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PT056 Factors Associated With Uncontrolled Blood Pressure in Primary Care
POSTER ABSTRACTS
Methods: A questionnaire was administered to 1,224 eligible adults born November 1, 1956–September 30, 1964. The cross-sectional survey was conducted from July to September 2009 in Chongqing, China; adopted multi-stage stratified random sampling to collect 1,224 eligible adults. Results: 12.25% of the respondents reported that they have hypertension. People with exposure to famine during childhood were more likely to have hypertension (OR¼1.602, 95% CI [1.028, 2.553]) than those who were not exposed to famine. However, no significant difference was observed in the prevalence of hypertension between individuals who were exposed to famine during their fetal stage and those who were not exposed to famine (OR¼1.180, 95% CI [0.770, 1.810]). Females were less likely to suffer from hypertension than males (OR¼0.338, 95% CI [0.224, 0.508]). People with an average monthly income of 851 Yuan to 1600 Yuan (OR¼0.580, 95% CI [0.353, 0.954]) were less likely to suffer from high blood pressure than those who earned less than 850 Yuan. Individuals who suffer from poor sleep quality (OR¼2.005, 95% CI [1.064, 3.776]) were more likely to suffer from hypertension than those with good sleep quality. Conclusion: Approximately 12.25% of the respondents self-reported their diagnoses of hypertension. This study may indicate the high prevalence of undiagnosed hypertension in Chongqing, China. Our study emphasizes that early life environment is critical for the risk of hypertension in adult life. Disclosure of Interest: None Declared PT056 Factors Associated With Uncontrolled Blood Pressure in Primary Care H. Badillo*1, C. Lerma2, on behalf of Sociedad Mexicana de Salud Pública 1 Centro de Salud Dr. Manuel Escontria, Servicios de Salud Publica, 2Instrumentacion Electromecánica, Instituto Nacional de Cardiologia Ignacio Chavez, Distrito Federal, Mexico Introduction: The prevalence of hypertension in Mexico is 31.5%. The incidence of hypertension is associated with age, obesity, gender, and other comorbidities, and is the second cause of consultation in primary care. Only 40.4% of hypertensive patients with treatment is under control (blood pressure < 140/90 mmHg). Objectives: To evaluate the characteristics of care of hypertensive patients and their association with uncontrolled blood pressure in a health center primary care level. Methods: This transversal study included a sample of 347 medical records of patients with diagnosed arterial hypertension. Somatometric variables, laboratory variables and type of pharmacological treatment were obtained. The odds ratio (OR) for each variable as a factor for uncontrolled blood pressure was calculated with logistic regression, and a multivariate logistic regression model was used to evaluate independent association. Results: One hundred and one (29.1%) patients had uncontrolled blood pressure. The prevalence of comorbidities was similar in both groups: diabetes mellitus (84 vs 87%), hypercholesterolemia (35 vs 36%), hypertriglyceridemia (41 vs 47%), metabolic syndrome (75 vs 80%) and glucosuria (90 vs 84%). Both groups had antihypertensive monotherapy (64 vs 63%) and there were no differences by type of antihypertensive drug. The factors independently associated with uncontrolled high blood pressure were; body mass index (Kg/m2): (OR, 1.05; 95% CI 1.01 - 1.10), uncontrolled glycosylated hemoglobin (OR, 1.64; 95% CI 1.00 - 2.70), whereas bezafibrate prescription was associated with better BP control (OR, 0.49; 95% CI 0.25 - 0.95). Conclusion: Despite a high prevalence of comorbidities, only few factors were independently associated with uncontrolled blood pressure in these patients from primary care. These factors could be crucial to decrease more efficiently the rate of uncontrolled blood pressure in this specific population. Disclosure of Interest: None Declared PT057 The Hypertension in Cuba. Magnitude of the Problem and Control D. R. J. De La Noval*1, A. Dueñas2, N. Armas2, M. Acosta2 1 Preventive Cardiology, Cardiology Institute, 2Preventive Cardiology, Institute of Cardiology and Cardiovascular Surgery, La Habana, Cuba Introduction: According to the World Health Organization (WHO), cardiovascular diseases are a major cause of morbidity and mortality in adults in industrialized countries and developing.It is estimated that there are over 1 500 million worldwide hypertensive (blood pressure 140 / 90 mm Hg) and this figure is expected to increase more in the coming years. This disease affects approximately 30% of adults, so together with obesity classified by the WHO as pandemics of the century. Objectives: To know the prevalence of hypertension in Cuba. To know the number of treated hypertensives patients to know the level of control of hypertension in Cuba. Methods: Statistic from: Ministry of Public Health Cuba 2014 Report III National Risk Factor Survey (2012). Results: Statistics from the Ministry of Public Health 2014 of Cuba shows that 19.4% of women and 23.4% of men are identified as hypertensive. In the III Cuban National Risk Factor Survey (2012) they were detected in the country 2594741 hypertensive (30.9%) of the total population over 15 years (31.2% in women) and (30.6% men), (31.9% in urban population) and (28.0% in rural population). They were known hypertensive 1,881,187 potential, of which 1,668,019 had antihypertensive treatment (89.2% of all known) and were really controlled hypertensive 924,585 which constitutes 55.1% of patients, 49.2 % of known and only 37.6% of hypertensive potential,
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Conclusion: The level of hypertensives patients in Cuba is low. Is fulfilled the rule of half in control patient. For this reason there is still much to be done to increase the number of controlled patients in this silent enemy, the only way we will achieve significant reductions in morbidity and mortality from cardiovascular and cerebrovascular major complications of this chronic disease. Recall that the relationship between blood pressure and risk of events related to cardiovascular disease is continuous, consistent and independent of other risk factors. Disclosure of Interest: None Declared
PT060 Analysis of Heart Rate Variability in Patients With Refractory Systemic Arterial Hypertension Treated by Renal Denervation With Radiofrequency Catheter C. G. Galvan-Vargas1, L. Hernandez-Jimenez1, P. Martin-Hernández*1, J. L. Ojeda-Delgado1, A. Ricalde-Alcocer1, A. Meneses-Bonilla1 1 Cardiology, Hospital Central Militar, D.F., Mexico Introduction: Refractory hypertension is blood pressure in the office above the appropriate goal despite the use of three or more antihypertensive agents, one of which is a diuretic; renal denervation by radiofrequency ablation is a treatment for this condition, which is effective and safe. We consider the renal denervation lowers the tone of the autonomic nervous system kidneys doing the same with the activity of the renin-angiotensin-aldosterone axis, so the result will be the reduction of systemic blood pressure without affecting heart rate variability. Renal denervation by radiofrequency ablation is a treatment for this condition, which is effective and safe. We consider the renal denervation lowers the tone of the autonomic nervous system kidneys doing the same with the activity of the renin-angiotensin-aldosterone axis, so the result will be the reduction of systemic blood pressure without affecting heart rate variability. Objectives: Determine if there is change in the heart rate variability in patients with refractory hypertension who are treated by renal denervation by radiofrequency catheter. Methods: Observational, longitudinal and descriptive study of 6 patients with hypertension who were treated by renal radiofrequency ablation catheter. The variability of heart rate (time domain, frequency domain and nonlinear method by scatterplot), before and two months after the procedure was measured. Statistical analysis of results was by Student t test for related samples. Results: In patients with refractory hypertension treated by renal radiofrequency ablation, there was no statistically significant increase in the variability of the heart rate 24 hours measurements SDNN, statistically significant decrease in the carding area to LF both daytime and night (frequency domain) and a decrease in systolic blood pressure office with statistical significance. Conclusion: In patients with refractory hypertension treated by renal radiofrequency ablation catheter, two months follow-up there was a statistically significant decrease in the load area LF both day and night as well as a decrease in systolic blood pressure in the office 23 mmHg on average without modifying the previous medical treatment with statistical significance. Disclosure of Interest: None Declared
GHEART Vol 11/2S/2016
j
June, 2016
j
POSTER/WCC_2016-POSTERS
Methods: A questionnaire was administered to 1,224 eligible adults born November 1, 1956–September 30, 1964. The cross-sectional survey was conducted from July to September 2009 in Chongqing, China; adopted multi-stage stratified random sampling to collect 1,224 eligible adults. Results: 12.25% of the respondents reported that they have hypertension. People with exposure to famine during childhood were more likely to have hypertension (OR¼1.602, 95% CI [1.028, 2.553]) than those who were not exposed to famine. However, no significant difference was observed in the prevalence of hypertension between individuals who were exposed to famine during their fetal stage and those who were not exposed to famine (OR¼1.180, 95% CI [0.770, 1.810]). Females were less likely to suffer from hypertension than males (OR¼0.338, 95% CI [0.224, 0.508]). People with an average monthly income of 851 Yuan to 1600 Yuan (OR¼0.580, 95% CI [0.353, 0.954]) were less likely to suffer from high blood pressure than those who earned less than 850 Yuan. Individuals who suffer from poor sleep quality (OR¼2.005, 95% CI [1.064, 3.776]) were more likely to suffer from hypertension than those with good sleep quality. Conclusion: Approximately 12.25% of the respondents self-reported their diagnoses of hypertension. This study may indicate the high prevalence of undiagnosed hypertension in Chongqing, China. Our study emphasizes that early life environment is critical for the risk of hypertension in adult life. Disclosure of Interest: None Declared PT056 Factors Associated With Uncontrolled Blood Pressure in Primary Care H. Badillo*1, C. Lerma2, on behalf of Sociedad Mexicana de Salud Pública 1 Centro de Salud Dr. Manuel Escontria, Servicios de Salud Publica, 2Instrumentacion Electromecánica, Instituto Nacional de Cardiologia Ignacio Chavez, Distrito Federal, Mexico Introduction: The prevalence of hypertension in Mexico is 31.5%. The incidence of hypertension is associated with age, obesity, gender, and other comorbidities, and is the second cause of consultation in primary care. Only 40.4% of hypertensive patients with treatment is under control (blood pressure < 140/90 mmHg). Objectives: To evaluate the characteristics of care of hypertensive patients and their association with uncontrolled blood pressure in a health center primary care level. Methods: This transversal study included a sample of 347 medical records of patients with diagnosed arterial hypertension. Somatometric variables, laboratory variables and type of pharmacological treatment were obtained. The odds ratio (OR) for each variable as a factor for uncontrolled blood pressure was calculated with logistic regression, and a multivariate logistic regression model was used to evaluate independent association. Results: One hundred and one (29.1%) patients had uncontrolled blood pressure. The prevalence of comorbidities was similar in both groups: diabetes mellitus (84 vs 87%), hypercholesterolemia (35 vs 36%), hypertriglyceridemia (41 vs 47%), metabolic syndrome (75 vs 80%) and glucosuria (90 vs 84%). Both groups had antihypertensive monotherapy (64 vs 63%) and there were no differences by type of antihypertensive drug. The factors independently associated with uncontrolled high blood pressure were; body mass index (Kg/m2): (OR, 1.05; 95% CI 1.01 - 1.10), uncontrolled glycosylated hemoglobin (OR, 1.64; 95% CI 1.00 - 2.70), whereas bezafibrate prescription was associated with better BP control (OR, 0.49; 95% CI 0.25 - 0.95). Conclusion: Despite a high prevalence of comorbidities, only few factors were independently associated with uncontrolled blood pressure in these patients from primary care. These factors could be crucial to decrease more efficiently the rate of uncontrolled blood pressure in this specific population. Disclosure of Interest: None Declared PT057 The Hypertension in Cuba. Magnitude of the Problem and Control D. R. J. De La Noval*1, A. Dueñas2, N. Armas2, M. Acosta2 1 Preventive Cardiology, Cardiology Institute, 2Preventive Cardiology, Institute of Cardiology and Cardiovascular Surgery, La Habana, Cuba Introduction: According to the World Health Organization (WHO), cardiovascular diseases are a major cause of morbidity and mortality in adults in industrialized countries and developing.It is estimated that there are over 1 500 million worldwide hypertensive (blood pressure 140 / 90 mm Hg) and this figure is expected to increase more in the coming years. This disease affects approximately 30% of adults, so together with obesity classified by the WHO as pandemics of the century. Objectives: To know the prevalence of hypertension in Cuba. To know the number of treated hypertensives patients to know the level of control of hypertension in Cuba. Methods: Statistic from: Ministry of Public Health Cuba 2014 Report III National Risk Factor Survey (2012). Results: Statistics from the Ministry of Public Health 2014 of Cuba shows that 19.4% of women and 23.4% of men are identified as hypertensive. In the III Cuban National Risk Factor Survey (2012) they were detected in the country 2594741 hypertensive (30.9%) of the total population over 15 years (31.2% in women) and (30.6% men), (31.9% in urban population) and (28.0% in rural population). They were known hypertensive 1,881,187 potential, of which 1,668,019 had antihypertensive treatment (89.2% of all known) and were really controlled hypertensive 924,585 which constitutes 55.1% of patients, 49.2 % of known and only 37.6% of hypertensive potential,
e136
Conclusion: The level of hypertensives patients in Cuba is low. Is fulfilled the rule of half in control patient. For this reason there is still much to be done to increase the number of controlled patients in this silent enemy, the only way we will achieve significant reductions in morbidity and mortality from cardiovascular and cerebrovascular major complications of this chronic disease. Recall that the relationship between blood pressure and risk of events related to cardiovascular disease is continuous, consistent and independent of other risk factors. Disclosure of Interest: None Declared
PT060 Analysis of Heart Rate Variability in Patients With Refractory Systemic Arterial Hypertension Treated by Renal Denervation With Radiofrequency Catheter C. G. Galvan-Vargas1, L. Hernandez-Jimenez1, P. Martin-Hernández*1, J. L. Ojeda-Delgado1, A. Ricalde-Alcocer1, A. Meneses-Bonilla1 1 Cardiology, Hospital Central Militar, D.F., Mexico Introduction: Refractory hypertension is blood pressure in the office above the appropriate goal despite the use of three or more antihypertensive agents, one of which is a diuretic; renal denervation by radiofrequency ablation is a treatment for this condition, which is effective and safe. We consider the renal denervation lowers the tone of the autonomic nervous system kidneys doing the same with the activity of the renin-angiotensin-aldosterone axis, so the result will be the reduction of systemic blood pressure without affecting heart rate variability. Renal denervation by radiofrequency ablation is a treatment for this condition, which is effective and safe. We consider the renal denervation lowers the tone of the autonomic nervous system kidneys doing the same with the activity of the renin-angiotensin-aldosterone axis, so the result will be the reduction of systemic blood pressure without affecting heart rate variability. Objectives: Determine if there is change in the heart rate variability in patients with refractory hypertension who are treated by renal denervation by radiofrequency catheter. Methods: Observational, longitudinal and descriptive study of 6 patients with hypertension who were treated by renal radiofrequency ablation catheter. The variability of heart rate (time domain, frequency domain and nonlinear method by scatterplot), before and two months after the procedure was measured. Statistical analysis of results was by Student t test for related samples. Results: In patients with refractory hypertension treated by renal radiofrequency ablation, there was no statistically significant increase in the variability of the heart rate 24 hours measurements SDNN, statistically significant decrease in the carding area to LF both daytime and night (frequency domain) and a decrease in systolic blood pressure office with statistical significance. Conclusion: In patients with refractory hypertension treated by renal radiofrequency ablation catheter, two months follow-up there was a statistically significant decrease in the load area LF both day and night as well as a decrease in systolic blood pressure in the office 23 mmHg on average without modifying the previous medical treatment with statistical significance. Disclosure of Interest: None Declared
GHEART Vol 11/2S/2016
j
June, 2016
j
POSTER/WCC_2016-POSTERS