- Email: [email protected]
PS061 Relationship Between Retinopathy and Renal Abnormalities in Black Hypertensive Patients
POSTER ABSTRACTS Conclusion: BHB plans to strengthen every facet of its programmes to reach out to a billion people by 2030. And if the progress in the past five years is anything to go by, India’s battle against heart disease could well be a winning battle. Disclosure of Interest: None Declared PS054 Prevalence and Patterns of Cardiac Diseases Among HIV Infected People Following Antiretroviral Clinic at Jimma University Specialized Hospital, Southwest Ethiopia E. Tegene*1, T. Belachew2 Internal Medicine, 2Population and family Health Department, Jimma University, Jimma, Ethiopia
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Introduction: Cardiac diseases are among the most common complications of HIV infection; they are present in up to half of people living with HIV. The most common forms of heart disease in these people are dilated cardiomyopathy, coronary heart diseases, and pericardial effusion. Although this has been reported from other countries, there is no study that evaluated the prevalence of the problem and its patterns in Ethiopia in general and in the study area, in particular. Objectives: The objective of this study was to determine the prevalence, patterns and factors that are associated with cardiovascular diseases among adult people with HIV who are on follow up at Jimma University Specialized Hospital (JUSH), antiretroviral therapy (ART) clinic. Methods: A cross sectional hospital based study was conducted on 280 people living with HIV aged >18 years attending the ART clinic of JUSH from sept16/2012-Dec15/ 2012. Data were collected using structured questionnaire containing socio-demographic characteristics, heart failure symptoms, HIV status. A detailed Trans thoracic Echocardiography was done for all the participants. Data were analyzed using SPSS for windows version 16 of the computer software. A P value of < 0.05 was considered statistically significant. Independent variables were assessed for association with the heart disease using bivariate and multivariable logistic regression analyses to generate odds ratios. Results: Of the total 280 participants 66.1%were females and 64.7% were on ART. The mean (sd) age of the participants was 33.62(8.29) years. Cardiac abnormalities were found in 42.1% of individuals, the most common being diastolic dysfunction and Left Ventricular Hypertrophy (LVH), each accounting for 21.2%. Dilated cardiomyopathy (DCM) was found in 12.7% of the cases. DCM was significantly associated with lower CD4 counts (p¼0.002), being ART Naïve (p¼0.025) and lower body mass index (BMI) (p¼0.042). Pericardial effusion was found in 5.9% and was significantly associated with being ART naïve (p¼0.014). Conclusion: The findings showed high prevalence of cardiac abnormalities (42.1%) and its link with low CD4 count, poor nutritional status and being ART naïve implying the need for periodic screening for cardiac abnormalities and nutritional status. Disclosure of Interest: None Declared PS055 To Evaluate the Role of Non Hdl-C, Lp(a), Apo-B as a Clinical Surrogate Marker for Coronary Artery Disease S. Tewari*1, P. Agarwal1, P. Goel1 1 Cardiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India Introduction: The early identification of individuals at increased risk of cardiovascular diseases is of pivotal importance in order to modify the factors contributing to this highrisk profile. Elevated serum LDL cholesterol and low HDL cholesterol are most important modifiable major risk factor for atherosclerosis and Cardiovascular disease (CVD). Lipoprotein(a) [Lp(a)], a large protein attached to LDL particle possess potent atherogenic and thrombogenic properties.Indians have double the risk of CAD due to high prevalence of emerging risk factors, especially lipoprotein(a) a genetic risk factor for premature CAD found in 35-40% of Indians. Objectives: The present study was conducted to establish a relationship between these new markers and CVD events and elucidate their potential role as marker of clinical risk. It was
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conducted to help clinicians to use serum Apo-lipoproteins and Lp(a) values in future while providing health care to patients with CAD. Methods: A total of 500 patients (350cases, 150control) undergoing coronary angiography were included in the study. Mean age was 5411 yrs (95% Cl; 52.74, 54.77). Females comprised 21% of case group but 60% of control group. Two most common non-lipid conventional modifiable risk factors were smoking (39%, 95%Cl; 32,45) and type 2 diabetes mellitus (26%, 95%Cl; 20,31). Results: There was significant and direct correlation of CAD with TC, LDL-C, TG, TC/ HDL, non HDL-C, ApoB, ApoB/ApoA1 and Lp(a) (p<0.001) whereas with TG, HDL and ApoA1 was not significant statistically. These parameters are also correlated with severity of CAD on univariate analysis. On polynomial regression analysis Lp(a) (P<.001) was invariably associated with severe CAD while LDL levels were found to be insignificant (p¼.91). Lp(a) was much higher in our study population with Lp(a) >30mg/dl in 23% of control (non CAD) and 64% of case group (CAD). Conclusion: Lipid levels though lower in Indian population as compared to Caucasians are significant risk factors for CAD. Apolipoproteins especially ApoB/ApoA1 ratio is another significant risk factor for CAD. This also adds to data in support of Lp(a) as an independent risk factor for CAD especially in Indian population. Lp(a) levels are indicator of severity of CAD even with normal or high normal LDL levels. All these risk factors significantly associated with severe CAD and also have prognostic signifinance. Disclosure of Interest: None Declared PS059 Prevalence of Essential Hypertension and Assessment of Cardiac Risk in Pakistani Adults – The Reveal Study M. A. Ebrahim*1, M. I. khowaja1 1 Medicine, Jamal Noor Hospital, Karachi, Pakistan Introduction: Prevalence of hypertension (HTN) is 18% (National Health Survey of Pakistan) with 17% population carrying 2 cardiovascular (CV) risk factors. Objectives: To estimate the prevalence of HTN in outpatients aged 18 years and general 10 year CV risk score in patients aged 30 years. Methods: This observational cross sectional study was conducted between November 2012 and October 2014 in patients (18 years) seeking consultation for any ailment in 140 randomly selected outpatient centers. Blood pressure (BP) cut-offs cited in JNC 7 were used to determine prevalence of HTN and its staging. Ten year CV risk and its categorization were calculated using laboratory and non-laboratory predictors suggested by Framingham studies. Results: Mean age of patients (N¼2336) was 40.8 13.1 years with 72% patients 30 years of age and 56% were males. There were 535 (23%) patients with diabetes. There were 51.5% (C.I. 49.4 – 53.4) patients with HTN. Prevalence of HTN in nondiabetic patients was 30% (C.I. 28.2 – 31.9) and 21.4% (C.I. 19.8 – 23.2) in diabetics. Only 13% were normotensive. There were 30% patients in Stage 1 and 26% in Stage 2. Same estimates for diabetics were 4% (normal), 36% in Stage 1 and 34% in Stage 2 respectively. 84.4% hypertensive patients (1014/1202) were prescribed either mono or combination therapy of ACEI (41%), CCBs (26.9%), ARBs (22.1%), BBs (19.7%) and Diuretics (12.9%) at consultation. Mean CV risk score by Framingham for non-laboratory and laboratory predictors were 18.1 and 14.8 respectively for females and 16.3 and 16.9 for males. For same predictors, 54% and 37% females were in medium to high risk category combined for CV events. For males, these estimates were 57% and 59% respectively. Conclusion: Almost every second adult patient is likely to be hypertensive. Over 50% patients are at medium to high risk of developing CVD in the next 10 years. BP assessments, Framingham risk scoring and treatment optimization in ambulatory settings may reduce morbidity and mortality from CV events. Disclosure of Interest: None Declared PS061 Relationship Between Retinopathy and Renal Abnormalities in Black Hypertensive Patients P. M. Kolo*1, A. B. Omotoso1, T. Olanrewaju1, J. F. Owoeye2, on behalf of Hypertension Complications Project 1 Department of Medicine, University of Ilorin, Nigeria, 2Department of Ophthalmology, University of Ilorin, Nigeria, Ilorin, Nigeria Introduction: Complications of hypertension are particularly common in people of African descent but previous reports had suggested rarity of hypertensive retinopathy in black Africans. Objectives: We evaluated retinal changes among Nigerian hypertensive patients and determined their relationship with renal function. Methods: Hypertensive patients who were 18 years who met the inclusion criteria were selected for the study. The socio-demographic characteristics of the participants were obtained; anthropometric parameters and blood pressure were measured. All patients had ophthalmoscopic examination after pupillary dilatation and the severity of patient’s retinal changes was determined and graded according to Keith-Wegener’s classification. Blood samples were taken from each patient for blood urea nitrogen, lipids and C-reactive protein; and urine was collected for microalbuminuria. Results: Of the 240 patients studied, 187 (78%) had one form of retinopathy or the other. While 85 (35.4%) patients had grade 1 retinopathy, 87 (36.3%) had grade 2, 13 (5.4%)
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PS063 Analysis on ECG P-wave Changing in Masked Hypertension Patients L. Nie*1, Z. LI1, Y. Jing1 Department of electrocardiogram, The Second Affiliated Hospital of Zhengzhou University, zhengzhou, China
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Introduction: Masked hypertension is easily progressing to sustained hypertension causing a certain degree of target organ damage, which is always being overlooked ,while,no invasive electrical inspection method can provide some help. Objectives: To investigate the significance on ECG P-wave changing in masked hypertension patients. Methods: One hundred and fifty patients diagnosed as masked hypertension(study group) and 150 sustained hypertension subjects(control group) from January 2013 to march 2014 in the second affiliated hospital of Zhengzhou University were selected.Together with the ECG changes of two groups ,we were to analyse the Significances of P-wave broadening and P-wave Bimodal changing in masked hypertension patients. Results: Compared with control group, study group has lower age(45.65.2) VS(60.44.8) ,lower complications [44.7%(67/150)VS 62.0%(93/150)] and more males [98 cases(65.3%)VS 78 cases(52.0%)] .Compared with control group, study group has statistically significant difference in the following three aspects:the incidence of Left ventricular hypertrophy:[7.3%(11/150)vs24.7%(37/150)],the incidence of ST-T changing [13.3%(20/150)vs56.0%(84/150)],the incidence of conduction block[4.6%(7/150) vs22.0%(33/150)],P<0.05;However,the incidence of P-wave broadening[(78.6%(118/150) vs82.7%(124/150),P¼0.381]and the incidence of P-wave Bimodal changing [(58.7%(88/ 150)vs66.7%(100/150),P¼0.152] has no statistically significant difference. Conclusion: ECG P-wave changing may indicate early manifestation of cardiac electrical damage in masked hypertension. Disclosure of Interest: None Declared PS064
media offers an opportunity for healthcare workers to reach the public with accurate information. Disclosure of Interest: E. Ogola Grant/research support from: Project sponsored by Astra Zeneca, F. Okello Consultancy for: Consultant for Astra Zeneca, G. Yonga Grant/research support from: Project sponsored by Astra Zeneca, E. Mac Gregor-Skinner Consultancy for: Consultant for Astra Zeneca, N. Ramchandarani Consultancy for: Consultant for Astra Zeneca PS069 Intense Supervised Exercise Training and Blood Pressure in Hypertension Results From the Ergociser-Rr Study F. Van Buuren*1, J. B. Dahm2, K.-P. Mellwig1, D. Horstkotte1 1 Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, 2Dept. of Cardiology and Sports Medicine, Herz- und Gefäßzentrum, Göttingen, Germany Introduction: Aerobic physical activity generates beneficial effects on blood pressure (BP) and other cardiovascular risk factors. Objectives: In this prospective study over 2 years we investigated the influence of a moderately intense, long-term supervised aerobic exercise training (IAET) on blood pressure, with special emphasis on the physician’s role regarding motivation. Methods: 7 patients (4211 years) conducted a daily IAET (5 times weekly, 25-30 min/ day, 70% of their maximum exercise capacity) for > 120 weeks (control group 9 patients, once weekly 90 minutes). Submaximal-BP, drug therapy and serum-lipids were measured on follow-up (3, 6, 12, 18, 24 months). The influence of physician’s feedback on motivation was evaluated through energy utilization during a timely limited period of less physician’s assistance. Results: Under IAET (98983 J/week) exercise capacity improved (32.6%; p<0.001), submaximal-BP decreased (9.7%; p<0.001), drug-therapy declined significantly (27.9%; p<0.001), HDL-cholesterol increased (18.5%; p¼0.007), body mass index dropped (4.1%; p¼0.002). Motivation and maintenance declined substantially and energy utilization decreased significantly by 9.3% to 898 88 J/week during reduced physician’s feedback. Exercise capacity did not differ between the two groups at baseline. Patients of the IAETgroup fulfilled 178 98 minutes aerobe exercise training per week with a working load of estimated 989 83 J/week. The exercise capacity of the IAET-group increased significantly by 32.5% after 3 months from 109 9.5 (range 98-122) to 144 12.1 (130-161) watt and sustained constant around 140 W after 24 months, while it remained unchanged in the control group with corresponding values of 114 13.3 (range 96-132) at baseline and 115 12.0 (100-132) at 3 months. Conclusion: In contrast to a once weekly physical fitness program, IAET with a work load of 1000 J/week has favorable effects. Because of its easy availability in their own homes, it should be recommended but physician’s assistance is crucial to keep motivation high. Disclosure of Interest: None Declared
Knowledge About Hypertension in the Population: Results of Baseline Survey of a Population Intervention Program to Control Hypertension
PS070
E. N. Ogola*1, F. O. Okello2, G. Yonga3, E. Mac Gregor-Skinner2, N. Ramchandarani2 1 Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya, 2Abt Associates, Bethesda, United States, 3Aga Khan University Hospital, Nairobi, Kenya
Rosuvastatin Dose-Dependently Improves Flow-Mediated Dilation, but Reduces Adiponectin Levels and Insulin Sensitivity in Hypercholesterolemic Patients
Introduction: Hypertension is a major cardiovascular risk factor and the leading cause of mortality worldwide. Africa has the highest prevalence rates (30%), but very low rates of awareness and treatment leading to control rates of only 7%. Impacting the burden of hypertension requires a system wide approach to increase screening, initiation and retention in treatment. Healthy Heart Africa (HHA) is an Astra Zeneca sponsored program to increase awareness, screening and control of hypertension in Africa, the first of its kind. This is a report of the baseline survey of population knowledge at household level prior to program implementation. Objectives: To determine the population knowledge of hypertension; risk factors, consequences and management options. Methods: The study used a quasi experimental design with pre and post intervention surveys conducted in households in the intervention and control areas. These are results of the baseline survey. All consenting adults 18 years were interviewed. The data were analyzed descriptively and presented as proportions. Results: A total of 2937 respondents were interviewed (1518 intervention, 1419 control). About two thirds (67%) were in the age group 18-39 years, 53% were female. 87% had heard of hypertension, 72% from family or friends and 36% from media. Only 33% heard from a health institution and 6 % from a community health worker. Self reported hypertension was 12%. Knowledge of risk factors for hypertension was as follows: salt intake 50%, alcohol 5%, overweight 38%, lack of physical activity 12% and low potassium intake 8%. Knowledge of hypertension related complications was: stroke 30%, heart attack 29%, and heart failure 11% with no mention of kidney disease. Concerning measures to reduce blood pressure (BP), the responses were: medication 31%, salt reduction 18%, exercise 34%, reduction in alcohol 10% and weight loss 21%. Conclusion: Though hypertension awareness was high, most of the information is from lay sources with the potential for wrong information. There is low awareness of the risks for, complications of and evidence based measures for lowering BP. There is need to strengthen primary healthcare and empower primary healthcare workers. The prominence of the
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K. Koh*1 Gachon University Gil Medical Center, Incheon, Korea, Republic Of
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Introduction: Genetic analysis from patients participated in the randomized trials reported that the increased risk of type 2 diabetes noted with statins is at least partially explained by HMG-coenzyme A reductase inhibition. Objectives: We investigated vascular and metabolic phenotypes of different dosages of rosuvastatin in hypercholesterolemic patients. Methods: This was a randomized, single-blind, placebo-controlled, parallel study. Age, sex, and body mass index were matched among groups. Forty-eight patients were given placebo, and 47, 48, and 47 patients given rosuvastatin 5,10, and 20 mg, respectively daily during a 2 month treatment period. Results: Placebo therapy did not significantly change insulin, adiponectin, glycated hemoglobin, and insulin sensitivity relative to baseline measurements. Rosuvastatin 5,10, and 20 mg dose-dependently and significantly improved flow-mediated dilation (34, 40, and 46%) after 2 months therapy when compared with baseline (P<0.001 by paired t-test) or when compared with placebo (P<0.001 by ANOVA). Rosuvastatin 5,10, and 20 mg dosedependently and significantly increased insulin (median % changes; 16, 20, and 20%, respectively) and glycated hemoglobin levels (mean % changes; 2, 2, and 3%, respectively), and decreased adiponectin levels (mean % changes; 3, 9, and 14%, respectively) and insulin sensitivity (mean % changes; 2, 3, and 4%, respectively) after 2 months therapy when compared with either baseline (all P<0.05 by paired t-test). These effects with rosuvastatin 5,10, and 20 mg were significant when compared with placebo (P¼0.006 for insulin, P¼0.012 for glycated hemoglobin, P¼0.007 for adiponectin, and P¼0.002 for insulin sensitivity by ANOVA). Conclusion: Despite beneficial reductions in LDL cholesterol and improvement of flowmediated dilation, rosuvastatin treatment dose-dependently and significantly resulted in decreasing insulin sensitivity and increasing ambient glycemia by reducing adiponectin levels and increasing insulin levels in hypercholesterolemic patients. Disclosure of Interest: None Declared
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POSTER ABSTRACTS
had grade 3 and 2 (0.83%) had grade 4 respectively. When patients with hypertensive retinopathy were compared with those without retinopathy, the former were older (p¼0.001) and had longer duration of systemic hypertension (p¼0.001). Similarly, hypertensive patients with retinopathy had higher total cholesterol and low density lipoprotein cholesterol (p¼0.017, p¼0.041 respectively). On the other hand, estimated glomerular filtration rate (eGFR) was lower in individuals with hypertensive retinopathy (46.2 ml/min/1.73) compared with those with normal retinal (55.9 ml/min/1.73) findings, p¼0.019. Conclusion: Hypertensive retinopathy is a common clinical finding among hypertensive Nigerians and occurs pari passu with renal damage as consequences of long standing hypertension. Disclosure of Interest: None Declared
1
Introduction: Cardiac diseases are among the most common complications of HIV infection; they are present in up to half of people living with HIV. The most common forms of heart disease in these people are dilated cardiomyopathy, coronary heart diseases, and pericardial effusion. Although this has been reported from other countries, there is no study that evaluated the prevalence of the problem and its patterns in Ethiopia in general and in the study area, in particular. Objectives: The objective of this study was to determine the prevalence, patterns and factors that are associated with cardiovascular diseases among adult people with HIV who are on follow up at Jimma University Specialized Hospital (JUSH), antiretroviral therapy (ART) clinic. Methods: A cross sectional hospital based study was conducted on 280 people living with HIV aged >18 years attending the ART clinic of JUSH from sept16/2012-Dec15/ 2012. Data were collected using structured questionnaire containing socio-demographic characteristics, heart failure symptoms, HIV status. A detailed Trans thoracic Echocardiography was done for all the participants. Data were analyzed using SPSS for windows version 16 of the computer software. A P value of < 0.05 was considered statistically significant. Independent variables were assessed for association with the heart disease using bivariate and multivariable logistic regression analyses to generate odds ratios. Results: Of the total 280 participants 66.1%were females and 64.7% were on ART. The mean (sd) age of the participants was 33.62(8.29) years. Cardiac abnormalities were found in 42.1% of individuals, the most common being diastolic dysfunction and Left Ventricular Hypertrophy (LVH), each accounting for 21.2%. Dilated cardiomyopathy (DCM) was found in 12.7% of the cases. DCM was significantly associated with lower CD4 counts (p¼0.002), being ART Naïve (p¼0.025) and lower body mass index (BMI) (p¼0.042). Pericardial effusion was found in 5.9% and was significantly associated with being ART naïve (p¼0.014). Conclusion: The findings showed high prevalence of cardiac abnormalities (42.1%) and its link with low CD4 count, poor nutritional status and being ART naïve implying the need for periodic screening for cardiac abnormalities and nutritional status. Disclosure of Interest: None Declared PS055 To Evaluate the Role of Non Hdl-C, Lp(a), Apo-B as a Clinical Surrogate Marker for Coronary Artery Disease S. Tewari*1, P. Agarwal1, P. Goel1 1 Cardiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India Introduction: The early identification of individuals at increased risk of cardiovascular diseases is of pivotal importance in order to modify the factors contributing to this highrisk profile. Elevated serum LDL cholesterol and low HDL cholesterol are most important modifiable major risk factor for atherosclerosis and Cardiovascular disease (CVD). Lipoprotein(a) [Lp(a)], a large protein attached to LDL particle possess potent atherogenic and thrombogenic properties.Indians have double the risk of CAD due to high prevalence of emerging risk factors, especially lipoprotein(a) a genetic risk factor for premature CAD found in 35-40% of Indians. Objectives: The present study was conducted to establish a relationship between these new markers and CVD events and elucidate their potential role as marker of clinical risk. It was
e26
conducted to help clinicians to use serum Apo-lipoproteins and Lp(a) values in future while providing health care to patients with CAD. Methods: A total of 500 patients (350cases, 150control) undergoing coronary angiography were included in the study. Mean age was 5411 yrs (95% Cl; 52.74, 54.77). Females comprised 21% of case group but 60% of control group. Two most common non-lipid conventional modifiable risk factors were smoking (39%, 95%Cl; 32,45) and type 2 diabetes mellitus (26%, 95%Cl; 20,31). Results: There was significant and direct correlation of CAD with TC, LDL-C, TG, TC/ HDL, non HDL-C, ApoB, ApoB/ApoA1 and Lp(a) (p<0.001) whereas with TG, HDL and ApoA1 was not significant statistically. These parameters are also correlated with severity of CAD on univariate analysis. On polynomial regression analysis Lp(a) (P<.001) was invariably associated with severe CAD while LDL levels were found to be insignificant (p¼.91). Lp(a) was much higher in our study population with Lp(a) >30mg/dl in 23% of control (non CAD) and 64% of case group (CAD). Conclusion: Lipid levels though lower in Indian population as compared to Caucasians are significant risk factors for CAD. Apolipoproteins especially ApoB/ApoA1 ratio is another significant risk factor for CAD. This also adds to data in support of Lp(a) as an independent risk factor for CAD especially in Indian population. Lp(a) levels are indicator of severity of CAD even with normal or high normal LDL levels. All these risk factors significantly associated with severe CAD and also have prognostic signifinance. Disclosure of Interest: None Declared PS059 Prevalence of Essential Hypertension and Assessment of Cardiac Risk in Pakistani Adults – The Reveal Study M. A. Ebrahim*1, M. I. khowaja1 1 Medicine, Jamal Noor Hospital, Karachi, Pakistan Introduction: Prevalence of hypertension (HTN) is 18% (National Health Survey of Pakistan) with 17% population carrying 2 cardiovascular (CV) risk factors. Objectives: To estimate the prevalence of HTN in outpatients aged 18 years and general 10 year CV risk score in patients aged 30 years. Methods: This observational cross sectional study was conducted between November 2012 and October 2014 in patients (18 years) seeking consultation for any ailment in 140 randomly selected outpatient centers. Blood pressure (BP) cut-offs cited in JNC 7 were used to determine prevalence of HTN and its staging. Ten year CV risk and its categorization were calculated using laboratory and non-laboratory predictors suggested by Framingham studies. Results: Mean age of patients (N¼2336) was 40.8 13.1 years with 72% patients 30 years of age and 56% were males. There were 535 (23%) patients with diabetes. There were 51.5% (C.I. 49.4 – 53.4) patients with HTN. Prevalence of HTN in nondiabetic patients was 30% (C.I. 28.2 – 31.9) and 21.4% (C.I. 19.8 – 23.2) in diabetics. Only 13% were normotensive. There were 30% patients in Stage 1 and 26% in Stage 2. Same estimates for diabetics were 4% (normal), 36% in Stage 1 and 34% in Stage 2 respectively. 84.4% hypertensive patients (1014/1202) were prescribed either mono or combination therapy of ACEI (41%), CCBs (26.9%), ARBs (22.1%), BBs (19.7%) and Diuretics (12.9%) at consultation. Mean CV risk score by Framingham for non-laboratory and laboratory predictors were 18.1 and 14.8 respectively for females and 16.3 and 16.9 for males. For same predictors, 54% and 37% females were in medium to high risk category combined for CV events. For males, these estimates were 57% and 59% respectively. Conclusion: Almost every second adult patient is likely to be hypertensive. Over 50% patients are at medium to high risk of developing CVD in the next 10 years. BP assessments, Framingham risk scoring and treatment optimization in ambulatory settings may reduce morbidity and mortality from CV events. Disclosure of Interest: None Declared PS061 Relationship Between Retinopathy and Renal Abnormalities in Black Hypertensive Patients P. M. Kolo*1, A. B. Omotoso1, T. Olanrewaju1, J. F. Owoeye2, on behalf of Hypertension Complications Project 1 Department of Medicine, University of Ilorin, Nigeria, 2Department of Ophthalmology, University of Ilorin, Nigeria, Ilorin, Nigeria Introduction: Complications of hypertension are particularly common in people of African descent but previous reports had suggested rarity of hypertensive retinopathy in black Africans. Objectives: We evaluated retinal changes among Nigerian hypertensive patients and determined their relationship with renal function. Methods: Hypertensive patients who were 18 years who met the inclusion criteria were selected for the study. The socio-demographic characteristics of the participants were obtained; anthropometric parameters and blood pressure were measured. All patients had ophthalmoscopic examination after pupillary dilatation and the severity of patient’s retinal changes was determined and graded according to Keith-Wegener’s classification. Blood samples were taken from each patient for blood urea nitrogen, lipids and C-reactive protein; and urine was collected for microalbuminuria. Results: Of the 240 patients studied, 187 (78%) had one form of retinopathy or the other. While 85 (35.4%) patients had grade 1 retinopathy, 87 (36.3%) had grade 2, 13 (5.4%)
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PS063 Analysis on ECG P-wave Changing in Masked Hypertension Patients L. Nie*1, Z. LI1, Y. Jing1 Department of electrocardiogram, The Second Affiliated Hospital of Zhengzhou University, zhengzhou, China
1
Introduction: Masked hypertension is easily progressing to sustained hypertension causing a certain degree of target organ damage, which is always being overlooked ,while,no invasive electrical inspection method can provide some help. Objectives: To investigate the significance on ECG P-wave changing in masked hypertension patients. Methods: One hundred and fifty patients diagnosed as masked hypertension(study group) and 150 sustained hypertension subjects(control group) from January 2013 to march 2014 in the second affiliated hospital of Zhengzhou University were selected.Together with the ECG changes of two groups ,we were to analyse the Significances of P-wave broadening and P-wave Bimodal changing in masked hypertension patients. Results: Compared with control group, study group has lower age(45.65.2) VS(60.44.8) ,lower complications [44.7%(67/150)VS 62.0%(93/150)] and more males [98 cases(65.3%)VS 78 cases(52.0%)] .Compared with control group, study group has statistically significant difference in the following three aspects:the incidence of Left ventricular hypertrophy:[7.3%(11/150)vs24.7%(37/150)],the incidence of ST-T changing [13.3%(20/150)vs56.0%(84/150)],the incidence of conduction block[4.6%(7/150) vs22.0%(33/150)],P<0.05;However,the incidence of P-wave broadening[(78.6%(118/150) vs82.7%(124/150),P¼0.381]and the incidence of P-wave Bimodal changing [(58.7%(88/ 150)vs66.7%(100/150),P¼0.152] has no statistically significant difference. Conclusion: ECG P-wave changing may indicate early manifestation of cardiac electrical damage in masked hypertension. Disclosure of Interest: None Declared PS064
media offers an opportunity for healthcare workers to reach the public with accurate information. Disclosure of Interest: E. Ogola Grant/research support from: Project sponsored by Astra Zeneca, F. Okello Consultancy for: Consultant for Astra Zeneca, G. Yonga Grant/research support from: Project sponsored by Astra Zeneca, E. Mac Gregor-Skinner Consultancy for: Consultant for Astra Zeneca, N. Ramchandarani Consultancy for: Consultant for Astra Zeneca PS069 Intense Supervised Exercise Training and Blood Pressure in Hypertension Results From the Ergociser-Rr Study F. Van Buuren*1, J. B. Dahm2, K.-P. Mellwig1, D. Horstkotte1 1 Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, 2Dept. of Cardiology and Sports Medicine, Herz- und Gefäßzentrum, Göttingen, Germany Introduction: Aerobic physical activity generates beneficial effects on blood pressure (BP) and other cardiovascular risk factors. Objectives: In this prospective study over 2 years we investigated the influence of a moderately intense, long-term supervised aerobic exercise training (IAET) on blood pressure, with special emphasis on the physician’s role regarding motivation. Methods: 7 patients (4211 years) conducted a daily IAET (5 times weekly, 25-30 min/ day, 70% of their maximum exercise capacity) for > 120 weeks (control group 9 patients, once weekly 90 minutes). Submaximal-BP, drug therapy and serum-lipids were measured on follow-up (3, 6, 12, 18, 24 months). The influence of physician’s feedback on motivation was evaluated through energy utilization during a timely limited period of less physician’s assistance. Results: Under IAET (98983 J/week) exercise capacity improved (32.6%; p<0.001), submaximal-BP decreased (9.7%; p<0.001), drug-therapy declined significantly (27.9%; p<0.001), HDL-cholesterol increased (18.5%; p¼0.007), body mass index dropped (4.1%; p¼0.002). Motivation and maintenance declined substantially and energy utilization decreased significantly by 9.3% to 898 88 J/week during reduced physician’s feedback. Exercise capacity did not differ between the two groups at baseline. Patients of the IAETgroup fulfilled 178 98 minutes aerobe exercise training per week with a working load of estimated 989 83 J/week. The exercise capacity of the IAET-group increased significantly by 32.5% after 3 months from 109 9.5 (range 98-122) to 144 12.1 (130-161) watt and sustained constant around 140 W after 24 months, while it remained unchanged in the control group with corresponding values of 114 13.3 (range 96-132) at baseline and 115 12.0 (100-132) at 3 months. Conclusion: In contrast to a once weekly physical fitness program, IAET with a work load of 1000 J/week has favorable effects. Because of its easy availability in their own homes, it should be recommended but physician’s assistance is crucial to keep motivation high. Disclosure of Interest: None Declared
Knowledge About Hypertension in the Population: Results of Baseline Survey of a Population Intervention Program to Control Hypertension
PS070
E. N. Ogola*1, F. O. Okello2, G. Yonga3, E. Mac Gregor-Skinner2, N. Ramchandarani2 1 Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya, 2Abt Associates, Bethesda, United States, 3Aga Khan University Hospital, Nairobi, Kenya
Rosuvastatin Dose-Dependently Improves Flow-Mediated Dilation, but Reduces Adiponectin Levels and Insulin Sensitivity in Hypercholesterolemic Patients
Introduction: Hypertension is a major cardiovascular risk factor and the leading cause of mortality worldwide. Africa has the highest prevalence rates (30%), but very low rates of awareness and treatment leading to control rates of only 7%. Impacting the burden of hypertension requires a system wide approach to increase screening, initiation and retention in treatment. Healthy Heart Africa (HHA) is an Astra Zeneca sponsored program to increase awareness, screening and control of hypertension in Africa, the first of its kind. This is a report of the baseline survey of population knowledge at household level prior to program implementation. Objectives: To determine the population knowledge of hypertension; risk factors, consequences and management options. Methods: The study used a quasi experimental design with pre and post intervention surveys conducted in households in the intervention and control areas. These are results of the baseline survey. All consenting adults 18 years were interviewed. The data were analyzed descriptively and presented as proportions. Results: A total of 2937 respondents were interviewed (1518 intervention, 1419 control). About two thirds (67%) were in the age group 18-39 years, 53% were female. 87% had heard of hypertension, 72% from family or friends and 36% from media. Only 33% heard from a health institution and 6 % from a community health worker. Self reported hypertension was 12%. Knowledge of risk factors for hypertension was as follows: salt intake 50%, alcohol 5%, overweight 38%, lack of physical activity 12% and low potassium intake 8%. Knowledge of hypertension related complications was: stroke 30%, heart attack 29%, and heart failure 11% with no mention of kidney disease. Concerning measures to reduce blood pressure (BP), the responses were: medication 31%, salt reduction 18%, exercise 34%, reduction in alcohol 10% and weight loss 21%. Conclusion: Though hypertension awareness was high, most of the information is from lay sources with the potential for wrong information. There is low awareness of the risks for, complications of and evidence based measures for lowering BP. There is need to strengthen primary healthcare and empower primary healthcare workers. The prominence of the
GHEART Vol 11/2S/2016
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June, 2016
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K. Koh*1 Gachon University Gil Medical Center, Incheon, Korea, Republic Of
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Introduction: Genetic analysis from patients participated in the randomized trials reported that the increased risk of type 2 diabetes noted with statins is at least partially explained by HMG-coenzyme A reductase inhibition. Objectives: We investigated vascular and metabolic phenotypes of different dosages of rosuvastatin in hypercholesterolemic patients. Methods: This was a randomized, single-blind, placebo-controlled, parallel study. Age, sex, and body mass index were matched among groups. Forty-eight patients were given placebo, and 47, 48, and 47 patients given rosuvastatin 5,10, and 20 mg, respectively daily during a 2 month treatment period. Results: Placebo therapy did not significantly change insulin, adiponectin, glycated hemoglobin, and insulin sensitivity relative to baseline measurements. Rosuvastatin 5,10, and 20 mg dose-dependently and significantly improved flow-mediated dilation (34, 40, and 46%) after 2 months therapy when compared with baseline (P<0.001 by paired t-test) or when compared with placebo (P<0.001 by ANOVA). Rosuvastatin 5,10, and 20 mg dosedependently and significantly increased insulin (median % changes; 16, 20, and 20%, respectively) and glycated hemoglobin levels (mean % changes; 2, 2, and 3%, respectively), and decreased adiponectin levels (mean % changes; 3, 9, and 14%, respectively) and insulin sensitivity (mean % changes; 2, 3, and 4%, respectively) after 2 months therapy when compared with either baseline (all P<0.05 by paired t-test). These effects with rosuvastatin 5,10, and 20 mg were significant when compared with placebo (P¼0.006 for insulin, P¼0.012 for glycated hemoglobin, P¼0.007 for adiponectin, and P¼0.002 for insulin sensitivity by ANOVA). Conclusion: Despite beneficial reductions in LDL cholesterol and improvement of flowmediated dilation, rosuvastatin treatment dose-dependently and significantly resulted in decreasing insulin sensitivity and increasing ambient glycemia by reducing adiponectin levels and increasing insulin levels in hypercholesterolemic patients. Disclosure of Interest: None Declared
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had grade 3 and 2 (0.83%) had grade 4 respectively. When patients with hypertensive retinopathy were compared with those without retinopathy, the former were older (p¼0.001) and had longer duration of systemic hypertension (p¼0.001). Similarly, hypertensive patients with retinopathy had higher total cholesterol and low density lipoprotein cholesterol (p¼0.017, p¼0.041 respectively). On the other hand, estimated glomerular filtration rate (eGFR) was lower in individuals with hypertensive retinopathy (46.2 ml/min/1.73) compared with those with normal retinal (55.9 ml/min/1.73) findings, p¼0.019. Conclusion: Hypertensive retinopathy is a common clinical finding among hypertensive Nigerians and occurs pari passu with renal damage as consequences of long standing hypertension. Disclosure of Interest: None Declared