non-severe CAD (29.113.52 vs. 27.694.50, p¼0.11). After adjusting for all traditional risk factors, an increase in red meat consumption lead to a 47% increase in the probability of having severe CAD (p<0.01). Moreover, dietary pattern consisting of high consumption of red meat, sweets, pasta, potatoes and low consumption of fruits and vegetables was associated with higher probability of having severe CAD (p<0.01). This
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GHEART Vol 9/1S/2014
j
March, 2014
j
POSTER/2014 WCC Posters
generated curcumin dispersed with colloidal nano-particle, TheracurminÒ which increases its oral bioavailability 30-fold higher that curcumin powder in both rats and humans. However, the comparative study to measure plasma curcumin levels taking TheracurminÒ and other commercially available curcumin beverages has not been reported. Objectives: In this study, to evaluate the absorption efficiency of this type of curcumin, we performed a double-blind, single-dose, randomized, 4-way crossover study. Methods: Twenty-four volunteers (male/female¼13/11, age 23-32) were divided into four groups and administrated TheracurminÒ beverage (30 mg) and other 3 drinkable types of curcumin (Drink A: 30 mg, B: 40 mg, and C: 30 mg) at interval of 1 week. Blood specimens were obtained immediately at 0.5, 1, 2, 4, and 8 hours after taking them. Results: At all point, plasma levels of curcumin were higher in TheracurminÒ than Drink A, B, and C. Plasma maximum concentration values (Cmax) of TheracurminÒ (25.512.2 ng/ml) were higher than those of Drink A (14.95.4 ng/ml), Drink B (8.64.9 ng/ml), and Drink C (6.73.0 ng/ml), respectively. The calculated AUC at 0-8 hours was significantly higher in TheracurminÒ (121.265.6 ng/ml) than Drink A (79.531.4 ng/ml), Drink B (40.924.9 ng/ml), and Drink C (30.114.4 ng/ml). Individual differences in pharmacokinetics of curcumin are shared by all 4 types of curcumin beverages. Conclusion: These findings indicate that our newly prepared TheracurminÒ beverage exhibits the highest bioavailability among currently available preparations of curcumin. Thus, TheracurminÒ may be useful to exert its benefits for cardiovascular diseases in humans at low dosage. Disclosure of Interest: S. Hirano: None Declared, Y. Sunagawa: None Declared, Y. Katanasaka: None Declared, O. Doi: None Declared, T. Yokoji: None Declared, H. Wada: None Declared, A. Imaizumi Employee from: Theravalues Corporation, T. Hashimoto Employee from: Theravalues Corporation, A. Shimatsu: None Declared, H. Kakeya: None Declared, K. Hasegawa: None Declared, T. Morimoto: None Declared PM305 Atherosclerosis, Target Organ Damage in Patients with Metabolic Syndrome and Hypertension Sang-Hyun Kim*1, Hyang-Lim Lee2, Yeon Lee2, Young-Joon Seong1, Hack-Lyoung Kim1, Jae-Bin Seo1, Woo-Young Chung1, Joo-Hee Zo1, Myung-A. Kim1 1 Cardiology, Internal Medicine, Seoul Boramae Hospital, Seoul National University College of Medicine, 2Internal Medicine, Seoul Bukbu Hospital, Seoul, Korea, Republic Of Introduction: Metabolic syndrome is the constellation of risk factors of cardiovascular disease. Objectives: The metabolic syndrome consists of abdominal obesity, insulin resistance, glucose intolerance, hypertension, and dyslipidemia. The prevalence of metabolic syndrome (MS) in Korea is continuously increasing. Hypertension is a component of metabolic syndrome and has intimate relations with pathophysiology and clinical importance. The aim of this study is to evaluate clinical and chemical characters in hypertensive patients with MS. Methods: We reviewed medical records of patients with hypertension in BORAMAE Medical center. Only the patients with metabolic syndrome were included. Anti-hypertension medications were classified according to their action mechanism. The prevalence of target-organ damage was evaluated, including left ventricular hypertrophy, heart failure, coronary artery disease, albuminuria, renal failure, carotid atheroma, arterial stiffness, cerebrovascular disease. Results: Of 155 patients with MS, 66% was obese, 46% had high triglyceride, 61% had low HDL-cholsterol, 62% was glucose intolerance. ACE inhibitor and angiotension II receptors blocker (ARB) were used in 86 patients, beta blocker in 34 patients, calcium channel blocker in 86 patients, diuretics in 25 patients. The prevalence of disease related with target-organ was 31, 28, 15, 16 events respectively for heart, kidney, peripheral vessels, brain. 5% of total patients showed left ventricular hypertrophy, 7% showed heart failure, 10% showed coronary artery disease. 9% of total patients showed microalbuminuria, 14% showed decrease of glomerular filtation rate.
Conclusion: The hypertensive patients with MS showed multiple target-organ damage and need proper management on hypertension, diabetes, dyslipidemia, obesity. Disclosure of Interest: None Declared PM306 A User-Centred Design Process Informs The Development of A Web-Based Cardiovascular Prevention Program Lis Neubeck*1,2, David Peiris1,3, Genevieve Coorey1, Fred Hersch4, Bindu Patel1, Marilyn Lyford1, Jax Wechsler5, Lauren Tan5, Julie Redfern1,3 1 Cardiovascular, The George Institute for Global Health, 2Sydney Nursing School, 3Sydney Medical School, The University of Sydney, Sydney, Australia, 4Essential Healthcare, The George Institute for Global Health, Oxford, United Kingdom, 5Sticky Design Studio, Sydney, Australia Introduction: Cardiovascular disease (CVD) is the leading killer globally and secondary prevention substantially reduces risk. However access to preventive programs is low, leading to development of alternative models of care. Objectives: To inform the development of a web-based preventive program integrated with general practitioner (GP) record systems, we undertook a collaborative user-centred design process to understand the needs of patients with prior CVD event and those at high risk of CVD. Methods: A five stage iterative process was utilised involving seven multidisciplinary clinicians and academics (GP, public health nurses and allied health professionals), two strategic design consultants and nine proposed end-users. The two-month process included (i) literature search and competitor review; (ii) face-to-face interviews, (iii) enduser diary studies, (iv) user experience strategy workshops and (v) co-design and prototype validation activities with prospective users. This work enabled deep understanding of user contexts, specifying the user and organisational requirements, and producing increasingly detailed designs and prototypes. Results: We reviewed ten related apps/websites and 15 observational and interventional studies in a half-day workshop and derived a set of core components and ideal features for the system. These included the need for interactivity, visual appeal, credible information, virtual rewards and need for emotional and physical support. Four ‘personas’ and two customer journey frameworks were consequently developed. These personas were used as a starting point and were then iteratively refined based on user research. The following three features were identified as essential: (i) both mobile and web-enabled ‘apps’, (ii) an emphasis on medication management, and (iii) strong psychosocial support component. Subsequent workshops (n¼6; 2 x 1.5 hours) informed the development of functionality and lo-fidelity sketches of interfaces for the tool. These ideas were next tested in focus groups with patients (n¼9; 3 x 1.5 hours). Finally, prototypes of increasing fidelity were developed emphasising workflow of the application, including language, navigation and labels, and specifics features e.g. tracking bio-metric data. Conclusion: End-users of web-based CVD preventive programs have complex needs including physical and psychosocial support. A user-centred design process aided the integration of these needs into the development and refinement of our web-based application for prevention of CVD. Disclosure of Interest: None Declared PM307 Higher Adherence to a Western Type of Diet is Associated With Higher Probability of Severe Coronary Artery Disease Eleni Kokkou1, Dimitris Tousoulis*2, Gerasimos Siasos2, Evangelos Oikonomou1, Stamatios Kioufis1, Marina Zaromitidou1, Konstantinos Maniatis1, Savvas Mazaris1, Nikolaos Gouliopoulos1, Theodosia Konsola1, Konstantinos Zisimos1, Panagiotis Tourikis1, Vasiliki Genimata3, Christodoulos Stefanadis1 1 1st Cardiology Department, University of Athens Medical School, “Hippokration” Hospital, 2 1st Cardiology Department, University of Athens Medical School, “Hippokration” Hospital, Athens, Greece, 3University of Athens Medical School, “Hippokration” Hospital, Athens, Greece Introduction: The association of dietary pattern with cardiovascular disease is well established. Objectives: In this study we examined the association between different dietary patterns and the severity of coronary artery disease (CAD). Methods: The study population consisted of 188 consecutive symptomatic CAD patients recruited from the outpatient clinic of our Hospital. All patients underwent coronary angiography and they were categorized in subjects with one, two or three vessel disease (1VD, 2VD, 3VD respectively) and in subjects with LM disease. Accordingly, patients with LM disease (stenosis50%), 3VD, or 2VD marked by stenosis of the proximal left anterior descending artery 70% were characterized as having angiographically severe CAD. Among several other demographics and clinical characteristics all subjects were tested with a validated semi quantitative food frequency questionnaire. Univariate and multivariate (principal components analysis) analyses were used in order to evaluate the relationship between dietary habits and the severity of CAD, adjusting for potential confounders. Results: There was no statistically significant difference in the presence of diabetes mellitus, hypertension, hyperlipidemia, family history of CAD and smoking habits between patients with severe and non-severe CAD. Body mass index did not differ between patients with severe and non-severe CAD (29.113.52 vs. 27.694.50, p¼0.11). After adjusting for all traditional risk factors, an increase in red meat consumption lead to a 47% increase in the probability of having severe CAD (p<0.01). Moreover, dietary pattern consisting of high consumption of red meat, sweets, pasta, potatoes and low consumption of fruits and vegetables was associated with higher probability of having severe CAD (p<0.01). This
e124
GHEART Vol 9/1S/2014
j
March, 2014
j
POSTER/2014 WCC Posters