- Email: [email protected]
Prevalence, awareness and management of arterial hypertension: About a Tunisian population-based survey
Arterial hypertension and vascular disease 174
Prevalence and determinants of Masked Hypertension among obese individuals at the Yaoundé Central Hospital: A cross-sectional study in sub-Saharan Africa B. Hamadou 1,∗ , S. Ndongo Amougou 2 , Y. Tchuendem 3 , C.N. Nganou-Gnindjio 3 , L. Mfeukeu Kuate 3 , A. Tankeu 3 , A.J. Foka 3 , A.P. Menanga 4 , S. Kingue 4 1 Hôpital Central de Yaoundé, FMSB-Université de Yaoundé 1, Yaoundé 2 Centre Hospitalier et Universitaire de Yaoundé 3 Hôpital Central de Yaoundé 4 Hôpital Général de Yaoundé, Yaoundé, Cameroun ∗ Corresponding author. E-mail address: [email protected] (B. Hamadou) Introduction Several studies on the prognosis of masked hypertension suggest that it portends risks for cardiovascular morbidity and mortality that are comparable to the risks of sustained hypertension. obese individuals could have an increased risk of developing masked hypertension, data on the topic are scarce in our context. Purpose The aim of this study was to investigate the prevalence and associated factors of masked hypertension in obese patients in Yaoundé. Methods We carried out a cross-sectional study from January to September 2017 at the National Obesity Center of the Yaoundé Central Hospital. Masked hypertension was defined when the mean 24-hour Systolic Blood Pressure was greater than or equal to 130 mmHg and/or the mean 24 hour Diastolic Blood Pressure was greater than or equal to 80 mmHg with normal office blood pressure. Logistic regression was used to examine the relationship of masked hypertension with associated factors. Results Among the 90 participants included, 67.8% were females. Mean age (± SD) was 46 (± 8) years. The mean clinical measurements were 120 ± 9.4 mm Hg and 75.5 ± 7.9 mm Hg respectively for the systolic and the diastolic blood pressure. On 24-hour Ambulatory measurement, the mean was 123.9 ± 14.4/74.7 ± 8.9 mm Hg respectively for the systolic/diastolic blood pressure. The prevalence of masked hypertension was 33.3%. Masked hypertension was significantly associated with high-normal office blood pressure [odds ratio (OR) =2.90, P = 0.02] and to dyslipidemia [OR = 3.60, P = 0.01], but not to male sex, diabetes, physical activity, tobacco/alcohol. Conclusion Our findings suggest that the prevalence of masked hypertension is high and that physicians should consider ambulatory blood pressure monitoring for obese individuals with high-normal office blood pressure and/or dyslipidemia. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.391 500
Carotid plaque score, independent risk factor for cardiovascular events and mortality after acute coronary syndrome N. Laraba 1,∗ , F. Menzou 2 , M. Ait-Ali 3 , M. Krim 3 , A. Berrah 1 Médecine interne, Centre hospitalo-universitaire de Bab El-Oued, Alger 2 Service de cardiologie, Centre hospitalo-universitaire de Douéra, Douéra 3 Service de cardiologie, Centre hospitalo-universitaire Issaad Hassani Bénimessous, Beni-Messous, Algérie ∗ Corresponding author. E-mail address: [email protected] (N. Laraba)
1
The carotid plaque score (CPS) is the sum of max endoluminals eaves of all atherosclerostic plaques of Common carotids carotid, bifurcations and Internal Carotides. It reflects the atherosclerotic load of
137 the carotid arteries. As intima media thickness, it is strongly related to mortality risk in hypertensive patient and the increase of stroke risk. It is also an independant predictor of coronary heart disease and has a strong link with the SYNTAX score. By a prospective study, recruiting consecutive three hundred thirty-six inpatient coronary care unit for acute coronary syndrome, the aim is to evaluate the impact of a high CPS on mortality and cardiovascular events at 6 and 12 months of follow-up. Results Among patients (Men = 69.0%; mean age = 63.3y), The carotid bulb is the most frequent location of atherosclerotic plaques: 207 patients (61.3%). In our study population, 20.8% have cerebrovascular disease and 16.1% peripheral artery disease (defined by Anckle brachial index < 0.9). One hundred and seven patients (31.8%) have an atherosclerotic bulb plaque of more than 3 mm. A CPS greater than 7 mm is objectified in 91 patients (27.1%) and a significant carotid stenosis is seen in 57 patients (16.7%). A High CPS is significantly related with the presence of multitroncular coronary disease. CPS greater than 12 mm appears as an independent and powerful predictor of mortality and cardiovascular events in medium term in patients with acute coronary syndrome. The hazard ratio of High CPS (CPS > 12 mm) for cardiovascular events at 6 and 12 months of hospitalization are respectively 3,5 (95% CI:1.75—7.13) and 3.4 (95% CI:1.78—6.5). The hazard ratio of High CPS (CPS > 12 mm) for cardiovascular mortality at 6 and 12 months of hospitalization are 4.23 (95% CI:1.42—12.66) and 5.77 (95% CI:2.30—14.47) respectively. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.392
Thursday, January 16th, 2020 345
Prevalence, awareness and management of arterial hypertension: About a Tunisian population-based survey A. Mrabet , L. Bezdah ∗ , A. Dhib , O. Saidi , H. Ben Romdhane Laboratoire de recherche en épidémiologie et prévention des maladies cardiovasculaires en Tunisie, Faculté de Médecine de Tunis, Tunis, Tunisie ∗ Corresponding author. E-mail address: [email protected] (L. Bezdah) Background Hypertension represents a public health problem in Tunisia as in all the world. Purposes Estimate prevalence of hypertension in Tunisia, its associated cardiovascular risk factors and evaluate awareness and access of hypertensive patients to health care. Methods Descriptive transversal regional investigation, realized in 2009, which studied by a home survey a representative sample of Tunisian population. The study was conducted among 1340 persons aged 18 and over, residing in the area of Ariana in Tunis. It included an interview and a physical examination with measurement of blood pressure and anthropometric measurements. Results Prevalence of hypertension was 36%, higher in men (41%) than women (34%). It was inversely related to educational and socioeconomic level. The prevalence of associated cardiovascular risk factors was high: 10% for diabetes, 9% for dyslipidemia, 24% for obesity and 25% for smoking. Half of hypertensive subjects were aware of having hypertension, among them 96% were receiving treatment. Conclusion The prevalence of hypertension was high in 2009 in this cohort of Tunisian population. As primary prevention, it is important to consider lifestyle modification of the Tunisian people
138 in order to reduce this cardiovascular risk factor. Also, screening for hypertension and improving access to health must be established in order to reduce the burden of this cardiovascular risk factor. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.393 479
Peculiarity of hypertension and pregnancy about 544 cases Z. El Abasse Cardiologie-Casablanca, CHU Ibn-Rochd, Casablanca, Maroc E-mail address: [email protected] Introduction Hypertension and pregnancy is a clinical diagnosis defined by the new onset of hypertension (systolic blood pressure ≥ 140 mm Hg and/or diastolic blood pressure ≥ 90 mm Hg. The objective of this work is to specify the epidemiological, clinical, para-clinical, therapeutic and prognostic. Method A total of 5946 deliveries collected at the gynecoobstetric. All pregnant women were included in this study with the diagnosis of hypertension. Result This is a retrospective study of 544 cases of hypertension and pregnancy collected at the Lalla Meryem maternity hospital Ibn Rochd hospital in Casablanca for a period of 2 years. The incidence is 9.2%. The average age of onset was 30 years with an age range of 15 to 45 years. The primiparous were the most exposed 261 cases (48%). Three hundred and ten cases (57%) have an unsupported pregnancy. Two hundred and ninety cases (53.3%) had a systolic blood pressure greater than or equal to 160 mm Hg, and 160 cases (29.4%) had a diastolic blood pressure ≥ 110 mm Hg. The most used medical conduct was the combination of rest and antihypertensives. Obstetrical behavior was marked by the frequency of vaginal deliveries (63.4%). Maternal complications represent (14.7%) dominated by retro-placental hematoma (5.1%) and eclampsia (3.7%). Perinatal mortality represents 57 cases (9.9%). The factors of bad fœto-maternal prognosis are for the fetus: the low gestational age, the low parity, the non monitoring of the pregnancy, the massive proteinuria and the hyperuricemia. For the mother, young maternal age, primiparity, non-pregnancy monitoring, diastolic blood pressure ≥ 110 mm Hg, systolic blood pressure ≥ 160 mm Hg, and massive proteinuria. Conclusion This study concludes that high blood pressure and pregnancy is a major cause of maternal mortality and morbidity. These complications can be reduced by a better physiopathological understanding and a better knowledge of fetal and maternal prognostic factors. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.394 108
A connection between arterial hypertension, dyslipidemia and activity of interleukin-1 and interleukin-6 IN type 2 diabetes mellitus L. Zhuravlyova ∗ , N. Sokolnikova Kharkiv national medical university, Kharkiv, Ukraine ∗ Corresponding author. E-mail address: [email protected] (L. Zhuravlyova) Purpose To determine the relationship between blood pressure (BP), lipid metabolism and levels of IL-1 and IL-6 in patients with type 2 diabetes mellitus (T2DM). Methods Ninety six patients with T2DM (mean age 52.74 ± 9.56, 38 women) were examined, and 20 healthy volunteers. A systolic
Arterial hypertension and vascular disease blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were measured; levels of total cholesterol (TC), high density lipoprotein cholesterol (HDL), triglycerides (TG), low density lipoprotein cholesterol (LDL)were determined. The levels of IL-1- and IL-6 were determined by the immune-enzymatic method. Results SBP (mm Hg) in main group −141.76 ± 1.31, in control group - 120.75 ± 1.51; DAT (mm Hg)—88.43 ± 0.68 and 77.75 ± 0.85, respectively; MAP −106.23 ± 0.87 and 92.08 ± 0.98, respectively (P < 0.05). TC (mmol/L) in the main group was 5.29 ± 0.15, in the control group− 4,06 ± 0.05; TG (mmol/L) 1.20 ± 0.02 and 1.3 ± 0.03, respectively; LDL (mmol/L) 3.28 ± 0.14 and 2.01 ± 0.04, respectively (P < 0.05). IL-1 (ng/mL) in main group was 13.58 ± 0.29, control group − 8.12 ± 0.24; IL-6 (ng/mL) 12.37 ± 0.3 and 8.83 ± 0.22, respectively (P < 0.05). Significant correlations were revealed between the studied indices in the main group: SBP and TC (r = 0.29), SBP and TG (r = 0.28), SBP and LDL (r = 0.28), SBP and IL-1 (r = 0.41), SBP and IL-6 (r = 0.25); DBT and IL-1 (r = 0.25); MAP and TC (r = 0.26), MAP and TG (r = 0.29), MAP and LDL (r = 0.27), MAP and IL-1 (r = 0.39), MAP and IL-6 (r = 0.28). There were no significant correlations in the control group. Conclusions The revealed interrelations indicate that the risk of arterial hypertension is increased even with a slight elevation of BP in patients with T2DM. The reasons for this include not only the increase of vascular resistance and the decrease of the elasticity of the vascular wall, but also the progression of dyslipidemia and deployment of systemic inflammatory response due to the increased levels of proinflammatory cytokines IL-1 and IL-6. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.395 228
High blood pressure in adult patients with sickle cell disease: New insight from an ambulatory blood pressure monitoring pilot study C. Lam 1,∗ , G. Loko 1 , B. Meunier 2 , A. Bourguignon 1 , R. Ifrim 1 , N. Ozier-Lafontaine 1 , L. Haustant-Andry 1 , R. Banydeen 1 , R. Neviere 1 , J. Inamo 1 1 CHU de Martinique, Fort-de-France 2 Assistance Publique-Hôpitaux de Marseille, Marseille, France ∗ Corresponding author. E-mail address: [email protected] (C. Lam) Introduction Sickle cell disease (SCD) is a common genetic disorder leading to severe hematologic and cardiovascular complications. Increasing lifespan of patients is associated with increased prevalence of cardiovascular diseases, especially high blood pressure (BP). However, the clinical and epidemiological characteristics of high BP in these patients remain poorly defined. Notably, the usefulness of 24h-ambulatory blood pressure monitoring (ABPM) has not been assessed in adults, and specific cut-off for BP values are still debated. Purpose To analyze office blood pressure and 24-h ABPM values in SCD adult patients. Material and methods A prospective pilot study with systematic ABPM readings of SCD adult patients from October 2017 to April 2018, conducted in the SCD reference center of Martinique. Consistent Hypertension was defined as office BP ≥ 140/90 mm Hg and 24-h mean BP ≥ 130/80 mm Hg. Masked hypertension was defined as office BP < 140/90 mm Hg and 24-h mean BP ≥ 130/80 mm Hg. High Office BP was defined as SBP between 130—139 mm Hg and DBP between 85-89 mm Hg. White coat hypertension was defined as office BP ≥ 140/90 mm Hg and 24-h mean BP < 130/80 mm Hg. Results We enrolled twenty-one patients age 50.9 years (± 14.3). Hypertension was diagnosed in 10 patients (47.6%) of which 7 (70% of the hypertensive, 33.3% of the entire group) had consistent
Prevalence and determinants of Masked Hypertension among obese individuals at the Yaoundé Central Hospital: A cross-sectional study in sub-Saharan Africa B. Hamadou 1,∗ , S. Ndongo Amougou 2 , Y. Tchuendem 3 , C.N. Nganou-Gnindjio 3 , L. Mfeukeu Kuate 3 , A. Tankeu 3 , A.J. Foka 3 , A.P. Menanga 4 , S. Kingue 4 1 Hôpital Central de Yaoundé, FMSB-Université de Yaoundé 1, Yaoundé 2 Centre Hospitalier et Universitaire de Yaoundé 3 Hôpital Central de Yaoundé 4 Hôpital Général de Yaoundé, Yaoundé, Cameroun ∗ Corresponding author. E-mail address: [email protected] (B. Hamadou) Introduction Several studies on the prognosis of masked hypertension suggest that it portends risks for cardiovascular morbidity and mortality that are comparable to the risks of sustained hypertension. obese individuals could have an increased risk of developing masked hypertension, data on the topic are scarce in our context. Purpose The aim of this study was to investigate the prevalence and associated factors of masked hypertension in obese patients in Yaoundé. Methods We carried out a cross-sectional study from January to September 2017 at the National Obesity Center of the Yaoundé Central Hospital. Masked hypertension was defined when the mean 24-hour Systolic Blood Pressure was greater than or equal to 130 mmHg and/or the mean 24 hour Diastolic Blood Pressure was greater than or equal to 80 mmHg with normal office blood pressure. Logistic regression was used to examine the relationship of masked hypertension with associated factors. Results Among the 90 participants included, 67.8% were females. Mean age (± SD) was 46 (± 8) years. The mean clinical measurements were 120 ± 9.4 mm Hg and 75.5 ± 7.9 mm Hg respectively for the systolic and the diastolic blood pressure. On 24-hour Ambulatory measurement, the mean was 123.9 ± 14.4/74.7 ± 8.9 mm Hg respectively for the systolic/diastolic blood pressure. The prevalence of masked hypertension was 33.3%. Masked hypertension was significantly associated with high-normal office blood pressure [odds ratio (OR) =2.90, P = 0.02] and to dyslipidemia [OR = 3.60, P = 0.01], but not to male sex, diabetes, physical activity, tobacco/alcohol. Conclusion Our findings suggest that the prevalence of masked hypertension is high and that physicians should consider ambulatory blood pressure monitoring for obese individuals with high-normal office blood pressure and/or dyslipidemia. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.391 500
Carotid plaque score, independent risk factor for cardiovascular events and mortality after acute coronary syndrome N. Laraba 1,∗ , F. Menzou 2 , M. Ait-Ali 3 , M. Krim 3 , A. Berrah 1 Médecine interne, Centre hospitalo-universitaire de Bab El-Oued, Alger 2 Service de cardiologie, Centre hospitalo-universitaire de Douéra, Douéra 3 Service de cardiologie, Centre hospitalo-universitaire Issaad Hassani Bénimessous, Beni-Messous, Algérie ∗ Corresponding author. E-mail address: [email protected] (N. Laraba)
1
The carotid plaque score (CPS) is the sum of max endoluminals eaves of all atherosclerostic plaques of Common carotids carotid, bifurcations and Internal Carotides. It reflects the atherosclerotic load of
137 the carotid arteries. As intima media thickness, it is strongly related to mortality risk in hypertensive patient and the increase of stroke risk. It is also an independant predictor of coronary heart disease and has a strong link with the SYNTAX score. By a prospective study, recruiting consecutive three hundred thirty-six inpatient coronary care unit for acute coronary syndrome, the aim is to evaluate the impact of a high CPS on mortality and cardiovascular events at 6 and 12 months of follow-up. Results Among patients (Men = 69.0%; mean age = 63.3y), The carotid bulb is the most frequent location of atherosclerotic plaques: 207 patients (61.3%). In our study population, 20.8% have cerebrovascular disease and 16.1% peripheral artery disease (defined by Anckle brachial index < 0.9). One hundred and seven patients (31.8%) have an atherosclerotic bulb plaque of more than 3 mm. A CPS greater than 7 mm is objectified in 91 patients (27.1%) and a significant carotid stenosis is seen in 57 patients (16.7%). A High CPS is significantly related with the presence of multitroncular coronary disease. CPS greater than 12 mm appears as an independent and powerful predictor of mortality and cardiovascular events in medium term in patients with acute coronary syndrome. The hazard ratio of High CPS (CPS > 12 mm) for cardiovascular events at 6 and 12 months of hospitalization are respectively 3,5 (95% CI:1.75—7.13) and 3.4 (95% CI:1.78—6.5). The hazard ratio of High CPS (CPS > 12 mm) for cardiovascular mortality at 6 and 12 months of hospitalization are 4.23 (95% CI:1.42—12.66) and 5.77 (95% CI:2.30—14.47) respectively. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.392
Thursday, January 16th, 2020 345
Prevalence, awareness and management of arterial hypertension: About a Tunisian population-based survey A. Mrabet , L. Bezdah ∗ , A. Dhib , O. Saidi , H. Ben Romdhane Laboratoire de recherche en épidémiologie et prévention des maladies cardiovasculaires en Tunisie, Faculté de Médecine de Tunis, Tunis, Tunisie ∗ Corresponding author. E-mail address: [email protected] (L. Bezdah) Background Hypertension represents a public health problem in Tunisia as in all the world. Purposes Estimate prevalence of hypertension in Tunisia, its associated cardiovascular risk factors and evaluate awareness and access of hypertensive patients to health care. Methods Descriptive transversal regional investigation, realized in 2009, which studied by a home survey a representative sample of Tunisian population. The study was conducted among 1340 persons aged 18 and over, residing in the area of Ariana in Tunis. It included an interview and a physical examination with measurement of blood pressure and anthropometric measurements. Results Prevalence of hypertension was 36%, higher in men (41%) than women (34%). It was inversely related to educational and socioeconomic level. The prevalence of associated cardiovascular risk factors was high: 10% for diabetes, 9% for dyslipidemia, 24% for obesity and 25% for smoking. Half of hypertensive subjects were aware of having hypertension, among them 96% were receiving treatment. Conclusion The prevalence of hypertension was high in 2009 in this cohort of Tunisian population. As primary prevention, it is important to consider lifestyle modification of the Tunisian people
138 in order to reduce this cardiovascular risk factor. Also, screening for hypertension and improving access to health must be established in order to reduce the burden of this cardiovascular risk factor. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.393 479
Peculiarity of hypertension and pregnancy about 544 cases Z. El Abasse Cardiologie-Casablanca, CHU Ibn-Rochd, Casablanca, Maroc E-mail address: [email protected] Introduction Hypertension and pregnancy is a clinical diagnosis defined by the new onset of hypertension (systolic blood pressure ≥ 140 mm Hg and/or diastolic blood pressure ≥ 90 mm Hg. The objective of this work is to specify the epidemiological, clinical, para-clinical, therapeutic and prognostic. Method A total of 5946 deliveries collected at the gynecoobstetric. All pregnant women were included in this study with the diagnosis of hypertension. Result This is a retrospective study of 544 cases of hypertension and pregnancy collected at the Lalla Meryem maternity hospital Ibn Rochd hospital in Casablanca for a period of 2 years. The incidence is 9.2%. The average age of onset was 30 years with an age range of 15 to 45 years. The primiparous were the most exposed 261 cases (48%). Three hundred and ten cases (57%) have an unsupported pregnancy. Two hundred and ninety cases (53.3%) had a systolic blood pressure greater than or equal to 160 mm Hg, and 160 cases (29.4%) had a diastolic blood pressure ≥ 110 mm Hg. The most used medical conduct was the combination of rest and antihypertensives. Obstetrical behavior was marked by the frequency of vaginal deliveries (63.4%). Maternal complications represent (14.7%) dominated by retro-placental hematoma (5.1%) and eclampsia (3.7%). Perinatal mortality represents 57 cases (9.9%). The factors of bad fœto-maternal prognosis are for the fetus: the low gestational age, the low parity, the non monitoring of the pregnancy, the massive proteinuria and the hyperuricemia. For the mother, young maternal age, primiparity, non-pregnancy monitoring, diastolic blood pressure ≥ 110 mm Hg, systolic blood pressure ≥ 160 mm Hg, and massive proteinuria. Conclusion This study concludes that high blood pressure and pregnancy is a major cause of maternal mortality and morbidity. These complications can be reduced by a better physiopathological understanding and a better knowledge of fetal and maternal prognostic factors. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.394 108
A connection between arterial hypertension, dyslipidemia and activity of interleukin-1 and interleukin-6 IN type 2 diabetes mellitus L. Zhuravlyova ∗ , N. Sokolnikova Kharkiv national medical university, Kharkiv, Ukraine ∗ Corresponding author. E-mail address: [email protected] (L. Zhuravlyova) Purpose To determine the relationship between blood pressure (BP), lipid metabolism and levels of IL-1 and IL-6 in patients with type 2 diabetes mellitus (T2DM). Methods Ninety six patients with T2DM (mean age 52.74 ± 9.56, 38 women) were examined, and 20 healthy volunteers. A systolic
Arterial hypertension and vascular disease blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were measured; levels of total cholesterol (TC), high density lipoprotein cholesterol (HDL), triglycerides (TG), low density lipoprotein cholesterol (LDL)were determined. The levels of IL-1- and IL-6 were determined by the immune-enzymatic method. Results SBP (mm Hg) in main group −141.76 ± 1.31, in control group - 120.75 ± 1.51; DAT (mm Hg)—88.43 ± 0.68 and 77.75 ± 0.85, respectively; MAP −106.23 ± 0.87 and 92.08 ± 0.98, respectively (P < 0.05). TC (mmol/L) in the main group was 5.29 ± 0.15, in the control group− 4,06 ± 0.05; TG (mmol/L) 1.20 ± 0.02 and 1.3 ± 0.03, respectively; LDL (mmol/L) 3.28 ± 0.14 and 2.01 ± 0.04, respectively (P < 0.05). IL-1 (ng/mL) in main group was 13.58 ± 0.29, control group − 8.12 ± 0.24; IL-6 (ng/mL) 12.37 ± 0.3 and 8.83 ± 0.22, respectively (P < 0.05). Significant correlations were revealed between the studied indices in the main group: SBP and TC (r = 0.29), SBP and TG (r = 0.28), SBP and LDL (r = 0.28), SBP and IL-1 (r = 0.41), SBP and IL-6 (r = 0.25); DBT and IL-1 (r = 0.25); MAP and TC (r = 0.26), MAP and TG (r = 0.29), MAP and LDL (r = 0.27), MAP and IL-1 (r = 0.39), MAP and IL-6 (r = 0.28). There were no significant correlations in the control group. Conclusions The revealed interrelations indicate that the risk of arterial hypertension is increased even with a slight elevation of BP in patients with T2DM. The reasons for this include not only the increase of vascular resistance and the decrease of the elasticity of the vascular wall, but also the progression of dyslipidemia and deployment of systemic inflammatory response due to the increased levels of proinflammatory cytokines IL-1 and IL-6. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.395 228
High blood pressure in adult patients with sickle cell disease: New insight from an ambulatory blood pressure monitoring pilot study C. Lam 1,∗ , G. Loko 1 , B. Meunier 2 , A. Bourguignon 1 , R. Ifrim 1 , N. Ozier-Lafontaine 1 , L. Haustant-Andry 1 , R. Banydeen 1 , R. Neviere 1 , J. Inamo 1 1 CHU de Martinique, Fort-de-France 2 Assistance Publique-Hôpitaux de Marseille, Marseille, France ∗ Corresponding author. E-mail address: [email protected] (C. Lam) Introduction Sickle cell disease (SCD) is a common genetic disorder leading to severe hematologic and cardiovascular complications. Increasing lifespan of patients is associated with increased prevalence of cardiovascular diseases, especially high blood pressure (BP). However, the clinical and epidemiological characteristics of high BP in these patients remain poorly defined. Notably, the usefulness of 24h-ambulatory blood pressure monitoring (ABPM) has not been assessed in adults, and specific cut-off for BP values are still debated. Purpose To analyze office blood pressure and 24-h ABPM values in SCD adult patients. Material and methods A prospective pilot study with systematic ABPM readings of SCD adult patients from October 2017 to April 2018, conducted in the SCD reference center of Martinique. Consistent Hypertension was defined as office BP ≥ 140/90 mm Hg and 24-h mean BP ≥ 130/80 mm Hg. Masked hypertension was defined as office BP < 140/90 mm Hg and 24-h mean BP ≥ 130/80 mm Hg. High Office BP was defined as SBP between 130—139 mm Hg and DBP between 85-89 mm Hg. White coat hypertension was defined as office BP ≥ 140/90 mm Hg and 24-h mean BP < 130/80 mm Hg. Results We enrolled twenty-one patients age 50.9 years (± 14.3). Hypertension was diagnosed in 10 patients (47.6%) of which 7 (70% of the hypertensive, 33.3% of the entire group) had consistent