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PW199 Waist to height ratio and cardiovascular risk factors in a large representative North Indian Population
Statistically differences in interventional group in amotivation and Intrinsic Regulation
Baseline vs 4 months P values
PW195 Lipid profile and Carotid Intimal Medial thickness in different stages of Chronic Kidney Disease Avinash K. Dubey1, Yogesh Varma*1, Sonika dubey2, Gurmeet Singh2, Abhishek K. Dubey1, Virendra Sharma1, Swapnil Grade3 1 Department of medicine, 2Department of Cardiology, Gandhi Medical College Bhopal India, 3 Hamidia Hospital Bhopal, Bhopal, India Introduction: Cardiovascular disease has been recognised to be a major cause of morbidity and mortality in Chronic Kidney Disease (CKD). Lipid abnormalities were originally considered as complications of end stage renal disease; these changes can be present in early stages of CKD and may actively participate in the pathogenesis of serious complications such as atherosclerotic vascular disease. The dyslipidaemia can be influenced by several intrinsic (nephrotic range proteinuria, diabetes mellitus, hereditary disorders of lipid metabolism) or exogenous (erythropoietin administration, steroids, calcineurin inhibitors, etc.) factors. Objectives: Study of Carotid Intimal Medial thickness(CIMT) in different stages of CKD and its relation with lipid profile and comparing with similar control group. Methods: Inclusion criteria: Patients with CKD between the age group 18-85years, Exclusion criteria: patients with acute kidney injury, ischemic heart disease disease, stroke, on hypolipidaemic drugs. 70 cases of CKD were selected on basis of simple random sampling technique. 30 age and sex matched healthy control were taken. CKD patients were classified into different stages according to glomerular filtration rate. Results: Study showed 18 (25.7%) of the patients belonged to 4th and 5th decade. There was male preponderance 39 (55.7%). Most common etiology of CKD was Diabetic Nephrology 21 (30%). 16 (22.9%) patients were found to have Hypercholesterolemia, 42 (60%) had Triglyceride level 150 mg/dl. 23 (32.9%) patients had serum HDL-C 30 mg/dl. The mean CIMT in patients was 0.840.23mm and control was 0.460.19mm. There was statistically significant (p < 0.001) difference in CIMT between two groups. There was significant Univariate positive co-relation between CIMT and age (r¼0.605, p<0.001), BMI (r¼0.377, p¼0.001). Total cholesterol (r¼0.236, p<0.018) and serum Triglyceride (r¼0.387, p<0.001). Statistically significant correlation was found between CIMT and eGFR, VLDL and HDL-C. Conclusion: CIMT is significantly higher in CKD patients and is very well co-related with traditional cardiovascular risk factors like age, BMI, total Cholesterol and Triglyceride. Assessment of CIMT in different stages of CKD may act as a marker for premature or established atherosclerosis. Disclosure of Interest: None Declared PW198 Physical Activity Motivation: Impact of educational program in Primary care Ana Ramoa*1,2, Lucimere Bohn3, Helena Leal2,3, José Oliveira1 1 Ciafel, University of Porto, 2Usf Espaço Saude, 3University of Porto, Porto, Portugal Introduction: Cardiovascular disease (CVD) is common in general population, affecting the majority of adults past the age of 60 years. Many of important risk factors od CVD are modifiable by specific preventive measures. Regular physical activity (PA) is related to a reduced risk of fatal and non-fatal coronary events in healthy individuals, subjects with coronary risk factors and cardiac patients over a wide age range. A sedentary lifestyle is one of the major risk factors for CVD. Physical activity is therefore suggested by guidelines as a very important non-pharmacological tool for primary and secondary cardiovascular prevention. Lifestyle modification can reduce blood pressure and lower cardiovascular risk. Motivation is a critical factor in supporting sustained exercise. Studies support a positive relation between more autonomous forms of motivation and exercise, with a trend towards identified regulation predicting initial/short-term adoption more strongly than intrinsic motivation, and intrinsic motivation being more predictive of long-term exercise adherence. Objectives: The aim of this study is to evaluate the effects of a lifestyle educational intervention on motivation for physical activity Methods: Case-control study with 127 patients with moderate and high cardiovascular Risk (CVR). 61 patients were submitted to 3 educational sessions about healthy lifestyles and cardiovascular risk plus weekly encouragement and reinforcement via SMS. 66 patients were control group. The patients were evaluated before intervention, 4 and 10 after. BREQ2 was applied in all evalluations. Results: There is no differences between interventional and control group
Intervention Group 37:29
32:29
Age
56,4 6,7
54,6 7,6
Moderate
26
31
High and very high
40
31
CVR
j
March, 2014
j
Intervention group
Control group
Intervention group
Control group
Amotivation
0,002
0,537
0,010
0,514
External Regulation
0,023
0,590
0,891
0,715
Introjected Regulation
0,011
0,404
0,113
0,057
Identified Regulation
0,065
0,281
0,043
0,027
Intrinsic Regulation
0,0001
0,781
0,003
0,038
Conclusion: Data suggest that worksite approach in health promotion programs on CVR factors can be implemented and can have positive impact in amotivation and intrinsic motivation for PA. Disclosure of Interest: None Declared
PW199 Waist to height ratio and cardiovascular risk factors in a large representative North Indian Population Dorothy Lall*1, Pradeep A. Praveen2, Ritvik Amarchand2, Ruby Gupta3, Ambuj Roy2, Lakshmy Ramakrishnan2, K. Srinath Reddy3, Anand Krishnan2, Nikhil Tandon2, Dorairaj Prabhakaran1 1 Centre for Chronic Disease Control, 2All India Institute of Medical Sciences, 3Public Health Foundation of India, Delhi, India Introduction: Cardiovascular Disease (CVD) has emerged as the leading cause of death in the world. This burden is disproportionately higher in low and middle income countries like India. Obesity is associated not only with increased risk for CVD but is also an independent risk factor for other risk factors of CVD like diabetes and hypertension. Indices like BMI, Waist Circumference (WC), waist hip ratio (WHR), Waist circumference to height ratio (WHtR) and Body Adiposity Index (BAI) are used to estimate central obesity. This study aims to compare the discriminatory power of these indices for diabetes, hypertension, dyslipidaemias and for the clustering of 2 or more risk factors in a large representative population of northern India. Objectives: To determine the discriminatory power (by ROC curve) of BMI, WC, WHR, WHtR and BAI for cardiovascular risk factors (Hypertension, diabetes and dyslipidaemias) and their clustering in a representative North Indian population. Methods: Multistage, cluster and simple random sampling methods were used to select households in both urban and rural areas. All adults >30 years were invited and after informed consent, interviewed. Trained personnel, using calibrated and validated instruments, took anthropometric measurements and fasting blood samples. Diabetes, hypertension and dyslipidemias were defined as in guidelines by ADA, JNC 7 and ATP III respectively and clustering of risk factors as presence of 2 risk factors. Results: A total of 5851 persons, 46.3% male, 52.6% urban with average age of 46.2 (13.45) years accepted to participate in this study. The area under curve (AUC) values for WHtR (0.617–0.744) was higher than those for BMI and other indices for all outcomes in women and comparable to BMI and WC in men. Also, WHtR, BMI and WC had similar AUCs for dyslipidemia (Table 1). The AUCs for WHtR were significantly the highest for diabetes, 0.695 (.649-.716) and 0.733 (.701-.764) among men and women respectively. Clustering of risk factors was best predicted by BMI, AUC 0.724 (.683-.765) among men and by WHtR, AUC 0.740 (.696-.784) in women.
Control Group
Sex (W:M)
GHEART Vol 9/1S/2014
Motivation
Baseline vs 10 months P values
POSTER/2014 WCC Posters
Conclusion: The findings suggest the utility of waist to height ratio as a good predictor of cardiovascular risk and diabetes, significantly better or similar to other traditional measures of obesity. As a metric it is easier to apply in the field, requiring only tape measure and therefore is a useful measure. Disclosure of Interest: None Declared
e297
POSTER ABSTRACTS
higher than recommended lipid and BP levels leaving them at risk of a second event. Moreover, their ability to recognise a secondary event appears to be deficient. Disclosure of Interest: None Declared
Baseline vs 4 months P values
PW195 Lipid profile and Carotid Intimal Medial thickness in different stages of Chronic Kidney Disease Avinash K. Dubey1, Yogesh Varma*1, Sonika dubey2, Gurmeet Singh2, Abhishek K. Dubey1, Virendra Sharma1, Swapnil Grade3 1 Department of medicine, 2Department of Cardiology, Gandhi Medical College Bhopal India, 3 Hamidia Hospital Bhopal, Bhopal, India Introduction: Cardiovascular disease has been recognised to be a major cause of morbidity and mortality in Chronic Kidney Disease (CKD). Lipid abnormalities were originally considered as complications of end stage renal disease; these changes can be present in early stages of CKD and may actively participate in the pathogenesis of serious complications such as atherosclerotic vascular disease. The dyslipidaemia can be influenced by several intrinsic (nephrotic range proteinuria, diabetes mellitus, hereditary disorders of lipid metabolism) or exogenous (erythropoietin administration, steroids, calcineurin inhibitors, etc.) factors. Objectives: Study of Carotid Intimal Medial thickness(CIMT) in different stages of CKD and its relation with lipid profile and comparing with similar control group. Methods: Inclusion criteria: Patients with CKD between the age group 18-85years, Exclusion criteria: patients with acute kidney injury, ischemic heart disease disease, stroke, on hypolipidaemic drugs. 70 cases of CKD were selected on basis of simple random sampling technique. 30 age and sex matched healthy control were taken. CKD patients were classified into different stages according to glomerular filtration rate. Results: Study showed 18 (25.7%) of the patients belonged to 4th and 5th decade. There was male preponderance 39 (55.7%). Most common etiology of CKD was Diabetic Nephrology 21 (30%). 16 (22.9%) patients were found to have Hypercholesterolemia, 42 (60%) had Triglyceride level 150 mg/dl. 23 (32.9%) patients had serum HDL-C 30 mg/dl. The mean CIMT in patients was 0.840.23mm and control was 0.460.19mm. There was statistically significant (p < 0.001) difference in CIMT between two groups. There was significant Univariate positive co-relation between CIMT and age (r¼0.605, p<0.001), BMI (r¼0.377, p¼0.001). Total cholesterol (r¼0.236, p<0.018) and serum Triglyceride (r¼0.387, p<0.001). Statistically significant correlation was found between CIMT and eGFR, VLDL and HDL-C. Conclusion: CIMT is significantly higher in CKD patients and is very well co-related with traditional cardiovascular risk factors like age, BMI, total Cholesterol and Triglyceride. Assessment of CIMT in different stages of CKD may act as a marker for premature or established atherosclerosis. Disclosure of Interest: None Declared PW198 Physical Activity Motivation: Impact of educational program in Primary care Ana Ramoa*1,2, Lucimere Bohn3, Helena Leal2,3, José Oliveira1 1 Ciafel, University of Porto, 2Usf Espaço Saude, 3University of Porto, Porto, Portugal Introduction: Cardiovascular disease (CVD) is common in general population, affecting the majority of adults past the age of 60 years. Many of important risk factors od CVD are modifiable by specific preventive measures. Regular physical activity (PA) is related to a reduced risk of fatal and non-fatal coronary events in healthy individuals, subjects with coronary risk factors and cardiac patients over a wide age range. A sedentary lifestyle is one of the major risk factors for CVD. Physical activity is therefore suggested by guidelines as a very important non-pharmacological tool for primary and secondary cardiovascular prevention. Lifestyle modification can reduce blood pressure and lower cardiovascular risk. Motivation is a critical factor in supporting sustained exercise. Studies support a positive relation between more autonomous forms of motivation and exercise, with a trend towards identified regulation predicting initial/short-term adoption more strongly than intrinsic motivation, and intrinsic motivation being more predictive of long-term exercise adherence. Objectives: The aim of this study is to evaluate the effects of a lifestyle educational intervention on motivation for physical activity Methods: Case-control study with 127 patients with moderate and high cardiovascular Risk (CVR). 61 patients were submitted to 3 educational sessions about healthy lifestyles and cardiovascular risk plus weekly encouragement and reinforcement via SMS. 66 patients were control group. The patients were evaluated before intervention, 4 and 10 after. BREQ2 was applied in all evalluations. Results: There is no differences between interventional and control group
Intervention Group 37:29
32:29
Age
56,4 6,7
54,6 7,6
Moderate
26
31
High and very high
40
31
CVR
j
March, 2014
j
Intervention group
Control group
Intervention group
Control group
Amotivation
0,002
0,537
0,010
0,514
External Regulation
0,023
0,590
0,891
0,715
Introjected Regulation
0,011
0,404
0,113
0,057
Identified Regulation
0,065
0,281
0,043
0,027
Intrinsic Regulation
0,0001
0,781
0,003
0,038
Conclusion: Data suggest that worksite approach in health promotion programs on CVR factors can be implemented and can have positive impact in amotivation and intrinsic motivation for PA. Disclosure of Interest: None Declared
PW199 Waist to height ratio and cardiovascular risk factors in a large representative North Indian Population Dorothy Lall*1, Pradeep A. Praveen2, Ritvik Amarchand2, Ruby Gupta3, Ambuj Roy2, Lakshmy Ramakrishnan2, K. Srinath Reddy3, Anand Krishnan2, Nikhil Tandon2, Dorairaj Prabhakaran1 1 Centre for Chronic Disease Control, 2All India Institute of Medical Sciences, 3Public Health Foundation of India, Delhi, India Introduction: Cardiovascular Disease (CVD) has emerged as the leading cause of death in the world. This burden is disproportionately higher in low and middle income countries like India. Obesity is associated not only with increased risk for CVD but is also an independent risk factor for other risk factors of CVD like diabetes and hypertension. Indices like BMI, Waist Circumference (WC), waist hip ratio (WHR), Waist circumference to height ratio (WHtR) and Body Adiposity Index (BAI) are used to estimate central obesity. This study aims to compare the discriminatory power of these indices for diabetes, hypertension, dyslipidaemias and for the clustering of 2 or more risk factors in a large representative population of northern India. Objectives: To determine the discriminatory power (by ROC curve) of BMI, WC, WHR, WHtR and BAI for cardiovascular risk factors (Hypertension, diabetes and dyslipidaemias) and their clustering in a representative North Indian population. Methods: Multistage, cluster and simple random sampling methods were used to select households in both urban and rural areas. All adults >30 years were invited and after informed consent, interviewed. Trained personnel, using calibrated and validated instruments, took anthropometric measurements and fasting blood samples. Diabetes, hypertension and dyslipidemias were defined as in guidelines by ADA, JNC 7 and ATP III respectively and clustering of risk factors as presence of 2 risk factors. Results: A total of 5851 persons, 46.3% male, 52.6% urban with average age of 46.2 (13.45) years accepted to participate in this study. The area under curve (AUC) values for WHtR (0.617–0.744) was higher than those for BMI and other indices for all outcomes in women and comparable to BMI and WC in men. Also, WHtR, BMI and WC had similar AUCs for dyslipidemia (Table 1). The AUCs for WHtR were significantly the highest for diabetes, 0.695 (.649-.716) and 0.733 (.701-.764) among men and women respectively. Clustering of risk factors was best predicted by BMI, AUC 0.724 (.683-.765) among men and by WHtR, AUC 0.740 (.696-.784) in women.
Control Group
Sex (W:M)
GHEART Vol 9/1S/2014
Motivation
Baseline vs 10 months P values
POSTER/2014 WCC Posters
Conclusion: The findings suggest the utility of waist to height ratio as a good predictor of cardiovascular risk and diabetes, significantly better or similar to other traditional measures of obesity. As a metric it is easier to apply in the field, requiring only tape measure and therefore is a useful measure. Disclosure of Interest: None Declared
e297
POSTER ABSTRACTS
higher than recommended lipid and BP levels leaving them at risk of a second event. Moreover, their ability to recognise a secondary event appears to be deficient. Disclosure of Interest: None Declared