Self-learning interactive computer package on hypertension

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Abstracts

(FMSC) [aOR 1.57, p < 0.001], residence in more urbanized areas (aOR 0.87 for North district, p = 0.022), new visits (aOR 0.51 for follow-up visits, p < 0.001) and absence of concomitant comorbidities (aOR 0.62 for one comorbidity, p < 0.001; aOR 0.59 for more than one comorbidity, p < 0.001) were positively associated with drug discontinuation. Drug classes (sulphonylurea vs. metformin vs. combination therapy) were not significantly associated with drug discontinuation (p = 0.157). Conclusions: Among Chinese diabetic patients, younger subjects; those with poorer socioeconomic status; patients newly prescribed an antidiabetic medication and those with no concomitant comorbidities were more likely to be discontinuers of oral hypoglycemic agents. More intensive monitoring should be targeted towards these patients to optimize glycemic control in clinical practice. doi:10.1016/j.ijcard.2009.09.149 DB000517 Mechanism of Irbesartan suppressing oxidative stress in high glucose induced endothelial microparticles release in human umbilical vein endothelial cell GANG TIAN, YAN REN, QUN LU, MIN LU, YA PING WANG First Affiliated Hospital of Medical College, Xi'an Jiaotong University, China Objectives: Postprandial hyperglycemia is considered as a risk factor for cardiovascular disease. The aim of this study was to observe the potential effects and mechanism of an angiotensin II type 1 receptor (AT1) antagonist Irbesartan on the high glucose-induced release of endothelial microparticles (EMPs) in cultured human umbilical vein endothelial cells (HUVECs). Methods: The cultured HUVEC was divided into four groups. There are control group (5.5 mmol/L glucose), high glucose group (33.3 mmol/L glucose), Irbesartan, and diphenyleneiodonium (DPI), an inhibitor of NADPH oxidase (NOX), treatment group. For Irbesartan and DPI treatment groups, the cells were incubated with Irbesartan (10–5 mol/L) and DPI (10 μmol/L) respectively for 1 h, and subsequently stimulated with 33.3 mmol/L high glucose for another 24 h, 48 h and 72 h respectively. EMPs level and intracellular reactive oxygen species (ROS) were detected by flow cytometry. NADPH oxidase 4 (NOX4) and endothelial nitric oxide synthase (eNOS) expressions in HUVECs was detected by RT-PCR and western blot. Results: (1) The levels of EMPs and ROS induced high concentration glucose were suppressed by Irbesartan in time-dependent manner (P < 0.05). The maximum effects of Irbesartan were at 72 h; (2) Irbesartan reduced high glucose induced NOX4 gene (1.4± 0.6-fold; P < 0.05), and protein (1.8± 0.5-fold; P < 0.05) expression; (3) Irbesartan reduced eNOS gene (2.1 ± 0.8-fold; P < 0.05), and protein (2.8 ± 0.7-fold; P < 0.05) expression. Conclusions: It was suggested that Irbesartan can attenuate high glucose induced EMP release in HCAEC. This effect of Irbesartan was partly related to the inhibition of oxidative stress response, which may be mediated by the activation of NOX4. doi:10.1016/j.ijcard.2009.09.150 DB000537 Prevalence of the glycometabolic abnormality among community residents aged 40–79 years in Chengdu LINGYUN OUYANG, YA LIU, BIN HUANG, XIAO-BO HUANG The Second Municipal Hospital of Chengdu, China Objective: To estimate the prevalence of glycometabolic abnormality among community residents aged 40–79 years in Chengdu. Design and methods: A cross-sectional population survey for glycometabolic

abnormality using randomly cluster-sampling was performed in 2008, Questionnaire and 75 gram oral glucose tolerance test (OGTT) were conducted in 5495 subjects, and serum lipid-profile, uric acid as well as height, weight, blood pressure were measured. Results: The average fasting blood glucose was 5.6 ± 0.0 mmol/L. The average OGTT 2 hour blood glucose was 7.9 ± 0.1 mmol/L, they were increased with aging. Prevalence of diabetes mellitus, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were 16.1%, 2.5% and 20.1%, respectively. The prevalence of glycometabolic abnormality increased with aging; prevalence of diabetes mellitus in city community, urban–rural fringe community and rural community were 21.4%, 17.7% and 11.1%, respectively. The prevalence of glycometabolic abnormality has no differences between sexes. The prevalence of diabetes and IGT increased with aging, But the prevalence of IFG have no obvious relationship with age. Conclusions: Our results showed that the glycometabolic abnormality are highly prevalent in Chengdu residents; over half of them are undiagnosed diabetes, they need to be find out as soon as possible. The prevalence of diabetes increased with aging. doi:10.1016/j.ijcard.2009.09.151 DB000857 Relationship between the cardiovascular disease, kidney disease, retinopathy and blood pressure, lipids disorder, blood glucose level in the Chinese diabetic patients ZHANGRONG XU, LINTAO SHI, AIHONG WANG, YUZHEN WANG Diabetes Center, 306th Hospital of PLA, China Objective: To analyze the impact of blood systolic–diastolic-pressure (SBP, DBP) increase, lipids disorder, and blood glucose level on the main diabetic complications, cardiovascular (CVD), kidney disease (DN) and retinopathy (DR) in the Chinese diabetic patients. Patients and methods: 9258 diabetic patients (male 5158 and female 4200), age 55.1+11.7 years, diabetes duration 1–480 months; BMI 25.8+3.4 kg/m2, were divided into different groups based on their blood pressure level (grouped on every 20 mmHg SBP from 90 to 230 mmHg and 10 mmHg or 20 mmHg DBP from 60 to 120 mmHg ), the blood lipids and glucose level (quartile). Cardiovascular disease, kidney diseases and diabetic retinopathy were compared and analyzed. Results: Blood pressure increased significantly with aging and longer duration of diabetes. The prevalence of CVD, DN and DR were significantly higher in this group with higher SBP or DBP. There were higher prevalence of CVD in the patients with TC level 5.0– 5.72 mmol/L and >5.72 mmol/L than those with TC <5.0 mmol/L, higher CVD, DN, DR prevalence in the patients with HbA1c>6.5% than those with HbA1c<6.5%. Multiple regression analysis showed SBP and DBP were the risk factors of the DN, DR and CVD. Conclusions: Hypertension aggravates the diabetic macro-and micro-vascular complication. doi:10.1016/j.ijcard.2009.09.153

Educational Programs ED000028 Self-learning interactive computer package on hypertension ARUNODAYA BARMAN School of Medical Sciences, Malaysia Introduction: Though students spend most of their time in class room learning, they learn much by self-learning. Self-learning often depends on the learning materials that are available to them. Many students prefer lecture notes (1). Students read the handout as they are not sure about the sources of information that they need to

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achieve their learning objectives (2), computer-based up-to-date interactive and click-based contents can be enjoyable, meaningful and may improve learning. Constructive, timely, and relevant feedback and provision of self-assessment may improve their learning (3). In the expanding information overload we expect students to learn more in the same period of time, it will be of help to the students if learning information is easily available to them. Objectives: To make learning interesting, as if it is playing with the computer, have most of the information relating to the topic easily available, and make it interactive and enabling the user to learn and assess their knowledge on the topic. Methods and package: Information relating to hypertension and its management were collected from different text books and journals. Microsoft Visual Basic 6.0 computer programming codes are used to write-up this software to learn about hypertension.

nursing knowledge and mastery of skills. Methods: 60 cases of hypertensive patients to investigate the family primary caregivers to take care of home care knowledge and skills to master the situation, and then the home care for common problems, 3 months for a system of training, the training of home care before and after the knowledge and skills to take care of awareness, such as a comparison. Results: The training of family caregivers to take care of nursing knowledge and skills before training markedly improved geometric; take care of this training are to participate actively in, and fully affirmed the need for health education and its importance. Conclusion: Health care education, can effectively improve the care of their families to take care of nursing knowledge and skills to improve the quality of home care.

doi:10.1016/j.ijcard.2009.09.154

doi:10.1016/j.ijcard.2009.09.156

ED000120 Analysis of etiology and metabolic disorders of in-patients of 628 refractory hypertension

Endocrine Hypertension

LEI WANG, NANFANG LI, XINLIN WANG, FEIYA ZU, DELIAN ZHANG, GUIJUAN CHANG The Center of Diagnosis, Treatment and Research of Hypertension of Xinjiang Uygur Autonomous Region, China Objective: To analyze the etiology and metabolic disorders of refractory hypertension (RH) for in-patients in order to provide basis of correct diagnosis and therapy of RH. Design and methods: Retrospective study was performed based on etiology and metabolic disorders of 628 inpatients with RH in department of hypertension, People's Hospital of Xinjiang Uighur Autonomous Region, from September 1997 to December 2005(including 361 male and 267 female, average age: 55.93 ± 13.06 years). Differences in qualitative variable were analyzed by chi square test. Results: (1) Of 628 in-patients with RH, there were 80.10% of essential hypertension, 18.95% of secondary hypertension (SH) and 0.95% of indefinite diagnosis. (2) 119 SH comprised 33.61% of renovascular hypertension, 15.97% of renal hypertension, 23.53% of obstructive sleep apnea syndrome, 13.45% of primary aldosteronism, and 5.04% of pheochromocytoma. Highest prevalence rate of SH was renovascular hypertension. Fewer prevalence rates of SH were aortic stenosis (1.68%), Cushing syndrome (2.52%), hyperthyroidism (0.84%), and hypothyroidism (3.36%). (3) Of 628 in-patients with RH, there were 66.24% of dyslipidemia, and 43.78% of abnormality of glucose metabolism. Highest prevalence rate of dyslipidemia was hypertriglyceridemia (41.8%). In abnormality of glucose metabolism, type 2 diabetes mellitus and impaired glucose tolerance were 28.6% and 15.19%, respectively. (4) The number of overweight and obesity with hypertriglyceridemia were significantly higher than those of normal weight. The number of obesity with type 2 diabetes mellitus were significantly higher than those of normal weight and overweight. Conclusions: Secondary hypertension should be filtrated in RH. Most RH complicated with metabolic disorders, it play an important role on therapy of RH to rectify metabolic disorders. doi:10.1016/j.ijcard.2009.09.155 ED000697 Health education for hypertensive patients the level of family care FANG LI, BAILING ZHAO, LU DING The 1st Affiliated of Kunming Medical College, China Objective: To study patients with hypertension before and after health education of family caregivers to take care of the

EN000160 The role of endothelial nitric oxide synthase uncoupling in glucocorticoid-induced hypertension M. THIDAa, J. EARLb, Y. ZHAOc, H. WANGa, C.S. TSEa, J.J. VICKERSa, M. SUTTONa, S.L.H. ONGa, T.A. MORIc, K.D. CROFTc, J.A. WHITWORTHa, Y. ZHANGa a The High Blood Pressure Research Unit, The John Curtin School of Medical Research, The Australian National University, Canberra, Australia b The Children’s Hospital, Westmead, Sydney, Australia c School of Medicine and Pharmacology, University of Western Australia, Perth, Australia Objective: Glucocorticoid-induced hypertension is associated with imbalance between nitric oxide and superoxide. One of the pathways that causes this imbalance is endothelial nitric oxide synthase (eNOS) uncoupling. In the present study, adrenocorticotrophic hormone (ACTH)- and dexamethasone-treated rats were further treated with sepiapterin, a precursor of tetrahydrobiopterin, or N-nitro-L-arginine (NOLA), an inhibitor of NOS, to investigate the role of eNOS uncoupling in glucocorticoid-induced hypertension. Methods: Male Sprague-Dawley rats (n = 7-13/group) were treated with either sepiapterin (5 mg/kg/day, i.p.) or saline (sham) 4 days before and during ACTH (0.2 mg/kg/day, s.c.), dexamethasone (10 μg/rat/day, s.c.) or saline treatment. NOLA (0.4 mg/ml in drinking water) was given to rats 4 days before and during dexamethasone treatment. Systolic blood pressure (SBP) was measured by the tail cuff method. Results: (mean±SEM): Both ACTH (116 ± 2 to 135 ± 3 mmHg, P < 0.001) and dexamethasone (114 ± 4 to 133 ± 3 mmHg, P < 0.0005) increased SBP. Sepiapterin alone did not alter SBP. Sepiapterin did not prevent ACTH- (129 ± 4 mmHg, ns) or dexamethasone-induced hypertension (135 ± 3 mmHg, ns) although plasma total biopterin concentrations were increased. NOLA increased SBP in rats prior to dexamethasone or saline treatment. NOLA further increased SBP in both saline- (133 ±4 to 157 ± 3 mmHg, P < 0.05) and dexamethasone-treated rats (135 ± 5 to 170 ± 6 mmHg, P < 0.05). ACTH and dexamethasone increased plasma F2-isoprostane concentrations. Neither sepiapterin nor NOLA affected this marker of oxidative stress. Conclusion: Sepiapterin did not prevent ACTH- or dexamethasone-induced hypertension. NOLA exacerbated dexamethasone-induced hypertension. These data suggest that eNOS uncoupling does not play a major role in the genesis of glucocorticoid-induced hypertension in the rat. doi:10.1016/j.ijcard.2009.09.157