- Email: [email protected]
PT227 Large artery stiffness and carotid intima-media thickness in relation to markers of bone mineral metabolism in postmenopausal African women: The PURE-study
Table 1. Characteristics of the CCU sample (n¼115) 60.6315.39
Age,Mean±SD BMI,Mean±SD
29.37±5.41
SBP,Mean±SD
125.61±22.14
smoking,N(%)
43(37.70)
Family Hx-CAD,N(%)
30(26.30)
Medical Hx-HTN,N(%)
85(74.60)
Medical Hx–Coronary PCI,N(%)
44(38.60)
Coronary PCI during Current visit,N(%)
35(30.70)
PT227 Large artery stiffness and carotid intima-media thickness in relation to markers of bone mineral metabolism in postmenopausal African women: The PURE-study Aletta Schutte*1, Lebo Gafane1, Iolanthe Kruger2, Rudolph Schutte1 1 Hypertension in Africa Research Team (HART), 2Africa Unit for Transdisciplinary Health Research, North-West University, Potchefstroom, South Africa Introduction: Increased vascular calcification, cardiovascular morbidity and mortality have been associated with altered bone metabolism and associated calciotropic hormones. Objectives: Due to the lack of information on the contribution of altered bone metabolism and calciotropic hormones on cardiovascular disease in Africans, this study aimed to explore the relationships of carotid intima-media thickness (cIMT) and central pulse pressure (cPP) with the parathyroid hormone-to-vitamin D ratio (PTH:25-OH-D) and Ctelopeptide of type I collagen (CTX) in postmenopausal African women. Methods: A study population of 434 African women, aged 47 years, was divided into lean and overweight/obese groups. We assessed cPP and cIMT, and determined PTH, 25OH-D and CTX concentrations. Results: In the overweight/obese group we found elevated PTH and PTH:25-OH-D compared to the lean group (p<0.001), while the lean group had higher CTX concentrations (p<0.001). Single, partial and multiple regression analyses confirmed that only in lean women, cIMT was independently associated with PTH:25-OH-D (R2¼0.22; b¼0.26; p¼0.003); whereas in obese women, cPP associated with both PTH:25-OH-D (R2¼0.20; b¼0.17; p¼0.017) and CTX (R2¼0.20; b¼0.17; p¼0.025). Conclusion: In postmenopausal African women with increased adiposity, cPP, as indicator of central arterial stiffness, was positively associated with alterations in bone metabolism and calciotropic hormones, whereas cIMT of lean women was positively associated with PTH:25-OH-D. Our results suggest that alterations in bone metabolism may contribute to arterial calcification. Disclosure of Interest: None Declared PT229
Conclusion: Our study shows a lack of knowledge regarding salt major contributors in the Lebanese diet and allowed maximum intake levels relative to the community based sample. *Nasreddine et al. “Knowledge, Attitudes and Behaviors Related to Sodium Intake of Lebanese Consumers aged 19-60” (Unpublished data). Disclosure of Interest: None Declared PT226 Erectile dysfunction risk factors in patients with severe obstructive sleep apnea syndrome and identifying CPAP response predictors Haruki Sekiguchi*1,2, Ken Shimamoto1, Koji Narui3, Yuji Inoue4, Yufuko Takahashi1, Tatsumi Fujio1, Yasunobu Hashimoto5, Yoshiko Maeda5, Eri Watanabe1, Masatoshi Kawana1, Fujio Tatsumi1, Mayumi Suzuki6, Ken Shimamoto1, Kazuhiro Yamaguchi6, Masatoshi Kawana1 1 Cardiology, Aoyama Hospital, Tokyo Women’s Medical University, Tokyo, Japan, 2Cardiology, Aoyama Hospital, Tokyo Women’s Medical University, Tokyo, Jersey, 3Respiratory Medicine, Toranomon Hospital, 4Aoyama Hospital Tokyo Women’s Medical University, 5Urology, 6Aoyama Hospital, Tokyo Women’s Medical University, Tokyo, Japan Introduction: Erectile dysfunction (ED) is one of the important complications in patients with sleep apnea syndrome (SAS). ED is known as a risk factor and risk indicator for future cardiovascular diseases. However, risk factors related to ED as well as the efficacy of continuous positive airway pressure (CPAP) therapy on improving ED have not been established in Japanese subjects with obstructive SAS. Objectives: This study investigates risk factors of ED and factors predicting the efficacy of CPAP for the treatment of ED in Japanese SAS patients. Methods: We conducted a retrospective population-based study of Japanese subjects linking questionnaire data with characteristics of patients hospitalized (170 males, age: 4912.3 years) due to SAS diagnosis by polysomnography. SAS was diagnosed as AHI > 5 and ED diagnosed by an International Index of Erectile Function (IIEF)-5 score < 22. Thirty patients answered IIEF5 twice before CPAP treatment and at 6 months after CPAP treatment. We analyzed the correlation between ED and potential explanatory variables including age, body mass index (BMI), apnea/hypopnea index (AHI), micro-arousals, hypertension (HTN), diabetes mellitus (DM), dementia, ischemic heart disease, dyslipidemia, and benign prostatic hyperplasia. We also investigated predictors judging the efficacy of CPAP on improvement of ED. Results: In this study population, baseline BMI and AHI were, 27.34.0 kg/m2 and 43.127.8 /hr, respectively. ED was observed in 59.4% (101/170) of the patients. DM and HTN were found to be risk factors for ED (odds ratio: 2.89, [95% CI 1.46-5.68], P<0.001, OR: 3.47, [95% CI 1.77-6.85], P<0.01, respectively). Multivariate analysis revealed that DM (OR: 4.4, [95% CI 1.92-9.97], P<0.001) was a unique, independent risk factor for ED. After 6 months of CPAP treatment, IIEF5 scores significantly decreased in 53.3% (16/30) of ED patients (3.42.3, P<0.001). Baseline AHI for SAS diagnosed patients was significantly higher in CPAP responders compared to non-responders (53.922.9 vs. 37.019.8, P<0.05, respectively). However, in patients over 65 years of age (N¼5), CPAP therapy was not effective for treating ED (DIIEF 5 ¼ –5.48.0) in 80% of cases. Conclusion: DM is an important risk factor inducing ED in SAS patients. Furthermore, CPAP treatment should be considered for patients suffering from severe SAS complicated with ED. Disclosure of Interest: None Declared
GHEART Vol 9/1S/2014
j
March, 2014
j
POSTER/2014 WCC Posters
Assessment of quality of life and its correlates among Hypertensive patients in a West African Cardiology practice Amam C. Mbakwem*1, Francis Aina1, Casmir E. Amadi2, Abiola Akinbode2, Joy Mokwunyei3 1 Medicine, 2Psychiatry, University of Lagos, 3Medicine, Lagos University Teaching Hospital, Lagos, Nigeria Introduction: Hypertension (HTN) is majorly asymptomatic except when complicated and may not be expected to impact on the quality of life (QoL) of patients. Poor QoL may affect health seeking behaviour, adherence to treatment and disease outcome. The aspect of quality of life has not been given much prominence in the management of patients with hypertension. We therefore evaluated the QoL of hypertensive patients attending the cardiology clinic of our hospital using a generic instrument, the WHOQOL-BREF. Objectives: To determine the quality of life of hypertensive patients and its correlates in a cardiology practice in west Africa. Methods: Hypertensive patients without co-morbidities who were attending the cardiology clinic were recruited. Relevant clinical data were retrieved from their notes and subjects self completed the WHOQOL-BREF. The single item scores were computed and analysed. The domain scores in the WHOQOL-BREF were computed, transformed and analysed. These were correlated with the single item scores and clinical parameters. Results: There were 74 males and 110 females with mean age 56.4712.02yrs. About 40% had post high-school education, 72% had poor finances and most, 80% were married. About 16% felt their QoL was poor to average while 49% were dissatisfied with their health status. Transformed scores for the main domains, physical health, psychological, social relationships and environment were 67.3726.35, 68.7613.58, 67.9215.93 and 67.1413.86 respectively. Also 14.9%, 9.1%, 8.5% and 8.8% had scores less than 50% for physical health, psychological, social relationships and environment domains respectively. More females (18.2% vs. 12.2%, p ¼ 0.05) felt their quality of life was below average. There was positive correlation between age and domains of social relationships and the environment, r¼.214, p¼0.006 and r ¼.183, p¼0.02 respectively. Positive correlation was observed between perception of poor quality of life and health status and the four domains evaluated, p <0.0001. Conclusion: The QoL of hypertensive patients must be given consideration in their management as this may contribute to poor adherence and affect outcomes. Particular attention should be paid to female hypertensives who appear to have worse QoL scores. Disclosure of Interest: None Declared PT230 Role of Brain Natriuretic Peptide In Predicting The Short Term Cardiovascular Outcomes In Preeclampsia And Eclampsia Patients Ghada Youssef*1, Nader Haroon1, Reda Diab1, Essam Baligh1 1 Cardiology, Cairo University, Cairo, Egypt Introduction: Brain natriuretic peptide (BNP) concentrations were found to be higher in preeclampsia and other hypertensive disorders of pregnancy than in normal pregnancy. This may reflect ventricular stress and/or subclinical cardiac dysfunction associated with preeclampsia. Objectives: To evaluate the possible role of elevated BNP level in predicting the short-term maternal cardiovascular outcome in patients presented with preeclampsia/eclampsia disease. Methods: Fifty patients who presented with preeclampsia or eclampsia were included. They were followed up clinically and by echocardiography till delivery and at 1, 3 and 6
e211
POSTER ABSTRACTS
compare the awareness level of our study sample to healthy individuals in the community (HIC) from a previous study*. Methods: Based on unpublished data*, it is estimated that around 82.2% of Lebanese adults know that salt/sodium worsens human’s health. With a confidence interval of 7% and a type 1 error of 5%, we sampled 115 out of the annual 1500 Lebanese high CV risk patients admitted to the Cardiac Care Unit (CCU). They were administered a questionnaire developed to assess awareness of salt intake recommended level, content in food, and associated CV risk. Statistical analysis was conducted using SPSS 20 for Windows. Results: In terms of knowledge, 36.5% of CCU patients knew that the main source of salt in the diet is processed foods such as breads, cured meats, and canned food compared to 21.5% of HIC, while 47% thought it was salt added at the table compared to 42.1% of HIC. Moreover, 19.1% of CCU and 28.9% of HIC knew the maximum daily amount of salt recommended. In terms of attitudes and behaviors, 58.53% admitted they never look at the salt or sodium content on food labels compared to 66.5% of HIC. When asked about the main motive to reduce Salt intake, 65.8% of CCU and 51.7% of HIC admitted that it would be a dramatic change in health status.
Age,Mean±SD BMI,Mean±SD
29.37±5.41
SBP,Mean±SD
125.61±22.14
smoking,N(%)
43(37.70)
Family Hx-CAD,N(%)
30(26.30)
Medical Hx-HTN,N(%)
85(74.60)
Medical Hx–Coronary PCI,N(%)
44(38.60)
Coronary PCI during Current visit,N(%)
35(30.70)
PT227 Large artery stiffness and carotid intima-media thickness in relation to markers of bone mineral metabolism in postmenopausal African women: The PURE-study Aletta Schutte*1, Lebo Gafane1, Iolanthe Kruger2, Rudolph Schutte1 1 Hypertension in Africa Research Team (HART), 2Africa Unit for Transdisciplinary Health Research, North-West University, Potchefstroom, South Africa Introduction: Increased vascular calcification, cardiovascular morbidity and mortality have been associated with altered bone metabolism and associated calciotropic hormones. Objectives: Due to the lack of information on the contribution of altered bone metabolism and calciotropic hormones on cardiovascular disease in Africans, this study aimed to explore the relationships of carotid intima-media thickness (cIMT) and central pulse pressure (cPP) with the parathyroid hormone-to-vitamin D ratio (PTH:25-OH-D) and Ctelopeptide of type I collagen (CTX) in postmenopausal African women. Methods: A study population of 434 African women, aged 47 years, was divided into lean and overweight/obese groups. We assessed cPP and cIMT, and determined PTH, 25OH-D and CTX concentrations. Results: In the overweight/obese group we found elevated PTH and PTH:25-OH-D compared to the lean group (p<0.001), while the lean group had higher CTX concentrations (p<0.001). Single, partial and multiple regression analyses confirmed that only in lean women, cIMT was independently associated with PTH:25-OH-D (R2¼0.22; b¼0.26; p¼0.003); whereas in obese women, cPP associated with both PTH:25-OH-D (R2¼0.20; b¼0.17; p¼0.017) and CTX (R2¼0.20; b¼0.17; p¼0.025). Conclusion: In postmenopausal African women with increased adiposity, cPP, as indicator of central arterial stiffness, was positively associated with alterations in bone metabolism and calciotropic hormones, whereas cIMT of lean women was positively associated with PTH:25-OH-D. Our results suggest that alterations in bone metabolism may contribute to arterial calcification. Disclosure of Interest: None Declared PT229
Conclusion: Our study shows a lack of knowledge regarding salt major contributors in the Lebanese diet and allowed maximum intake levels relative to the community based sample. *Nasreddine et al. “Knowledge, Attitudes and Behaviors Related to Sodium Intake of Lebanese Consumers aged 19-60” (Unpublished data). Disclosure of Interest: None Declared PT226 Erectile dysfunction risk factors in patients with severe obstructive sleep apnea syndrome and identifying CPAP response predictors Haruki Sekiguchi*1,2, Ken Shimamoto1, Koji Narui3, Yuji Inoue4, Yufuko Takahashi1, Tatsumi Fujio1, Yasunobu Hashimoto5, Yoshiko Maeda5, Eri Watanabe1, Masatoshi Kawana1, Fujio Tatsumi1, Mayumi Suzuki6, Ken Shimamoto1, Kazuhiro Yamaguchi6, Masatoshi Kawana1 1 Cardiology, Aoyama Hospital, Tokyo Women’s Medical University, Tokyo, Japan, 2Cardiology, Aoyama Hospital, Tokyo Women’s Medical University, Tokyo, Jersey, 3Respiratory Medicine, Toranomon Hospital, 4Aoyama Hospital Tokyo Women’s Medical University, 5Urology, 6Aoyama Hospital, Tokyo Women’s Medical University, Tokyo, Japan Introduction: Erectile dysfunction (ED) is one of the important complications in patients with sleep apnea syndrome (SAS). ED is known as a risk factor and risk indicator for future cardiovascular diseases. However, risk factors related to ED as well as the efficacy of continuous positive airway pressure (CPAP) therapy on improving ED have not been established in Japanese subjects with obstructive SAS. Objectives: This study investigates risk factors of ED and factors predicting the efficacy of CPAP for the treatment of ED in Japanese SAS patients. Methods: We conducted a retrospective population-based study of Japanese subjects linking questionnaire data with characteristics of patients hospitalized (170 males, age: 4912.3 years) due to SAS diagnosis by polysomnography. SAS was diagnosed as AHI > 5 and ED diagnosed by an International Index of Erectile Function (IIEF)-5 score < 22. Thirty patients answered IIEF5 twice before CPAP treatment and at 6 months after CPAP treatment. We analyzed the correlation between ED and potential explanatory variables including age, body mass index (BMI), apnea/hypopnea index (AHI), micro-arousals, hypertension (HTN), diabetes mellitus (DM), dementia, ischemic heart disease, dyslipidemia, and benign prostatic hyperplasia. We also investigated predictors judging the efficacy of CPAP on improvement of ED. Results: In this study population, baseline BMI and AHI were, 27.34.0 kg/m2 and 43.127.8 /hr, respectively. ED was observed in 59.4% (101/170) of the patients. DM and HTN were found to be risk factors for ED (odds ratio: 2.89, [95% CI 1.46-5.68], P<0.001, OR: 3.47, [95% CI 1.77-6.85], P<0.01, respectively). Multivariate analysis revealed that DM (OR: 4.4, [95% CI 1.92-9.97], P<0.001) was a unique, independent risk factor for ED. After 6 months of CPAP treatment, IIEF5 scores significantly decreased in 53.3% (16/30) of ED patients (3.42.3, P<0.001). Baseline AHI for SAS diagnosed patients was significantly higher in CPAP responders compared to non-responders (53.922.9 vs. 37.019.8, P<0.05, respectively). However, in patients over 65 years of age (N¼5), CPAP therapy was not effective for treating ED (DIIEF 5 ¼ –5.48.0) in 80% of cases. Conclusion: DM is an important risk factor inducing ED in SAS patients. Furthermore, CPAP treatment should be considered for patients suffering from severe SAS complicated with ED. Disclosure of Interest: None Declared
GHEART Vol 9/1S/2014
j
March, 2014
j
POSTER/2014 WCC Posters
Assessment of quality of life and its correlates among Hypertensive patients in a West African Cardiology practice Amam C. Mbakwem*1, Francis Aina1, Casmir E. Amadi2, Abiola Akinbode2, Joy Mokwunyei3 1 Medicine, 2Psychiatry, University of Lagos, 3Medicine, Lagos University Teaching Hospital, Lagos, Nigeria Introduction: Hypertension (HTN) is majorly asymptomatic except when complicated and may not be expected to impact on the quality of life (QoL) of patients. Poor QoL may affect health seeking behaviour, adherence to treatment and disease outcome. The aspect of quality of life has not been given much prominence in the management of patients with hypertension. We therefore evaluated the QoL of hypertensive patients attending the cardiology clinic of our hospital using a generic instrument, the WHOQOL-BREF. Objectives: To determine the quality of life of hypertensive patients and its correlates in a cardiology practice in west Africa. Methods: Hypertensive patients without co-morbidities who were attending the cardiology clinic were recruited. Relevant clinical data were retrieved from their notes and subjects self completed the WHOQOL-BREF. The single item scores were computed and analysed. The domain scores in the WHOQOL-BREF were computed, transformed and analysed. These were correlated with the single item scores and clinical parameters. Results: There were 74 males and 110 females with mean age 56.4712.02yrs. About 40% had post high-school education, 72% had poor finances and most, 80% were married. About 16% felt their QoL was poor to average while 49% were dissatisfied with their health status. Transformed scores for the main domains, physical health, psychological, social relationships and environment were 67.3726.35, 68.7613.58, 67.9215.93 and 67.1413.86 respectively. Also 14.9%, 9.1%, 8.5% and 8.8% had scores less than 50% for physical health, psychological, social relationships and environment domains respectively. More females (18.2% vs. 12.2%, p ¼ 0.05) felt their quality of life was below average. There was positive correlation between age and domains of social relationships and the environment, r¼.214, p¼0.006 and r ¼.183, p¼0.02 respectively. Positive correlation was observed between perception of poor quality of life and health status and the four domains evaluated, p <0.0001. Conclusion: The QoL of hypertensive patients must be given consideration in their management as this may contribute to poor adherence and affect outcomes. Particular attention should be paid to female hypertensives who appear to have worse QoL scores. Disclosure of Interest: None Declared PT230 Role of Brain Natriuretic Peptide In Predicting The Short Term Cardiovascular Outcomes In Preeclampsia And Eclampsia Patients Ghada Youssef*1, Nader Haroon1, Reda Diab1, Essam Baligh1 1 Cardiology, Cairo University, Cairo, Egypt Introduction: Brain natriuretic peptide (BNP) concentrations were found to be higher in preeclampsia and other hypertensive disorders of pregnancy than in normal pregnancy. This may reflect ventricular stress and/or subclinical cardiac dysfunction associated with preeclampsia. Objectives: To evaluate the possible role of elevated BNP level in predicting the short-term maternal cardiovascular outcome in patients presented with preeclampsia/eclampsia disease. Methods: Fifty patients who presented with preeclampsia or eclampsia were included. They were followed up clinically and by echocardiography till delivery and at 1, 3 and 6
e211
POSTER ABSTRACTS
compare the awareness level of our study sample to healthy individuals in the community (HIC) from a previous study*. Methods: Based on unpublished data*, it is estimated that around 82.2% of Lebanese adults know that salt/sodium worsens human’s health. With a confidence interval of 7% and a type 1 error of 5%, we sampled 115 out of the annual 1500 Lebanese high CV risk patients admitted to the Cardiac Care Unit (CCU). They were administered a questionnaire developed to assess awareness of salt intake recommended level, content in food, and associated CV risk. Statistical analysis was conducted using SPSS 20 for Windows. Results: In terms of knowledge, 36.5% of CCU patients knew that the main source of salt in the diet is processed foods such as breads, cured meats, and canned food compared to 21.5% of HIC, while 47% thought it was salt added at the table compared to 42.1% of HIC. Moreover, 19.1% of CCU and 28.9% of HIC knew the maximum daily amount of salt recommended. In terms of attitudes and behaviors, 58.53% admitted they never look at the salt or sodium content on food labels compared to 66.5% of HIC. When asked about the main motive to reduce Salt intake, 65.8% of CCU and 51.7% of HIC admitted that it would be a dramatic change in health status.