TY - JOUR
AB - 233 Effect of Ramadan fasting on acenocoumarol-induced antocoagulant effect K Mzoughi1, I Zairi1, Z Jnifene1, M Ben Kilani1, F Ben Moussa1, S Kamoun1, S Fennira1, S Kraiem1 1Habib Thameur Hospital, Department of Cardiology, Tunis, Tunisia Topic: Environmental factors Introduction: Eating patterns, food intake and type of alimentation vary greatly during the month of Ramadan. Furthermore, fasting, which practiced during the month of Ramadan, can have an impact on drug's metabolism. These two factors, fasting and eating habits changes during the month of Ramadan, may impact acenocoumarol anticoagulant effect, translated by variations of INR values. Aim: Study Ramadan fasting effects on INR variations in patients treated by acenocoumarol's antiocoagulant. Methods: A Prospective monocentric study was conducted during the Ramadan month of 2015 at Habib Thameur Hospital on fasting outpatients that were treated by Acenocoumarol. Baseline INR values (e.i. most recent available value before the month of Ramadan) were compared to INR values obtained during the month of Ramadan. All patients were monitored for signs of secondary hemorrhagic complications linked to treatment by anti-vitamin K (AVK) Results: 30 patients were included in the study (15 male and 15 female patients). The mean age of the patients were 65 years. Around two thirds of the patients treated by AVK for atrial fibrillation. The majority of patients (94%) have been treated by AVK for more than a year. The mean INR was significantly higher during the month of Ramadan than baseline (3.51 vs. 2.52; p< 0.0001). There were also more overdoses during the month of Ramadan than baseline (9 vs. 0; p=0.014). While, no serious hemorrhagic complication was observed during that month, two patients had minor hemorrhages (epistaxis and gingivorrhagia). Conclusion: The increased INR values highlights the need of a close monitoring of INR values during the month of Ramadan, particularly in patients with a high haemorrhagic risk. 234 Toxic urban waste's assault on cardiovascular risk M L De Rosa1, M Cerini2, L Cerini3, N Ferrara1 1University Hospital Federico II, Naples, Italy 2Nuclear Dept, Politecnico of Milan, Milan, Italy 3Economics and Menagment of Innovation andTechonology,Bocconi University, Milan, Italy Funding Acknowledgements: none Topic: Environmental factors Background:A cardiovascular health (CH) survey of 1203 persons (P)in households located near the hazardous waste disposal sites, Campania, region of Southern Italy, was conducted from 2009 until today to assess whether rates of adverse CH outcomes were elevated among P living near the sites Methods:Data included a household questionnaire, medical records of reported cardiovascular diseases (CD) certificates and hospital admission for CD from our database Results:The study areas appeared similar with respect to mortality, cancer incidence, and pregnancy outcomes. In contrast, rate ratios were greater than 1.5 for 2 of 19 reported disease, i.e., angina pectoris, and strokes. Prevalence odds ratios for 23 symptoms (S) were uniformly greater than 1.0, and 12 S had odds ratios greater than 1.5: anginal pain, deep, frightening, sometimes burning, typically triggered by physical activity,dyspnea with a feeling of suffocation, pale skin, the state of anguish and terror of P, accompanied by palpitations, faintness, marked fatigue, nausea,vomiting. The apparent broad-based elevation in reported disease and S may reflect increased perception or recall of conditions by P living near the sites. There are few data on the full range of regulated community air pollutants (CAP) as PM2,5, sulfur and nitrogen dioxide, carbon monoxide and ozone. The our study considered all CAP and found cardiovascular risk associated only with PM2.,5 concentrations, which might derive from uncontrolled burning of municipal solid waste in particular sites of our region. Our analysis demonstrated a relationship between increased levels of eventual fine particulate CAP and higher rates of death and complications from cerebrovascular and CD, depending not only on which city a P lived in but also on where in that city P lived Conclusions:Combustion not checked of urban refusals releases a number of toxic substances, most in small quantities and at extremely low levels. Because of the wide range of CAP, the different pathways of exposure, long-term low levels exposure, and the potential for synergism among the CAP, concerns remain about potential CH but there are many uncertainties involved in the assessment 235 White coat hypertension, is it really benign? M Matangi1, U Jurt1, M Cases1, D Brouillard1 1Kingston Heart Clinic, Kingston, Canada Topic: Hypertension Background: We defined white coat hypertension (WCH) using 24hr ABPM as office systolic BP >140mmHg with average daytime systolic BP <135mmHg in the absence of drugs. We analyzed outcome in patients presenting with WCH to determine who became hypertensive using a subsequent ABPM. Methods: Our ABPM database was searched for patients with WCH who had at least 1 further ABPM. The second ABPM results were defined as either WCH, Hypertensive, treated hypertensive or masked hypertension. The unpaired t-test, Fischer's exact test and multivariate analysis were used. Results: There were 19,068 patients, 2,675 with WCH and 462 patients (17.3%) with at least one follow-up ABPM (range 2-12). Females 253, males 209 with a mean age of 53.5 ± 6.0 years. The mean time between the first and ABPM was 4.3 ± 2.9 years. The average daytime ABPM SBP was 127.5 ± 5.5mmHg and DBP 76.8 ± 6.1mmHg. The average office SBP was 151.7 ± 8.8mmHg and DBP 90.3 ± 9.6mmHg. Of the 462 patients 226 (49%) either remained WCH (194) or became normotensive (32). Two-hundred and thirty-six became abnormal (51%) with 229 becoming hypertensive and 7 developing masked hypertension. A further 15 patients with WCH on the first and second ABPM became hypertensive on the third ABPM increasing the number of abnormals to 251 (54.3%). Univariate analysis (Table 1) indicates age, office systolic BP and office diastolic BP to be important variables. Multivariate analysis shows the only independent variable to be office systolic BP. Conclusions: In patients with WCH by ABPM, 51% who are referred back for a second ABPM are diagnosed with hypertension with a further 3.3% added by the third ABPM. The problem with this data is that it represents only a small percentage (17.3%) of all WCH patients. This could lead to an overestimation of the development of hypertension due to selection bias, those with suspected hypertension being more likely to be referred back for subsequent testing. Despite this bias white coat hypertension may not be as benign as previously thought? Office systolic BP is the only independent predictor for the development of hypertension. WCH-WCH or N WCH-H Number 226 236 P value Age (yrs). 56.2 ± 13.8 59.5 ± 11.3 <0.005 Office SBP (mmHg). 149.0 ± 12.2 158.2 ± 15.9 <0.0001 Office DBP (mmHg). 89.1 ± 10.0 91.6 ± 12.5 <0.02 WCH-WCH or N WCH-H Number 226 236 P value Age (yrs). 56.2 ± 13.8 59.5 ± 11.3 <0.005 Office SBP (mmHg). 149.0 ± 12.2 158.2 ± 15.9 <0.0001 Office DBP (mmHg). 89.1 ± 10.0 91.6 ± 12.5 <0.02 WCH=White coat hypertension. N= Normotensive. H= Hypertensive.Multivariate analysis shows that only office systolic BP (P=0.0008) is an independent predictor of developing hypertension when presenting with WCH. Open in new tab WCH-WCH or N WCH-H Number 226 236 P value Age (yrs). 56.2 ± 13.8 59.5 ± 11.3 <0.005 Office SBP (mmHg). 149.0 ± 12.2 158.2 ± 15.9 <0.0001 Office DBP (mmHg). 89.1 ± 10.0 91.6 ± 12.5 <0.02 WCH-WCH or N WCH-H Number 226 236 P value Age (yrs). 56.2 ± 13.8 59.5 ± 11.3 <0.005 Office SBP (mmHg). 149.0 ± 12.2 158.2 ± 15.9 <0.0001 Office DBP (mmHg). 89.1 ± 10.0 91.6 ± 12.5 <0.02 WCH=White coat hypertension. N= Normotensive. H= Hypertensive.Multivariate analysis shows that only office systolic BP (P=0.0008) is an independent predictor of developing hypertension when presenting with WCH. Open in new tab Open in new tabDownload slide Abstract number:235 236 Association between grade of blood pressure control and diastolic dysfunction: data from a community-based cohort EM Vilela1, R Fontes-Carvalho2, R Ladeiras-Lopes2, p Bettencourt3, A Leite-Moreira2, A Azevedo4 1Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal 2Faculty of Medicine University of Porto, Department of Physiology and Cardiothoracic Surgery, Porto, Portugal 3Faculty of Medicine University of Porto, Department of Medicine, Porto, Portugal 4Faculty of Medicine University of Porto, Department of Clinical Epidemiology, Predictive Medicine and Public Health, Porto, Portugal Topic: Hypertension Introduction: Hypertension is associated with changes in both cardiac structure and function, such as left ventricular hypertrophy and diastolic dysfunction. In hypertensive patients, diastolic function is of significant relevance, as diastolic dysfunction is an independent predictor of cardiovascular events. Despite this association, the relative impact of different blood pressure levels on diastolic function is still not fully ascertained. In particular, in hypertensive patients, it is not known if diastolic dysfunction can be fully reversible according to the grade of blood pressure (BP) control. Purpose: We aimed to assess the impact of BP control in diastolic function parameters in hypertensive patients from a community-based cohort. Methods: Community-based cohort study including 1,063 adults (at least 45 years old) without known cardiovascular disease at inclusion. All participants underwent clinical evaluation, including office BP measurement (mean of 3 measurements), and detailed echocardiographic examination. Hypertension was defined as systolic blood pressure (SBP) =140 mmHg or diastolic blood pressure (DBP) =90 mmHg or current use of anti-hypertensive medication. Hypertensive patients were dichotomized into two groups: controlled BP (defined as office SBP <140 mmHg and DBP <90 mmHg) versus uncontrolled BP. Diastolic function was analysed according to European consensus guidelines, using E' velocities and E/E' ratio. Multivariate linear and logistic regression analyses including age, gender and body mass index as covariates were performed for predicting E' and diastolic dysfunction, respectively. Results: In this cohort (mean age 62.4±10.6 years, 38% males) hypertension was present in 53.6% of participants. A total of 175 participants (30.7% of hypertensive participants) had controlled BP (mean SBP and DBP of 124.2±11.3 mmHg and 74.1±8.4 mmHg, respectively) and 395 participants (69.3% of hypertensive participants) had uncontrolled BP (mean SBP and DBP 152.1±19.6 and 85.3±11.9 mmHg, respectively). Both controlled and uncontrolled hypertensive participants had significantly lower E' velocity and higher E/E' ratio, when compared to participants with optimal BP. In the multivariate logistic regression analysis, the presence of hypertension was an independent predictor of diastolic dysfunction (adjusted OR=1.82, 95% CI:1.07-3.11). There were no significant differences in the E' velocity (9.7±3.2 cm/s versus 9.6±2.9 cm/s, respectively; p=0.715) or the E/E' ratio (8.1±3.1 versus 8.1±3.0, respectively; p=0.855) between controlled and uncontrolled hypertensive patients. Conclusion: In this large community-based cohort, hypertension was an independent predictor of diastolic dysfunction. There were no differences in diastolic parameters according to blood pressure control suggesting that, once established, these changes may not be fully reversible. 237 Hypertension affects inflammatory mediators in heart failure. K Kaminski1, K Ptaszynska-Kopczynska2, M Marcinkiewicz-Siemion2, A Szpakowicz2, A Lisowska2, E Waszkiewicz2, WJ Musial2 1Medical University of Bialystok, Bialystok, Poland 2Medical University of Bialystok, Department of Cardiology, Bialystok, Poland Funding Acknowledgements: National Leading Scientific Center of Medical University of Bialystok Topic: Hypertension Arterial hypertension (HA) is a major healthcare problems worldwide. It is a key risk factor for both coronary artery disease and heart failure. Despite decrease in incidence of myocardial infarction, the number of patients with heart failure is rapidly growing. In general it is accepted that low blood pressure is a sign of poor prognosis in patients with advanced heart failure. However, large studies proved, that HA is a risk factor of HF and augments its mortality and morbidity. HA often occurs in patients with metabolic syndrome, who also present pro-inflammatory phenotype, including high concentrations of inflammatory mediators, that may contribute to the progression of heart failure. We aimed to assess whether the presence of HA affects concentrations of inflammatory mediator – interleukin 6 (IL6) in patients with chronic heart failure with reduced ejection fraction (HFrEF). We enrolled 88 patients with HFrEF (left ventricle ejection fraction < 35%, confirmed by Simpson method in echocardiography, age 63.6±11 years) and 34 age, sex and comorbidities matched controls (age 63.2±9 years). Concentrations of IL6 and its circulation receptors – sIL-6R and sgp130 in serum was measures using commercially available ELISA kits. Differences between groups were assessed using t test. When variable distribution as evaluated by Shapiro-Wilk test did not comply with normal distribution, the variable was log-transformed to provide normal distribution. Patients with HFrEF presented significantly lower EF, lower sIL-6R, higher BNP and IL-6 concentrations than the controls. Fifty one patients with HFrEF (58%) and 24 controls (61%) also were diagnosed with HA. When two groups of patients with HFrEF were compared (with HA vs no HA), they presented comparable EF, BMI, BNP, urea, creatine, HDL-cholesterol, triglicerides and CRP concentrations. However, patients with HA and HFrEF had higher concentration of IL-6 when compared to subjects with HFrEF but without HA. No differences where noticed in the concentrations of soluble receptors of IL-6. Groups of controls with and without HA did not differ in respect to the analyzed variables. These results may suggest that HA contributes to the development of pro-inflammatory phenotype in larger extent in patients with HFrEF than in subjects without symptoms of heart failure. IL-6 may play a role in effects of hypertension in HFrEF. HFrEF HA(+) HFrEF HA(-) Controls HA+ Controls HA- IL-6 (pg/mL) 3.42 ± 2.24 * 2.76 ± 2.34 2.25 ± 1.11 2.29 ±0.88 sgp130 (ng/mL) 308 ± 71 314 ± 66 302 ± 62 316 ± 55 sIL-6R (ng/mL) 52.4 ± 17.6 51.1± 20.8 61.9 ± 30.5 66.4 ± 20.7 HFrEF HA(+) HFrEF HA(-) Controls HA+ Controls HA- IL-6 (pg/mL) 3.42 ± 2.24 * 2.76 ± 2.34 2.25 ± 1.11 2.29 ±0.88 sgp130 (ng/mL) 308 ± 71 314 ± 66 302 ± 62 316 ± 55 sIL-6R (ng/mL) 52.4 ± 17.6 51.1± 20.8 61.9 ± 30.5 66.4 ± 20.7 *p=0.04 t test vs HFrEF HA (-) Open in new tab HFrEF HA(+) HFrEF HA(-) Controls HA+ Controls HA- IL-6 (pg/mL) 3.42 ± 2.24 * 2.76 ± 2.34 2.25 ± 1.11 2.29 ±0.88 sgp130 (ng/mL) 308 ± 71 314 ± 66 302 ± 62 316 ± 55 sIL-6R (ng/mL) 52.4 ± 17.6 51.1± 20.8 61.9 ± 30.5 66.4 ± 20.7 HFrEF HA(+) HFrEF HA(-) Controls HA+ Controls HA- IL-6 (pg/mL) 3.42 ± 2.24 * 2.76 ± 2.34 2.25 ± 1.11 2.29 ±0.88 sgp130 (ng/mL) 308 ± 71 314 ± 66 302 ± 62 316 ± 55 sIL-6R (ng/mL) 52.4 ± 17.6 51.1± 20.8 61.9 ± 30.5 66.4 ± 20.7 *p=0.04 t test vs HFrEF HA (-) Open in new tab 238 Association between modified shuttle walk test and cardiorespiratory fitness in overweight/obese adults with primary hypertension: EXERDIET-HTA study B Jurio-Iriarte1, I Gorostegi-Anduaga1, GR Aispuru2, p Corres1, J Perez-Asenjo3, A Martinez-Aguirre1, PH Brubaker4, S Maldonado-Martin4 1University of the Basque Country (UPV/EHU), Physical Education and Sport, Vitoria-Gasteiz, Spain 2Primary Care, Hospital Santiago Ap򲳯l, Miranda de Ebro, Burgos, Spain 3Igualatorio M裩co Quir�o (IMQ-Am౩ca), Cardiology Unit., Vitoria-Gasteiz, Spain 4University of the Basque Country. Department of Physical Education and Sports., VITORIA-GASTEIZ, ARABA/ALAVA (BASQUE COUNTRY), Spain Funding Acknowledgements: The study was supported by the University of the Basque Country (GIU14/21 and EHU14/08) and by the Government of the Basque Country (SAIOTEK, SAI12/21 Topic: Hypertension Background: The aims of the study were: to validate the equation presented in previous study by Singh et al., to evaluate the relationship between Modified Shuttle Walk Test (MSWT) with peak oxygen uptake (V?2peak) in overweight/obese people with primary hypertension (HTN), and to develop a new equation for the MSWT to predict VO2peak. Methods: Participants (N=256, 53.9±8.1 yr old) with HTN and overweight/obesity performed a cardiorespiratory exercise test to peak exertion on an upright bicycle ergometer using an incremental ramp protocol and the 15-level MSWT. The formula of Singh et al. was used to predict V?2peak, and a new equation was generated from the measured V?2peak-MSWT relationship in this investigation. Results: The correlation between measured and predicted V?2peak for Singh et al. equation was moderate (r=0.60, p<0.001) with a standard error of estimate (SEE) of 4.92 mL·kg-1·min-1; SEE%=21%. The correlation between MSWT and measured V?2peak, as well as for the new equation was strong (r=0.72, p<0.001) with a SEE of 4.35 mL·kg-1·min-1; SEE%=19%. Conclusion: These results indicate that MSWT does not accurately predict functional capacity in overweight/obese people with HTN and questions the validity of using this test to evaluate exercise intolerance. Predicting V?2peak from Singh et al. equation using ISWT results in substantial variability. A more accurate determination from a new equation in the current study incorporating more variables from MSWT to estimate V?2peak has been performed, but still results in substantial error. 239 How to reliably diagnose arterial hypertension: predictive values based on 24h ambulatory blood pressure measurements V Raymaekers1, C Brenard1, L Hermans1, p Vanvoorden2, I Frederix3, p Dendale3 1Hasselt University, Diepenbeek, Belgium 2Virga Jesse Hospital, Hasselt, Belgium 3Heart Centre Hasselt, Hasselt, Belgium Topic: Hypertension Background: Hypertension is a common condition in modern society. The blood pressure is a value fluctuating at different moments in time though. This variability ensures that a single measurement of blood pressure is useless to diagnose hypertension. Besides, the blood pressure can be spuriously elevated when measured in a medical setting, a phenomenon called white coat hypertension. Nevertheless, an infrequent number of measurements is often used for diagnosing hypertension and adjusting or starting up a patient's treatment. As a single blood pressure measurement does not take into account the daily variability, the diagnosis and therapeutic control of hypertension are often suboptimal. Purpose: The aim of this study is to determine the number and timing of measurements that are needed in the home-setting to give a trustworthy approximation of the average blood pressure for an individual based on the analysis of 24h ambulatory blood pressure measurements. Methods: 408 clinically indicated 24h blood pressure measurements taken between 21/05/15 and 04/03/16 for several different indications were analysed in this study. Only measurements from 9:00 a.m. till 9:00 p.m. were used. The 306 patients with at least 70 per cent of correct measurements (75% of the sample) were used. Patient files were searched to complete the following variables: diagnosis based on the 24h measurements by the cardiologist, use of medication, age, gender, Body-Mass-Index and diabetes. Based on literature hypertension was defined as the daytime (9 a.m. – 9 p.m.) mean blood pressure exceeding 135/85mmHg. Results: Of the 306 patients included in this study, 162 (53%) had blood pressure values exceeding the previously mentioned criteria for hypertension. 132 (81%) had already been receiving treatment for high blood pressures. 162 patients (53%) of the study population were female. Statistics indicate that the decision about whether or not one is considered as being hypertensive – based on the 24h ambulatory blood pressure criteria – is significantly influenced by gender, age, BMI, and mean pulse pressure. Logistic regression shows that the positive predictive value to diagnose hypertension is highest for a mean blood pressure based on several measurements taken between 3 and 4 p.m. (88%). Sensitivity of the diagnostic test within this time interval is 78%, specificity 88% and negative predictive value 78%. Conclusion: The study shows that blood pressure measurements have the best predictive value when taken between 3 and 4 p.m. Therefore, several measurements should be taken at home during this interval to reliably diagnose hypertension. 240 Correlation between trombospondin-1, inflammatory markers and endothelial dysfunction in hypertensive patients treated with different therapeutically regimen M Andor1, V Buda1, C Cristescu1, MC Tomescu1 1University of Medicine & Pharmacy Victor Babes, Timisoara, Romania Topic: Hypertension Trombospondin-1 (TSP-1) is a matricellular protein involved in many inflammatory processes and neovascularization. The aim of our study is to analyze the concentration of TSP-1 in patients with arterial hypertension and endothelial dysfunction treated with different therapeutically regimen. Material and Method: In a prospective study we analyzed the 351 patients, 105 normotensive (group A), 117 hypertensive treated with ݭblockers, diuretics or calcium channel blockers (group B) and 129 hypertensive patients controlled with ACE-I (group C). We assessed endothelial dysfunction in all groups by measuring flow mediated vasodilatation (FMD) and intima media thickening (IMT) by echographic methods. We compared the classical inflammatory markers with new markers of endothelial dysfunction and correlate the degree of endothelial dysfunction with biological parameters. Results: In the group A we didn`t find any endothelial dysfunction. In group C the medium FMD was 14±0.03% compared with 10.63±0.30 in group B (p=0.00001). IMT was 0.92±0.18mm in group C compared with 0.95±0.18 in group B (p=0.00003). The value of inflammatory markers (hs-CRP) were normal in group A, highest value in group B: 0.40±0.56mg/dl and significantly statistically lower (p=0.0003) in group C: 0.26 mg/dl. The value of TSP-1 was normal in group A: 10882±7290ng/dl; in group B was significantly lower value 10221±6141ng/dl than in group C 14718±2578ng/dl. We also found a positive correlation only in group B between triglycerides, leucocytes and neutrophils. This correlation can be generated by an inflammation in the endothelium in the case of patients treated with diuretics, ݭblockers and calcium channel blockers. Conclusion: The value of TSP-1 is higher in group C, with hypertensive patients controlled with ACE-I than in group B, were the hypertensive patients were controlled with different therapeutically regimens, and even than in controlled group. We can conclude that ACE-I can control better the antiproliferative process and maintain the vascular tone comparing with other antihypertensive medication. 241 Association of nocturnal blood pressure dipping with cardiorespiratory fitness and body mass index in overweight/obese adults with primary hypertension: EXERDIET-HTA study S Maldonado-Martin1, I Gorostegi-Anduaga1, GR Aispuru2, p Corres1, B Jurio-Iriarte1, A Martinez De Aguirre1, SM Fryer3, I Mujika4, J Perez-Asenjo5 1University of the Basque Country (UPV/EHU), Department of Physical Education and Sport, VITORIA-GASTEIZ, Spain 2Primary Care, Hospital Santiago Ap򲳯l, Miranda de Ebro, Burgos, Spain 3UNIVERSITY OF GLOUCESTERSHIRE, SCHOOL OF SPORT AND EXERCISE. OXSTALLS CAMPUS, GLOUCESTER, United Kingdom 4UNIVERSITY OF THE BASQUE COUNTRY (UPV/EHU), Department of Physiology, BILBAO, Spain 5IMQ-AMARICA, Cardiology Unit, Vitoria-Gasteiz, Spain Funding Acknowledgements: University of the Basque Country (GIU14/21 and EHU14/08). The Government of the Basque Country (SAIOTEK, SAI12/217). Topic: Hypertension Introduction: Overweight or obesity and primary hypertension (HTN) often coexist in the same person being additive in terms of cardiovascular risk. Impaired nocturnal blood pressure dipping (NBPD) (i.e., <10% decline in NBP) and low cardiorespiratory fitness (CRF), evaluated by peak oxygen uptake (VO2peak), are significant cardiovascular risk predictors. Objectives: The purposes of this study were: 1) to examine the pattern of NBPD, and 2) to analyze the association between NBPD with CRF and body mass index (BMI) in overweight/obese adults with HTN. Methods: Overweight/obese non-Hispanic white participants with HTN (N=209; 54±8.1 yrs old) performed: an incremental ramp cardiorespiratory exercise test to peak exertion on an upright bicycle ergometer to evaluate VO2peak (22,0±1,0 ml·kg-1·min-1), BMI (31.3±4.6 kg·m2), and 24-hour ambulatory monitoring to evaluate systolic (SBP) and diastolic blood pressure (DBP). Mean dipping pattern was the percent of nocturnal reduction in BP in relation to diurnal mean SBP and DBP, and it was calculated as ([daytime SBP or DBP - nighttime SBP or DBP]/daytime SBP or DBPx100). Based on the % decline in NBP participants were grouped as extreme dippers (ED, >20%), dippers (D, 10-20%), non-dippers (ND, 0-10%) and risers (R, <0%). Pearson correlation coefficient was used to measure the relationship between different variables. Statistical significance was set at P<0.05. Results: Participants treated with antihypertensive medication were 85.7%. Participants' NBPD were as follows: 9.6% ED, 51.7% D, 33% ND, and 5.7% R. Mean dipping pattern of all participants was 11.3±7.0% and 15.7±8.1%, for SBP and DBP, respectively. Nocturnal decreases in SBP correlated negatively with BMI (r=-0.244, P<0.001) and a positive trend was observed with VO2peak (r=0.132, P=0.057). Nocturnal decreases in DBP correlated negatively with BMI (r=-0.213, P=0.002) and positively with VO2peak (r=0.199, P=0.004). Conclusions: Only half of the overweight/obese individuals with HTN presented a healthy NBPD status (i.e., dipper), despite most of them being pharmacologically treated. Individuals with higher BMI and poor CRF may have more cardiovascular risk related to a lower nocturnal fall in BP. A better control of NBPD is needed for this population, including non-pharmacological therapeutic strategies. Trial Registration: NCT02283047 242 The state of sexual function and dynamic of sexual hormones in men with essential hypertension in short-term monotherapy by bisoprolol and carvedilol G Nur-Mammadova1, N Ismaylova1 1Azerbaijan State Doctor's Advanced Training Institute, Baku, Azerbaijan Topic: Hypertension Objective: The aim of present investigation was to evaluate the influence of bisoprolol (B) and carvedilol (C) on the state of sexual function and dynamics of sexual hormones in monotherapy in men with essential hypertension (ESH). The purpose of our study was to determine possible beginnings and development of sexual dysfunction during treatment by beta-blockers. Method: 50 men with ESH on degree I and II (by WHO classification) were examined. After four weeks of placebo (Pl) period patients were randomized into two identical groups with 25 men in each, where the monotherapy of B (6,1±0,39 mg daily; aged 48,2±0,89 years; weight 88,1±0,76 kg) and C (22,5 ±1,02 mg daily; aged 47,1±1,1 years; weight 87,2±0,29 kg) was held. In the end of Pl and 2 months of the researched drugs all patients were checked by radioimmunoassay the content of testosterone(T), prolactin (PRL), estradiol (E2), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) and sexual status was studied by Vasilchenko questionnaire. Results: The treatment of B and C resulted significantly in decreasing of blood pressure and heart rate. The monotherapy with B is accompanied by the increasing of levels of T and PRL (13,6±2,56 to 24,4±5,98; 16,1±2,68 to 32,5±3,07; p<0,001) and decreasing of concentration of E2, FSH in serum (38,3±1,33 to 32,3±1,84; 40,3±3,9 to 32,7±2,29; p<0,001). The therapy by C caused in decreasing of T, PRL, LH(acc. 17,58±3,8 to 14,97±3,5; 7,85±2,4 to 4,72±1,38; 9,3±2,1 to 6,47±1,85), but levels of E2 and FSH were increased (acc. 28,66±5,72 to 31,88±5,09; 8,58±1,84 to 10,96±1,84) (p<0,001).There was established the negative correlation relationship between the initial levels of hormones and theirs changes in therapy: C - T-r=-0,74;PRL-r=-079;p<0,001; E2-r=-0,51; LH-r=-0,64; p<0,05; B – FSH-r=-0,49; p<0,05; LH-r=-0,77; p<0,01. Patients didn't notice any considerable changes in neurohumoral, ejaculation and other characteristics of the sexual function during two months of monotherapy with research drugs. Conclusion: So, the carried out researches showed that, in spite of the different influence on the hormones B and C don't worsen the sexual function during 2 months monotherapy. 243 Hypertension and its relation with waist-to-height ratio in children SK Romero Rondon1, CL Dominguez Urrego1, EM Gamboa Delgado2, DC Quintero Lesmes3 1Cardiecol, Proyecto SIMBA II, Floridablanca, Colombia 2Industrial University of Santander, nutrition department, Bucaramanga, Colombia 3Foundation Cardiovascular of Colombia, research department, Floridablanca, Colombia Funding Acknowledgements: Departamento Administrativo de Ciencia, Tecnología e Innovación (Colciencias)) Topic: Hypertension Introduction: waist-height ratio WHtR, is an indicator of cardio metabolic risk detection with clinical advantages because of its practicality and independence in front of changes in children's development and growth, its utility has been proved in primary prevention of sickness like hypertension HTN, which is recognized as the more prevalent sickness that increase cardiovascule Purpose: To evaluate association between WHtR and HTN inside a children's cohort. Methods: Study of transversal cohort in children between 6 and 10 years during period between April 2006 and April 2007, n=1,282. Dependent variable: HTN (systolic arterial pressure (SAP) or diastolic (DAP) = percentile 95 by age, gender and height was sized in three occasions. Pre-HTN: SAP o DAP = percentile 90 < p95 by age and gender. Independent variable: WHtR was calculated from height/waist circumference; WHtR risk was defined like a value > 0.5. Association between independent and dependent variables was evaluated through regression logistic models. A duplicate digitation of data was made in Microsoft excel program and then compared using Epi- info 2000 program. Results: 0.70% presented HTN (CI 95% 0.32% a 1.30%) and 6.13% (CI 95% 4.87% a 7.58%) pre-HTN. Comparison according sex: boys had higher level of SAP (p=0.00001). 9.77% presented WHtR risk (CI 95%: 8.19% to 11.52%). After adjusting by age, sex, socioeconomic level, physical activity; WHtR risk was significantly associated with HTN and pre HTN (OR=8.36 CI 95%: 1.99 to 35.15, p=0.004 and OR=2.98 CI 95%: 1.66 to 5.36, p=0.000, respectively). See table 1 Conclusion: children with WHtR risk have higher probability to develop elevated levels of arterial pressure. WHtR can be useful in clinical practice for risk detection of HTN in children and adolescents. To future protocols should be contemplated the introduction of serial ambulatory monitoring of HTN to help diagnostic differential of white coat syndrome and masked hypertension. characteristics Model 1 Model 1 Model 1 Model 2 Model 2 Model 2 OR CI 95% p OR CI 95% p HTN 11,97 3,17 - 45,21 * 8,36 1,99 - 35,15 0,004 Pre-HTN 2,94 1,66 - 5,23 * 2,98 1,66 - 5,36 * characteristics Model 1 Model 1 Model 1 Model 2 Model 2 Model 2 OR CI 95% p OR CI 95% p HTN 11,97 3,17 - 45,21 * 8,36 1,99 - 35,15 0,004 Pre-HTN 2,94 1,66 - 5,23 * 2,98 1,66 - 5,36 * Model 1: crude Model; Model 2: adjusted model by age, sex, socioeconomic level, physical activity, maternal antecedents; OR: Odds Ratio; CI 95%: Confidence Interval 95%. Value p= * < 0.00001 Open in new tab characteristics Model 1 Model 1 Model 1 Model 2 Model 2 Model 2 OR CI 95% p OR CI 95% p HTN 11,97 3,17 - 45,21 * 8,36 1,99 - 35,15 0,004 Pre-HTN 2,94 1,66 - 5,23 * 2,98 1,66 - 5,36 * characteristics Model 1 Model 1 Model 1 Model 2 Model 2 Model 2 OR CI 95% p OR CI 95% p HTN 11,97 3,17 - 45,21 * 8,36 1,99 - 35,15 0,004 Pre-HTN 2,94 1,66 - 5,23 * 2,98 1,66 - 5,36 * Model 1: crude Model; Model 2: adjusted model by age, sex, socioeconomic level, physical activity, maternal antecedents; OR: Odds Ratio; CI 95%: Confidence Interval 95%. Value p= * < 0.00001 Open in new tab 244 What is the importance of preoperative electrocardiogram in hypertensive patients for moderate/high risk noncardiac surgery?: a single-center randomized study L W Ramos1, B Cristina1, MV Ferreira2, CS Freitas1, E Elly1, MA Calil1, JCS Goes1 1Brazilian Institute for Cancer Control, Sao Paulo, Brazil 2FAMEMA Medical School, Mar쫩a, Brazil Topic: Hypertension Backgound: Some guidelines recommend that a preoperative electrocardiogram (EKG) should be obtained before a noncardiac surgery in hypertensive patients. However, the available data on its utility are based on less than robust levels of evidence. This is the first randomized study about this issue. Purpose: The aim of this study was to determine the role of EKG in hypertensive patients before moderate/high risk noncardiac surgery. Methods: A total of 997 asymptomatic hypertensive patients with normal physical examination findings and without other known comorbidities were randomized into 2 groups at the time of preoperative clinical evaluation. Of these, 9 did not undergo surgery, and were excluded from the study. All patients required surgical procedures under general anesthesia to treat neoplastic disease. Group A, who underwent EKG, had 495 patients (mean age, 47.0 ± 12.6 years), and group B, who did not undergo EKG, had 493 patients (mean age, 46.3 ± 10.5 years). Patient sex, age, level and duration of hypertension, antihypertensive drugs, surgical risk, previous chemotherapy or radiotherapy, chest X-ray results, blood tests results, duration of surgery, and in-hospital outcomes were analyzed. Adverse outcome was considered any major adverse cardiac event (MACE) or death from all causes. Results: Among the 495 EKG analyzed, 426 (86%) were normal. Patients from group A had more abnormal blood tests (12.2% vs 1.8%; p<0.001) and underwent longer surgical procedure (3.8±1.6 hours vs 3.0±1.6hours; p<0.001). A total of 21 patients from group A (4.3%) which underwent EKG, had some adverse outcome including 5 deaths, compared with 8 (1.6%) patients from group B including 3 deaths (p=0.014). After multivariate logistic regression analysis, perform EKG was not statistically significant (OR=1.60 CI 95% 0.68-3.8; p=0.282). Blood tests abnormalities (OR 3.55 CI95% 1.33-9.51; p=0.012) and a longer duration of surgery (OR 1.44 CI95% 1.18-1.76; p<0.001) had an influence on in-hospital outcomes. Conclusion: Obtaining a preoperative EKG in asymptomatic hypertensive patients with normal physical examination findings without other comorbidities does not have a significant impact on postoperative outcomes, suggesting that this test may not be useful for this patient cohort. 245 Assessment of cardiovascular risk and vascular age in overweight/obese adults with primary hypertension: EXERDIET-HTA study I Gorostegi-Anduaga1, GR Aispuru2, p Corres1, J Perez-Asenjo3, A Martinez-Aguirre1, B Jurio-Iriarte1, S Maldonado-Martin1 1University of the Basque Country (UPV/EHU), Physical Education and Sport, Vitoria-Gasteiz, Spain 2Primary Care, Hospital Santiago Ap򲳯l, Miranda de Ebro, Burgos, Spain 3Igualatorio M裩co Quir�o (IMQ-Am౩ca), Cardiology Unit., Vitoria-Gasteiz, Spain Funding Acknowledgements: University of the Basque Country (GIU14/21 and EHU14/08) and by the Government of the Basque Country (SAIOTEK, SAI12/217) Topic: Hypertension Hypertension (HTN) is often associated with the early development of cardiovascular (CV) disease. Population with HTN and obesity has an increased risk of CV event when additional modifiable and non-modifiable cardiovascular risk (CVR) factors are considered. The aims of this study were to: 1) estimate CVR and VA profiles of overweight/obese patients with HTN, (2) analyze potential sex differences in CVR and VA, (3) determine whether VA is higher than chronological age (CA) and, (4) determine whether CVR is associated with a low level of cardio-respiratory fitness (CRF). Overweight/obese non-Hispanic white participants (n=209; 141 male and 68 female) with primary HTN had their CVR and VA determined using anthropometric, blood pressure, peak aerobic capacity, fasting blood samples (glucose and lipid profile) and smoking status variables. New Pooled Cohort Risk Equations and The Framingham method used to estimate CVR and VA, respectively. The CVR was higher (p<0.001) in males compared to females, with lower (p=0.002) concentrations of high density lipoprotein cholesterol in males. Irrespective of sex VA was higher than CA (p<0.001). Cardio-respiratory fitness alone did not appear to significantly moderate CVD. Pooled Cohort Equations could underestimate the risk of suffering a CV event in the following 10 years in overweight/obese non-Hispanic white women with HTN compared to men due to the onset of the menopause. The VA seems a useful tool in communicating about CVR in this population irrespective of sex. The CRF could moderate the CVR in conjunction with other CVR factors such as body mass index and age. 246 Carotid endarterectomia as the method of arterial hypertension treatment O A Germanova1 1Samara State Medical University, Samara, Russian Federation Topic: Hypertension The operation of carotid endarterectomia (CE) is used to prevent an ischemic stroke. However in the list of its indications there's no mention about arterial hypertension (AH) with the hemodynamically important stenosis of carotid bifurcation. Aim of investigation is to study the impact of CE operation on course of arterial hypertension with the hemodynamically important stenosis of carotid bifurcation. Materials and methods. The investigation is based on the results of complex inspection and treatment of 320 patients with AH and hemodynamically important stenosis of carotid bifurcation. Including 243 (75,9%) men and 77 (24,1%) women. Middle age - 59,6±8,2. All the patients were performed the operation of CE, the 24-hours monitoring of blood pressure, ultrasonic investigation of carotid bifurcation before and after the operation of CE and other additional investigations to eliminate the reasons of the secondary arterial hypertension. Results and conclusion: AH with the hemodynamically important stenosis of carotid bifurcation is characterized by the features: high degrees of AH (in 202 cases 3 degree of AH is revealed); high level of the middle systolic and diastolic blood pressure per day, night, 24-hours; heightened variability of the middle systolic blood pressure per day, night, 24-hours; heightened variability of the middle diastolic blood pressure per night; great number of night-pickers (32,5%). After the CE operation it was revealed the tendency of positive transformation of degrees of AH or even normalization of blood pressure in mainly cases, duration of more than 1 year of investigation. After the CE in 257 (80,3%) patients it was revealed the depression of blood pressure, in 58 (18,1%) cases blood pressure was at the same level, and 5 (1,6%) it was noticed the tendency of its rising. We suppose it's necessary to separate the cerebrovascular arterial hypertension as the independent form of the secondary arterial hypertension. The main reason for it is the fact that development of AH in the patients of hemodynamically important stenosis of carotid bifurcation and its regression after the operation of CE. The operation of carotid endarterectomia brings a new quality – as an efficacy treatment of the secondary cerebrovascular arterial hypertension. Open in new tabDownload slide Abstract number:246 Results 247 Ethnic differences in hypertension prevalence in the three countries: Russia, Kyrgyzstan, Kazakhstan AO Myrzamatova1, AV Kontsevaya1, AG Polupanov2, AN Halmatov2, YK Iskakov3, AK Kashirin4, KA Alikhanova3, AT Altymysheva2, YA Balanova1 1National Research Center for Preventive Medicine, Moscow, Russian Federation 2National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan 3Karaganda state medical university, department of general practice and nursing, Karaganda, Kazakhstan 4Samara Regional Clinical Hospital for War Veterans, Samara, Russian Federation Topic: Hypertension Introduction: CIS (The Commonwealth of Independent States) countries often have multiethnic population and common problems in terms high cardiovascular mortality and morbidity and low disease and risk factors control. Many of countries include large Russian populations from the soviet time which leave in the environment of other cultures for several generations. High hypertension prevalence and low control is the common problem for most CIS countries. Purpose: to study the ethnic differences in hypertension prevalence among residents of the three countries. Methods: This study is cross-sectional epidemiology survey of chronic non-communicable diseases and its risk factors in rural areas of three countries performed in 2012-2014. Data on representative samples of the rural population of the Samara region of the Russian Federation (n = 1050), Chui region of the Kyrgyz Republic (n = 1341) and Karaganda region of Kazakhstan (n = 1807) were analyzed in terms of smoking prevalence. All results were age-standardized. Hypertension was defined as an average systolic blood pressure (SBP) =140 mmHg or diastolic blood pressure (DBP) =90 mmHg, based on the average of up to three blood pressure measurements, or self-report of currently using blood pressure-lowering medication. The share of Russian population in Kyrgyz and Kazakh samples were 36,8% and 32,9% respectively. Results: Age-standardized hypertension prevalence in Russia (Samara region) was 40,1%, in Kyrgyzstan – 37,1%, in Kazakhstan - 31,8%. In all three countries, it was significantly higher among women than men (p <0,01). In Russian region, average SBP was 127,1 ± 12,8 mmHg, DBP was 79,6 ± 13,7 mmHg, without gender differences. In Kyrgyzstan, among russian population the average SBP was 129,2 ± 26,2 mmHg, average DBP was 81 ± 12,1 mmHg, and among Kyrgyz population SBP was 124,1 ± 21,7 mmHg, DBP was 78,8 ± 12,4 mmHg. There were significant differences in SBP between the Russian and Kyrgyz women (129,3 and 123,3 mmHg, p <0,05), in males there were no differences. In Kazakhstan, among russian residents average SBP was 126,1 ± 22,2 mmHg, DBP was 79 ± 9,2 mmHg, among Kazakh residents SBP was 122,6 ± 20,8 mmHg (p <0,05), DBP was 78,9 ± 11,1 mmHg (p >0,05). There were no gender differences inside ethnic groups. However, significant differences in SBP were observed among Russian and Kazakh men (127,7 versus 122,2 mmHg, p <0,05). Conclusions: So, highest hypertension prevalence among the three countries was in the Russia population, and in Russian population in Kyrgyzstan a separate ethnic group. In Kyrgyzstan and Kazakhstan among men average SBP was significantly higher in the Russian population in comparison with the native inhabitants. In Kazakhstan there were substantial ethnic differences in hypertension prevalence between Russian and native population. 248 Long-term adherence to viniyoga in high-risk cardiac rehabilitation patients with systolic blood pressure between 140-160 mmHg W J Mayer-Berger1, S Schroeer2, C Pieper2 1Klinik Roderbirken, 42799 Leichlingen, Germany 2University Hospital of Essen, Essen, Germany Funding Acknowledgements: Refonet Topic: Hypertension Background: Viniyoga was found to have a profound blood pressure (BP) lowering effect in cardiac rehabilitation patients diagnosed with arterial hypertension (Viniyoga: syst. -21,2 mmHg, standard relaxation: syst. -12,6 mmHg; p=0.008). The aim of the present study was to maintain the achieved BP in the long-term by an intensified post-rehabilitation support. Methods: In this single-center study, cardiac rehabilitation patients were consecutively enrolled between April 2014 and June 2015 and randomly assigned to a long-term programme (intervention group IG) or control group (CG). Both groups received a standardised Viniyoga training during three weeks of inpatient rehabilitation. After discharge, the IG received an intensified post-rehabilitation support (12-month telephone reminders, follow-up meeting with Viniyoga refreshing) whereas the CG received usual care. Data was collected at admission (t1), at discharge (t2), six months (t3) and 12 months (t4) after inpatient cardiac rehabilitation. The primary endpoint was Viniyoga adherence at t3/t4 assessed in an intention-to-treat analysis. Results: Participants (n=228) were male cardiac rehabilitation patients (mean age 53.6 ± 5.6 years, mean BMI 30.5 ± 5.4 kg/m2) with increased BP (baseline BP 141.8 ±10.2/87.8 ± 8.0mmH) under antihypertensive treatment (mean 3.2 ± 2.2 DDD). At baseline both groups had similar demographics in terms of age, BMI, concomitant diseases, BP, social and clinical variables, medication and self-rated quality of life. During the follow-up period the intervention resulted in a substantial increase of long-term Viniyoga adherence (t4 available cases (n=152) KG: 36.0% vs. IG: 56.0%; worst case analysis (n=228) KG: 23.9% vs. IG: 36.5%). Referring to participants who were still practicing Viniyoga at 6 months follow-up (n=68) the intervention was further associated with a significant increase of weekly training frequency (KG: 4.5% vs. IG: 37.0% performed three training units per week, p=0.021) and duration of single training units (KG: 5-10min vs. IG: 11-20min, p=0.014). Following the 3-week Viniyoga training, a significant BP reduction was observed in the entire sample (syst.: -10.2 ± 12.0mmHg; dia.: -5.2 ± 7.4mmHg, p<0.0001) which could be maintained at 6 months follow-up in both groups, with slightly lower systolic BP (-2.2 mmHg, n.s.) in the IG. At 12 months follow-up BP was maintained at this level in both groups as well. Participants adhering to the Viniyoga practice at 12 months reported a better self-rated quality of life (PCS: +1.6, n.s.; MCS: +6.6., p=0.007) and showed lower systolic (-6.3 mmHg, n.s.) and diastolic BP (-2.2 mmHg, n.s.) when compared to participants who did not. Discussion: The findings of our study indicate that intensified post-rehabilitation support is an effective option to improve adherence to Viniyoga practice and to maintain achieved health benefits in the long term. 249 Hypertension control and patients adherence to treatment in the primary care settings. J Gajdosik1, p Sabaka1, M Vrbnjak1, F Simko2, AA Dukat1 1Comenius University, 2nd.Dept.of Internal Medicine, Bratislava, Slovak Republic 2Comenius University, 3rd.Dept.of Internal Medicine, Bratislava, Slovak Republic Topic: Hypertension Introduction: As the country shows unsatisfactory high cardiovascular morbidity and mortality, registry with the aim of management and improvement is of importance. Background: The creation of the patient's registry may give important data concerning the management of patients with hypertension in the common clinical practice. Methods: From the primary care physicians 19 644 patients 46.06% men and 53.94% women) with hypertension of mean age 67.17 +- 12.68 SD were followed-up for a period of 1-year. 13.79% were already after severe event (7.63% after MI, 6.16% after stroke). Medical reports and patients diaries were evaluated at entry and after 1-year. Results: Antihypertensive therapy was started in 70.54% by primary care physician and in 29.46% by specialists. Treatment control was done in 2.62% by specialists only, majority by primary care physicians: 70.54%. Control intervals were in 39.54% quarterly, 42.52 half yearly, 7.51% monthly 7.64% in yearly intervals. Informations about the treatment to the patients was given in 86.69% by physicians, 11.64% by specialists, 1.18% by nurses. 35.25% followed patients were on monotherapy, 41.36% on double combinations, 45.85% on triple and 7.62% on more combinations. Therapeutical spectrum included in 58.63% ACE-inhibitors, 20.43% ARBs, 11.2% betablockers, 8.14% calcium channel blockers, but only 0.63% diuretics. Suspicion for change in treatment (from the side of the patients) was present in 7.44% of the followed patients, despite 81.27% of the patients reported no adverse reactions with given therapy. Conclusions: In the large community settings patients with hypertension were controlled after the guidelines in small percentage, which was only one fifth (26.95%) in the common medical practice. 251 Detection of occult right ventricular dysfunction in young egyptians withType 1 diabetes mellitus by 2D speckle tracking echocardiography T Ahmed1, Y Ahmed2, A Arafa3, R Saleh4 1Al-Azhar University, cardiology, Cairo, Egypt 2Al- Azhar University, pediatric, cairo, Egypt 3Al-Azhar University, Endocrinology, Cairo, Egypt 4Al-Azhar University, Clinical pathology, Cairo, Egypt Topic: Imaging Background: Type 1 diabetes mellitus (T1DM) is one of the most common chronic disorders of childhood and adolescence. T1DM induced cardiomyopathy has a different entity than type II DM as it relies on different pathophysiological mechanisms, and rarely coexists with hypertension and obesity. Evaluation of right ventricular (RV) function in diabetic patients has been neglected despite the important contribution of RV to the overall cardiac function affecting both the course and prognosis in patients with diabetic cardiomyopathy. Objective: The aim of this work was to assess RV myocardial performance in course of asymptomatic T1DM. Using speckle tracking and standard echo parameters, and correlate the RV function with functional capacity using treadmill stress test in Egyptian young Adolescents. Patients and Methods: This work was conducted on 39 patients with TIDM (Group 1, mean age 18.2 ± 1.7y, BMI = 26.2 ± 3.9), with no evidence of any cardiac problem and 15 healthy apparently subject matched for age and BMI as a control group (Group 2, mean age 18.8 ± 2.3 y, BMI = 22.8 ± 3.3). RV function was evaluated in all subjects with comprehensive 2D and Doppler echocardiographic techniques using conventional, tissue Doppler and 2D speckle tracking echocardiography (STE) techniques. The peak RV global longitudinal strain (RV- GLS) was obtained. Functional capacity was assessed in all subjects by treadmill exercise test. Exercise capacity was estimated in metabolic equivalent (METS). Results: The study showed statistically highly significant decrease in the average peak right ventricular global longitudinal strain (RV- GLS) in Group 1 when compared to Group 2 ( -14.0± 6.9 vs. -22.7± 2.5 respectively), P< 0.001 and significant decrease in RV TDI S velocity in group 1 (9.5± 2.2 vs. 11.5± 1.8 respectively), P < 0.05, and reduced E/A ratio (1.0 ± 0.2 in group 1 vs. 1.1 ± 0.1 in group 2), P=0.023, also E/Em ratio showed a highly significant increase in group 1 (7.9 ± 3.2 vs. group 2 = 5.2±0.7 respectively) P< 0.001. On the other hand there was no significant difference between the two groups regarding the other conventional echo- Doppler and TDI parameters, Also there was no significant difference between the two groups as regard the functional capacity parameter by treadmill METS {group 1= 12.2± 2.3 VS. group 2 = 11.9± 1.4}. Conclusion: In asymptomatic patients with T1DM, in addition to RV diastolic dysfunction, early (subclinical) RV systolic dysfunction is preferentially observed with normal RV and LV ejection fraction (EF). 2D STE has the ability for early detection of subclinical RV systolic dysfunction. 252 Red blood cell distribution width & myocardial scar burden in coronary artery disease C J Magri1, TX Tian1, L Camilleri2, RG Xuereb1, J Galea1, S Fava1 1Mater Dei Hospital, Msida, Malta 2Directorate Health Information & Research, G'Mangia, Malta Topic: Imaging Introduction: Red blood cell distribution width (RDW) is a novel independent marker of cardiovascular disease, including heart failure, coronary artery disease and myocardial ischaemia. Purpose; The aim of the study was to investigate a possible relationship between RDW and myocardial scar burden, as assessed by a MIBI viability scan. A secondary objective was to assess for an association between RDW and left ventricular ejection fraction (LVEF). Methods: The study comprised 123 subjects known to suffer from ischaemic heart disease who underwent a myocardial viability scan between June 2008 and July 2014. Haemoglobin, mean corpuscular volume, RDW, platelet count, mean platelet volume (MPV), estimated glomerular filtration rate, fasting blood glucose, liver and lipid profiles were evaluated for all patients. The extent of myocardial scarring and LVEF were noted. Data were analysed using IBM SPSS Statistics 22.0. Univariate followed by multivariate analyses were performed to assess for independent predictors of myocardial scarring & LVEF respectively. Results: The mean age of the study population was 63.5 years; the majority of the subjects were males. The median LVEF was 31% & median percentage of myocardial scarring was 8.7%. Multivariate analyses revealed that RDW, HDL-cholesterol and alanine transaminase were independent predictors of myocardial scarring while RDW, MPV, total cholesterol and gamma-glutamyl transpeptidase were independent predictors of LVEF. Conclusions: Increased RDW is an independent predictor both of myocardial scar burden and impaired left ventricular function in subjects suffering from coronary artery disease. 253 Prevalence of coronary artery and thoracic aorta calcification detected incidentally on computed tomography chest imaging in a tertiary referral center in the middle east A Marzaro1, O Hamoui2, J Daher3, G Mouharram3, K Yammine3, E Chammas2, W Jaroudi2 1Lebanese University, Division of cardiovascular medicine, Beirut, Lebanon 2Clemenceau Medical Center, Division of cardiovascular medicine, Beirut, Lebanon 3Clemenceau Medical Center, Department of Radilogy, Beirut, Lebanon Topic: Imaging Background: Coronary artery calcifications (CAC) are indicative of atherosclerosis and are associated with worse prognosis. Although they can be easily detected on chest computed tomography (CT), they are sometime missed or not reported. Purpose: Among patients presenting to a tertiary care center in the Middle East, we sought to assess the prevalence and adequate reporting of coronary atherosclerosis detected on routine chest CT that are performed for non-cardiac indications. Methods: From the radiology database, we retrieved consecutive non-gated CT chest imaging without intravenous contrast that were performed between January 2015 and April 2015 for various reasons. Patients with known coronary artery disease or prior revascularization were excluded from the analysis, leaving a total of 235 studies. The images were retrieved from the archives and evaluated by a blinded board certified cardiologist with level III training in cardiac CT. The presence of any CAC or thoracic aorta calcification (TAC) was noted and reported as dichotomous variable (yes/no). Quantification was not performed. Results: There were 121 patients (51.5%) with CAC (older and more male than those without CAC) that was correctly reported in 80/121 patients (67%) There were no false reports of CAC (specificity and positive predictive value were 100%). However, the negative predictive value was only 74%. The prevalence of CAC increased with age but was underreported across all age groups irrespective of gender, although there was a trend of more under-reporting in female as compared to male (44.% vs. 28.2%, p=0.083). Furthermore, patients with CAC had twice the prevalence of thoracic aortic aneurysm and more than four-fold higher prevalence of TAC than those without CAC. In addition, the reporting of TAC was low at 27% (29/108) but with no false positive reading. On multivariate regression analysis, age, male gender, and presence of TAC were independent predictors of coronary artery calcification. However, no single variable could predict the under-reporting of CAC. Conclusion: Incidental CAC and TAC were quite prevalent in our study but were under-reported. There was no false reporting however. Future efforts should be put to report CAC and TAC, which have prognostic implication, in order to allow better stratification of individuals and provide adequate management. 254 Body composition and quality of life in patients with peripheral arterial disease G Seinost1, R Sherzay1, A Horina1, B Arefnia2, S Gutmann1, H Mangge3, G Silbernagel1, M Brodmann1, G Wimmer2 1Medical University Graz, Department of Internal Medicine, Division of Angiology, Graz, Austria 2Medical University of Graz, Division of Preventive and Operative Dentistry, Endodontics, Pedodontics and Minimally Invas. Dent., Graz, Austria 3Medical University of Graz, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Graz, Austria Funding Acknowledgements: Austrian Science Fond (FWF) Topic: Imaging Background/Introduction: In patients with peripheral arterial disease (PAD) quality of life (QoL) is as low as or lower than in patients with coronary artery disease or chronic heart failure. Factors that affect QoL in PAD include age, sex, functional status, treatment and disease-related and treatment-related complications. The influence of body composition measurements on QoL in PAD patients has not been studied in a larger cohort. Purpose: The purpose of the study was to correlate body composition measurements, especially fat and lean body mass, with QoL outcome measurements in PAD patients. We hypothesized that body composition affects patient-reported QoL. Methods: The study cohort included 381 patients with symptomatic and asymptomatic PAD (female: n=107). Symptomatic patients suffered from intermittent claudication. Currently asymptomatic patients had had undergone endovascular or surgical repair. Patients with resting pain or necrotic tissue damage were excluded (Fontaine Classification III/IV). The assessment of health related QoL was conducted using Short Form 36 Survey (SF-36), one of the most commonly used QoL measures in PAD research. The body composition measurements were performed using dual energy X-ray absorptiometry (DEXA) body density scans. Spearman's correlation coefficients were generated to analyse monotonic relationships. To account for multiple testing, we used the Bonferroni correction. Results: We found a positive correlation between lean body mass and physical functioning, physical role functioning, vitality, emotional role functioning, and mental health. After Bonferroni correction only physical functioning remained significantly correlated (p<0.001, rs=0.214). In male patients there was a correlation between lean body mass and physical functioning, physical role functioning, and emotional functioning that could not be found in women. Total fat mass, BMI, waist circumference, and waist-to-hip ratio did not have any influence on health related QoL in men and women. Physical functioning scale was significantly increased (p<0.001 after Bonferroni correction) in patients with high lean body mass and low total body fat compared to patients with high lean muscle mass and high total body fat. The lowest physical functioning score was seen in patients with low lean body mass independent of measured % total body fat. Conclusions: The results of our study show that lean body mass is the key parameter in health related QoL in patients with PAD. Total fat mass, BMI, waist circumference, and waist-to-hip ratio did not influence physical or mental items. Including strength training components into centre- and home-based PAD rehabilitation programs seem reasonable. 255 Is regional wall motion abnormality on screening echocardiography prior to trastuzumab therapy a factor influencing left ventricular function? KR Bhamidipati1, V Subramaniam1, B Skaria1, K Mahmood1, K Linn1 1Heart of England NHS Trust, Cardiology, Solihull, United Kingdom Topic: Imaging Introduction: Trastuzumab, used as an adjunct to chemotherapy in receptor positive breast cancer patients, results in cardiomyopathy with left ventricular systolic dysfunction(LVSD) in 27%, (NYHA class ¾ -16%) consequently, guidelines recommend surveillance echocardiograms. Purpose: The aim of this study was to compare mortality, morbidity, predisposing factors and regional wall motion abnormalities (RWMA) on echocardiogram influencing reversibility in patients receiving Trastuzumab therapy. Methods: This is a retrospective cohort study obtained from the echocardiography and patient electronic case records (January 2010-January 2014). We analysed 65 patients who had received adjunctive Trastuzumab therapy, following standard treatment (5- Fluorouracil, Epirubicin, Cyclophosphamide and Docataxel). All patients had screening and 3 monthly surveillance echocardiograms assessing LVSF(Ejection fraction calculated by Simpson's Biplane method) and RWMA. Trastuzumab therapy was stopped and medications (ACE inhibitors and Beta blockers) commenced, till LVSF was regained in patients with LVSD. Results: 65 Female patients underwent screening echocardiogram. 9 patients had RWMA on screening. 50 patients had stable left ventricular systolic function (Group 1) and 15 patients developed LVSD during treatment, necessitating discontinuation of Trastuzumab therapy (Group2).Patients in group 1 were 2 years older (59.9 group 1 vs 57.8 years group 2). In Group 1, 3 of 50 patients had RWMA as compared to 6 of 15 in Group 2 (P=0.003). In group 2 with RWMA, 4 had complete reversibility of left ventricular systolic function (LVSF) and 2 had mild reversibility (< 10%). Further, in Group 2, 9 patients with no RWMA, 7 had complete reversibility and 2 had mild reversibility. None of the patients in both groups had documented ventricular arrhythmias. I patient in group 1 died of Metastases to Liver, there were no deaths in Group 2.Use of ACEI, Beta blockers and diuretics was comparable in both groups. Conclusion: Patients with screening echocardiographic evidence of RWMA appear to have higher incidence of worsening LVSD following adjuvant chemotherapy with Trastuzumab, as compared to patients with no RWMA. However, this does not appear to be a predictor of complete reversibility of LVSF. Closer follow-up of these patients may be necessary. Further large scale clinical studies would be needed to assess this correlation between RWMA and LV systolic dysfunction Group Hypertension Diabetes Renal failure Group 1 11 3 1 Group 2 1 2 0 Group Hypertension Diabetes Renal failure Group 1 11 3 1 Group 2 1 2 0 Open in new tab Group Hypertension Diabetes Renal failure Group 1 11 3 1 Group 2 1 2 0 Group Hypertension Diabetes Renal failure Group 1 11 3 1 Group 2 1 2 0 Open in new tab 256 The crucial role of cardiac magnetic resonance in focal myocarditis V Lisignoli1, A Santilli1, G Grutter1, A Secinaro1, B Leonardi1, R Adorisio1, p Ciliberti1, F Drago1 1Bambino Gesu Childrens Hospital, Department of Pediatric Cardiology and Cardiac Surgery, Rome, Italy Topic: Imaging Background: Myocarditis is an acquired myocardial inflammation, proceeding from a focal to a global involvement. Diagnosis can be difficult and sometimes missed in mildly symptomatic patients. We present a study of 19 patients with similar clinical presentation who underwent cardiac magnetic resonance (CMR) for the detection of myocardial tissue alterations. Purpose: The diagnosis of acute myocarditis is often clinic, based on clinical presentation, ECG changes, elevated cardiac enzymes and lack of epicardial coronary artery disease. Endomyocardial biopsy (EMB), although very specific, has limited sensitivity mainly in focal myocardial involvement. CMR is the gold standard for the diagnosis of focal myocarditis in hemodynamically stable patients. Methods: Between August 2011 and April 2016, 19 patients, aged between 6 and 17 years old (mean age 13), were admitted to our ward for atypical chest pain. Most of them were referred after evidence of elevated Troponin I levels or admitted with ECG changes with a recent history of infections. This study population included only patients in stable clinical conditions with a normal or mildly decreased left ventricular function and with no evidence of pericardial effusion. No patients received anti-congestive therapy. All patients under clinical suspicion of myo-pericarditis underwent CMR using Siemens, MAGNETOM Aera 1,5 Tesla. CMR protocol for myocarditis was the following: T1-weighted spin echo before and after gadolinium enhancement, T2-weighted spin echo and late gadolinium enhancement (LGE) technique. Results: Nineteen patients were admitted for atypical chest pain: ECG abnormalities were detected in 12 patients (63%) and positive Troponin I was found in 17 (89%). Echocardiogram evaluation showed a mild systolic dysfunction of the left ventricle in only 4 patients (EF between 50 and 55%). Seventeen patients (89%) underwent CMR for tissue characterization within 1 week: T2-wieghted sequences (edema) were altered in 8 patients (42%), and among this subgroup T1-weighted sequences acquired early after gadolinium injection (hyperemia) were positive in 5 patients and LGE sequences (fibrosis) were positive in 7 cases. Left ventricle volumes and systolic function were normal. Conclusions: Most of our patients presented with ECG alterations without wall motion abnormalities; nevertheless, the clinical history suggested that an acute myocarditis could be the underlying disease. CMR is a sensitive technique for the diagnosis of myocarditis, especially in patients with mild clinical presentation in which echocardiogram may miss limited areas of dysfunctioned myocardium. Furthermore CMR may exclude coronary artery anomalies as primary cause of disease. Few papers deal with patients of pediatric age so the aim of this study, based on our own clinical experience, is to stress the indication to perform CMR in children and adolescents who are referred for chest pain with troponin I or ECG changes. 257 Rheumatic myocarditis in the mitral stenosis: myth or reality? R Hammami1, A Zouari1, A Elleuch1, N Tabebi1, A Ghayeza1, D Abid1, S Kammoun1 1Hedi Cheker Hospital, Department of Cardiology, Sfax, Tunisia Topic: Imaging Introduction: The overall function of the systolic left ventricles (LV) is generally preserved in the mitral stenosis, however, some studies suggest the possibility of impairment of LV contractility associated with rheumatic myocarditis. We propose in this work to detect the myocardial injury in patients with an isolated mitral stenosis based on new echocardiographic techniques. Patients and Methods: This is a case control study conducted between December 2012 and July 2016, including 60 patients with sinus rhythm and isolated mitral stenosis, who received a conventional echocardiography associated with a study of LV strain, measurement of the s wave and Tei index. We excluded patients with conditions that may change the LV systolic function (diabetes, hypertension, coronary heart disease, smoking, renal failure, COPD). These patients were compared with 80 controls of the same age and sex. Results: There were no differences between patients and controls with regard to the ejection fraction and shortening fraction. By against the wave velocity s of the LV (0.09 m / s ± 0.03 in patients versus 0.12 M / s ± 0.03 in patients, P <0.001) as well as the GLS (-16.08 ± 4, 6% in patients and 20.1 ± 2.2% in control with p <0.001) were significantly altered in patients compared to controls. Tei's index was higher in patients without significant differences. Excluding patients who have already received a percutaneous mitral commissurotomy, the mitral area was not correlated neither to the GLS, nor to the lateral s wave. Conclusion: A longitudinal systolic left ventricular dysfunction in the pure RM is confirmed reflecting a rhumastismal myocarditis but this dysfunction is not correlated with the severity of valve disease. 258 Social support in patients with coronary artery disease after percutaneous coronary intervention: a prospective study GS Pushkarev1, VA Kuznetsov1, EI Yaroslavskaya1 1Tyumen Cardiology Center, Tyumen, Russian Federation Topic: Psycho-social risk factors Background: It has been established that social isolated patients has a poor prognosis. However the presence of high level of social support is known to promote physical wellbeing. At the same time, the data about social support in patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI) are insufficient. Purpose: To assess the association between social support and total mortality in patients with CAD after PCI. Methods: The study included 977 patients with CAD (741 men and 236 women, mean age 58.6±9.4 years) who underwent PCI. Mean duration of follow-up was 12.0 ± 1.8 months. Multidimensional Scale of Perceived Social Support (MSPSS) was used to determine the level of perceived social support. The relationship between total mortality and social support was evaluated using Cox proportional hazards model. Hazard ratio (HR) and 95% confidence intervals (CI) were calculated after adjustment for the following confounders: age, gender, systolic and diastolic blood pressure, body mass index, smoking status, alcohol abuse, total cholesterol, hypodynamia, left ventricular ejection fraction, severity of heart failure and presence of acute coronary syndrome and severity of coronary lesions by SYNTAX score. Results: Mean MSPSS score was 70.0±12.3. Low social support was observed in 5.7% of patients, moderate social support in 30.4% of patients and high perceived social support in 63.9% of patients. During the prospective study period 24 (2.5%) patients died. After adjusting for all confounding factors, risk of total mortality was significantly higher in patients with low perceived social support: HR = 4.75 (95% CI 1.45 – 15.6) compared to patients with high social support. The multivariate HR for patients with moderate social support was 1.25 (95% CI 0.50 – 3.15). Conclusion: Low social support was independently associated with higher risk of total mortality in patients with CAD after PCI. 259 Low socioeconomic status as a risk factor for cardiovascular disease in the years of financial crisis (2002-2012). N Kollia1, D B Panagiotakos1, E Georgousopoulou1, C Chrysohoou2, D Tousoulis2, C Stefanadis2, C Papageorgiou3, C Pitsavos2 1Harokopio University, Athens, Greece 2University of Athens, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece 3University of Athens Medical School, Department of Psychiatry, Athens, Greece Funding Acknowledgements: Hellenic Cardiology Society (HCS/2002) and the Hellenic Atherosclerosis Society (HAS/2004/2015 Topic: Psycho-social risk factors Background/ Introduction: in the shadow of the adverse effects of the undergoing economic crisis in Europe, the expansion of research interest to a socio-economic level (i.e., beyond the established Cardiovascular Disease risk factors) is not only expected but mandatory as well. Purpose: to explore the effect of low socioeconomic status (SES) on 10-year Cardiovascular Disease (CVD) incidence, in apparently healthy individuals at the years of financial crisis. Methods: this is a population-based, health and nutrition prospective survey with 10-year follow-up. During 2001–2002, information from 1528 men (18–87 years old) and 1514 women (18–89 years old) was collected. Educational level and annual income were used to define their SES. At the end of the follow-up period CVD incidence was recorded. Results: educational level, but not financial status, was inversely associated with 10-year CVD incidence (p<0.001). After adjusting for gender, age, smoking habits, physical activity, adherence to the Mediterranean diet and the presence of Metabolic syndrome at baseline, increased 10-year CVD incidence was recorded among low SES individuals compared to the high SES class [adjusted odds ratio and 95% confidence interval: 2.7 (1.5, 4.9)], but this association was present only among the older participants (i.e., aged above 45 years). Furthermore, low SES individuals scored higher in the depression, anxiety, irrational beliefs and hypochondriasis scales, compared both to those of the middle and the high SES class (all p-values <0.001), they reported less physical activity (p=0.056) and they had higher prevalence of diabetes mellitus (p=0.002) and obesity (p=0.087). Conclusion: there is evidence for a consistent reverse association between SES and the incidence of CVD, especially in the middle-aged group, as well as for higher CVD risk factors among the most disadvantaged sections of society. 260 Gender features of cardiovascular risk in the population with vital exhaustion in Russia / Siberia: WHO program MONICA-psychosocial V Gafarov1, E Gromova1, D Panov1, I Gagulin1, A Gafarova1 1Research Institute of Internal and Preventive Medicine, Novosibirsk, Russian Federation Topic: Psycho-social risk factors Purpose: To determine gender differences in the effect of vital exhaustion (VE) on the risk of myocardial infarction (MI) and stroke in general population aged 25-64 years in Russia / Siberia. Methods: Under the third screening of WHO program "MONICA-psychosocial" a random representative sample of the population aged 25-64 were surveyed in Novosibirsk in 1994 (n = 657 men, n = 870 women). VE levels were measured at the baseline. Over the 16-year period were identified 15 and 35 cases of MI and stroke in women and 30 and 22 in male. Cox - proportional regression model was used for an estimation of hazard ratio (HR). Results: Levels of VE were follows: 66,8% in male (high level -14.6%) and 75,7% in female part of population (high level – 44.4%). HR of MI was 2-fold higher in men. There was no influence of VE on the risk of MI in women. In the analysis with adjustment for marital status: MI risk was higher in divorced women HR=5.4 than in men HR=4.7. MI risk was higher in men with VE: in those with elementary school education HR= 2.2; in those never married HR=3.7 or widowed HR= 7; at age 45-54yy HR=3.8 and 55-64yy HR=5.9. Women had no any associations like these. Stroke risk in persons with VE was higher in female HR=3.34 compared with male HR=3.1. But risk of stroke was higher in those men: with elementary school education HR= 4.8; in divorced HR= 3.8 and widowed men HR=3.6. Risk of stroke in persons older 55 years was higher in women HR= 2.9 than men HR=2.4. Conclusion: There is higher prevalence of VE in female compared to male. VE is a predictor of MI in men and stroke for both gender. 261 The study of coping with stressful and problematic situations in patients with risk factors for cardiovascular disease O Sivakova1, NA Sirota2 1National Research Center for Preventive Medicine, Moscow, Russian Federation 2Moscow State University Of Medicine And Dentistry, Moscow, Russian Federation Topic: Psycho-social risk factors Background: knowledge about preferable coping strategies of patients with risk factors for cardiovascular disease (RF CVD) may be useful for preventive counselling, behavioural change and increase of adherence. Purpose: to explore strategies of coping with stressful and problematic situations among patients with RF CVD. Methods: study included 140 patients, 76 men (54%) and 64 women (46%). The average age of patients was 53 +/- 17 years. Inclusion criteria: 1) age from 18 to 80 years, 2) presence of one or more RF CVD. Exclusion criteria: mental illness. To conduct the study the questionnaire "Method for psychological diagnostics of coping with stressful and problematic personal situations" was used. The method allows to estimate the frequency of use of main coping strategies: "Confrontation" (S1), "Distancing" (S2), "Self-control" (S3), "Search of social support" (S4), "Taking responsibility" (S5), "Escape-avoidance" (S6), "Planning for problem solution" (S7), "Positive reappraisal" (S8). Results: data analysis of the whole group of patients, and subgroups of men and women showed that the average values of standard T-scores of all major strategies of coping behavior are within the moderate level of use. In comparing subgroups of men and women between themselves significantly more often use of S1 by men was found (p=0.01). Analysis of the frequency of using of each particular strategy across the whole group of patients showed significantly more frequent use of S4 than S1 (p=0.003), S3 (p=0.005), S6 (p=0.01) and S8 (p=0.02). In male subgroup significantly more frequent use of S4 than S3 (p=0.01) and S6 (p=0.04) was found. In female subgroup significantly rarer use of S1 than S7 (p=0.02), S4 (p=0.004), S5 (p=0.02) was found. For other variants of comparison statistically significant differences was not found. Conclusion: for patients with RF CVD moderate level of use of all main types of coping strategies was found. Men use the strategy "Confrontation" more often than women do. Across the whole group and in the subgroup of men more frequent use of the strategy "Search of social support" (in comparison with some other strategies) was revealed. In subgroup of women less frequent use of the strategy of "Confrontation" (in comparison with some other strategies) was found. 262 Impact of long-term psychological support on health-related quality of life after rehabilitation W J Mayer-Berger1, B Simon1, C Kettner1, J Grebe2, S Neuhaeuser1 1Klinik Roderbirken, 42799 Leichlingen, Germany 2University of D�orf, Coordinating Centre for Clinical Studies, D�orf, Germany Funding Acknowledgements: Refonet Topic: Psycho-social risk factors Background and Purpose: In a former study we could show the positive effect on health-related quality of life (HRQL) of a longterm secondary prevention programme after rehabilitation. We hypothesized an even better efficacy with a special programme focussing on psycho-social problems. Here we present final data of our study in cardiovascular rehabilitation patients. Methods: In this randomized controlled study we recruited 253 patients with a cardiovascular diagnosis and psychological comorbidity (intervention group IG 127, control group CG 126). The latter was evaluated with the PHQ (patient health questionnaire). After confirmation of the comorbidity patients were randomized. The intervention consisted of a period of intensified sessions focussing on psycho-social therapy within 6 months after rehabilitation, followed by quarterly telephone contacts for 2 years. The CG received the commonly recommended psycho-social care. Somatic and sociodemographic data as well as questionnaires (SF12, HADS = hospital anxiety depression scale, JCQ = job content questionnaire) were evaluated at the end of the rehabilitation (t1) and after 2 years (t3), only in the IG at the refreshing course (t2). Results: The baseline data of both groups showed no significant difference. The mean age was 49, 211 were male and 42 female. The main diagnoses were myocardial infarction (223, IG 107, CG 116) and hypertension (154, IG 75, CG 79). The main comorbidity were adjustement disorder (171, IG 93, CG 78), depressive disorder(41, IG 17, CG 24) and anxiety disorder (38, IG 16, CG 22). Complete follow-up data exist for 90 % of the patients. For the SF12 there is no significant difference in physical health score between IG and CG and between t1 and t3. Regarding mental health there is improvement for both groups (IG t1 40 to t3 44 and CG t1 38 to t3 43). Regarding the HADS there is a significant difference with respect to the anxiety scale at t1 (IG 10,5, CG 12), with stronger improvement at t3 in the IG (IG –2,2, CG –1,7; not significant). There is even stronger improvement with respect to the depression scale from t1 to t3 (IG –3,14, CG –1,7; strong tendency but not significant). Regarding the JCQ factor control rises from t1 to t3 in the IG (0,53), whereas falling in the CG (-1,06), not significant. Complete data will be available till March 2017. Conclusion: Our data show better outcome for HRQL and the vocational situation in cardiovascular patients with psychological comorbidity with a special psychological long-term programme. 263 Psychosocial risk factors of cardiovascular diseases and hypertension in Polish adult population. Results of WOBASZ II study. J Piwonski1, p Kurjata1, A Piwonska1, W Bielecki2, K Kozakiewicz3, A Pajak4, A Tykarski5, T Zdrojewski6, W Drygas1 1National Institute of Cardiology, Warsaw, Poland 2Medical University of Lodz, Lodz, Poland 3Medical University of Silesia, Katowice, Poland 4Jagiellonian University, Krakow, Poland 5Poznan University of Medical Sciences, Poznan, Poland 6Medical University of Gdansk, Gdansk, Poland Topic: Psycho-social risk factors Introduction: Cardiovascular diseases (CVD), as well as hypertension (HT), are one of the most important healthy problems and the leading cause of hospitalization and deaths in Poland. It is stressed that psychosocial risk factors (f. e. depressive symptoms – DS and low social support - LSS) have an independent contribution to the origination of CVD. Purpose: to evaluate the prevalence of DS and LSS in persons with and without hypertension in Polish adult population in 2013-2014 and the relation of DS and LSS to hypertension. Methods: data come from the population survey WOBASZ II (2751 men and 3418 women, aged 20+, screened in 2013-2014). DS were assessed using Beck depression inventory (BDI; DS=10pts) and LSS using Berkmana i Syme questionnaire. HT was defined as BP = 140/90 or antihypertensive treatment. Results: HT was found in 49,5% of men and 41,9% of women. DS were observed in 17,6% of men and 23,4% of women, and LSS respectively in 45,3% and 52,1%. Among persons with HT, both DS as well as LSS, were significantly more prevalent compared to persons without HT (men: DS - 21,9% versus 13,6%, p< 0.0001; LSS - 51,3% versus 39,7%, p <0.0001; women respectively 27,3% versus 20,6% and 63,8% versus 44,1%, p for both < 0.0001). In men population, out of analyzed psychosocial risk factors statistically significant relation was found only between HT and DS after adjustment for age (OR=1,48; 95% CI: 1,18-1,85). In women the relation between LSS and HT was found (OR=1,32; 95% CI: 1,11-1,56). Conclusions: in the population survey conducting in 2013-2014, hypertension was found in about 50% of men and 40% of women, depressive symptoms in every fifth men and fourth women, and a low social support level in every second person. Depressive symptoms in men and low social support in women occurred to be associated with hypertension. 264 Impact of psychosocial risk factors in patients with coronary heart disease on medication adherence VA Kuznetsov1, G Pushkarev1, EI Yaroslavskaya1 1Tyumen Cardiology Center, Tyumen, Russian Federation Topic: Psycho-social risk factors Purpose: To assess the relationship between psychosocial risk factors and medication adherence in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Materials and Methods: A total of 974 patients after PCI (738 males and 236 females, mean age 58.6±9.4 years) were included in the study. Type D Scale (DS14) was used to assess personality type. Depressive and anxiety symptoms were measured using the Hospital Anxiety and Depression Scale (HADS). The four item Morisky Medication Adherence Scale (MMAS-4) was used to assess medication adherence. Patients who scored 4 points by MMAS-4 considered to be committed to the treatment, patients who scored less than 3 points had poor adherence to treatment. Results: In our study 153 (15.7%) patients with CHD had adherence to treatment. In patients with type D personality only 14.3% had adherence to treatment. In patients without type D personality 16.4% had adherence to treatment (p>0.05). Patients with borderline abnormal anxiety level has the lowest adherence to treatment – 11.5% compared to 16.9% in patients with clinically significant anxiety and 17.4% in patients without anxiety (p=0.09 and p=0.03, respectively). There was no statistically significant difference in adherence to treatment depending on the level of depression. In patients with borderline abnormal depression level the compliance rate was 13.9%, with clinically significant depression - 19.3%, in patients without depression - 15.7% (all p> 0.05). Conclusion: The lowest adherence to treatment patients was in patients with borderline abnormal anxiety level. There was no influence of type D personality and depression on adherence to treatment in patients with CHD. 265 Association between psychosocial risk factors and coronary artery disease in open male population VA Kuznetsov1, MM Kayumova1, EV Akimova1, VV Gafarov1 1Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Tyumen, Russian Federation Topic: Psycho-social risk factors The purpose was to study the prevalence of high levels of depression, trait anxiety and vital exhaustion and their association with coronary artery disease (CAD) in open male population aged 25-64 years. Methods: Representative sample of 1000 individuals (250 in every 4 decades: 25-34, 35-44, 45-54, 55-64 years) was formed by the method of random numbers from the election list of males of Tyumen urban population. The analysis of such psychosocial risk factors as trait anxiety, depression and vital exhaustion was carried out within the cardiac screening using standard self-administered WHO MONICA questionnaire. "Certain" CAD and "possible" CAD were defined. Association between high levels of psychosocial risk factors and CAD was assessed by calculating odds ratio (OR) and their 95% confidence intervals (CI). The response to cardiac screening was 85.0% - 850 patients. Results: The prevalence of high levels of psychosocial risk factors in male patients aged 25-64 years was: depression – 4.6%, trait anxiety – 36.6%, vital exhaustion – 15.9%. The prevalence of CAD in males aged 25-64 years was 12.4%. At high levels of depression and CAD in men aged 25-64 years OR was 21.07 (95% CI=10.76±41.26, p<0.05), at high levels of depression and "certain" CAD – OR was 39.84 (95% CI=19.61±80.9, p<0.05). In assessment of the impact of trait anxiety on the development of CAD and "certain" CAD on extended epidemiological criteria there was obtained OR 4.07 (95% CI=1.40±11.83, p<0.05). In presence - absence of CAD on extended epidemiological criteria and vital exhaustion OR was found to be 6.02 (95% CI=3.55±10.20, p <0.05). In assessment of the impact of vital exhaustion on the development of "certain" CAD there was detected OR 14.11 (95% CI=6.29±31.67, p<0.05), so the rate was more than twice higher compared to group with CAD on extended epidemiological criteria. In men aged 25-64 years with "possible" CAD and high-level vital exhaustion OR was not statistically significant. Conclusion: In the open male population aged 25-64 years with high psychosocial risk factors there was found the increased risk of development of "certain" CAD and CAD on extended epidemiological criteria. 267 Validity of the Japan's national checklist as an index of frailty and plasma fatty acid levels in elderly patients receiving cardiac rehabilitation M Kunimoto1, K Shimada1, M Yokoyama1, Y Hoshino1, S Takahashi1, T Shiozawa1, T Aikawa1, S Ouchi1, A Amano2, H Daida1 1Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan 2Juntendo University Graduate School of Medicine, Department of Cardiovascular Surgery, Tokyo, Japan Funding Acknowledgements: A Grant-in-Aid for Scientific Research from the Japan Society for the Promotions of Science, Japan Topic: Risk factors: others Aim: We investigated the validity of the Japan's national checklist, "Kihon Checklist (KCL)" as a frailty index and measured plasma fatty acid levels in elderly patients receiving cardiac rehabilitation (CR). Methods: One hundred eighty two consecutive elderly patients aged = 65 years receiving CR (ischemic heart disease n=31, open heart surgery n=95, chronic heart failure n=43, mean age 74 ± 5 years, 62% of male). We measured anthropometric parameters and performed the 6-min walk test (6MWT) at the beginning of CR. Patients were divided into non-frailty and frailty groups according to the KCL. Results: The frailty group comprised 73 patients (40%). No significant differences in age and gender were observed between the two groups. The frailty group had significantly lower body mass index, lean weight, hemoglobin and albumin levels, estimated glomerular filtration rate, eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratio, 6MWT, and hand grip strength than those in the non-frailty group. Plasma BNP levels in the frailty group were significantly higher than those in the non-frailty group. In multivariate logistic regression analyses, the 6MWT and EPA/AA ratio were significantly associated with the KCL frailty index (OR: 0.98, 95% CI: 0.97– 0.99, P = 0.02; OR: 0.045, 95% CI: 0.001–0.863, P = 0.03; respectively). Conclusions: The KCL items can be used as a frailty index for patients receiving CR. In addition, EPA/AA ratio might be a biomarker for assessing frailty. 268 Randomized controlled trials meta-analysis of fish oil supplementation effects on inflammatory markers of cardiovascular disease M L De Rosa1, L Cerini2, M Cerini3, N Ferrara1 1University Hospital Federico II, Naples, Italy 2Economics and Menagment of Innovation andTechonology,Bocconi University, Milan, Italy 3Nuclear Dept, Politecnico of Milan, Milan, Italy Funding Acknowledgements: none Topic: Risk factors: others Background: Effects of fish oil on systematic inflammation in cardiovascular disease remain unclear. In this meta-analysis, we aimed to evaluate the influence of fish oil supplementation on circulating levels of inflammatory markers in patients with cardiovascular disease. Methods: Human randomized controlled trials, which compared the effects of fish oil supplementation with placebo in patients with chronic heart failure, were identified by systematic search of Medline, Embase, Cochrane's library and references cited in related reviews and studies up to November 2013. Outcome measures comprised the changes of circulating inflammatory markers. Meta-analysis was performed with the fixed-effect model or random-effect model according to the heterogeneity. Results: A total of twelve trials with ten study arms were included. The pooled results indicated circulating levels of tumor necrosis factor a (SMD = -0.62, 95% CI -1.08 to -0.16, p = 0.009), interleukin 1 (SMD = -1.24, 95% CI -1.56 to -0.91, p < 0.001) and interleukin 6 (SMD = -0.81, 95% CI -1.48 to -0.14, p = 0.02) were significantly decreased after fish oil supplementation; however, high sensitivity C reactive protein, soluble intracellular adhesion molecular 1 and vascular cell adhesion molecular 1 were not significantly affected. Meta-regression and subgroup analysis results suggested the difference in dose of fish oil and follow-up duration might influence the effects of fish oil on tumor necrosis factor a and interleukin 6. Greater reduction of these two markers might be achieved in patients taking fish oil of a higher dose (over 1000 mg/day) or for a longer duration (over 4 months). Conclusions: Limited evidence suggests anti-inflammation may be a potential mechanism underlying the beneficial effects of fish oil for chronic cardiovascular disease. Further large-scale and adequately powered clinical trials are needed to confirm these effects. 269 Application of an expert system to improve cardiovascular risk in the workplace MA Sanchez Chaparro1, E Calvo Bonacho2, M Cabrera Sierra2, L Quevedo Aguado2, C Fernandez Labandera2, p Martinez Munoz2, JC Sainz Gutierrez2, C Catalina Romero2, A Fernandez Meseguer2, p Valdivielso Felices1 1UGC Medicina Interna. Hospital Universitario "Virgen de la Victoria". , Málaga, Spain 2Ibermutuamur, Madrid, Spain Funding Acknowledgements: The present study has been supported by grants of the Instituto de Salud Carlos III co-founded by Fondo Europeo de Desarrollo Regional - FEDER Topic: Risk factors: others Background and Objective: Under current guidelines for the prevention and management of cardiovascular diseases, only a third of workers with high cardiovascular risk (CVR) meet therapeutic goals for dyslipidaemia. Of them, only one-third receive adequate therapeutic pharmacological treatment given the inertia caused by the difficult task of integrating all the information that the physician handles when addressing CVR. The aim of this study was to design, develop and test an expert system to help professionals in clinical decision-making as providing an assessment of the health of workers at very high CVR. Material and Methods: It was designed and developed an operational web expert system in ASP language (Active Page Server), which gathers information on risk factors and returns an output with recommendations for management of risk factors based on the 2012 criteria of the European Guidelines on Cardiovascular Disease Prevention. In the case of needing an intervention or modification of drug treatment, the expert system helps to plan and optimize them. The CVR was stratified by the European SCORE system for low-risk countries. After a pilot study, the study was conducted providing to 85 workers with very high CVR (SCORE =10) a structured intervention based on interviews, and including the expert system recommendations. Further, their knowledge on risk level and recommendations was evaluated. The adherence to the Mediterranean diet was assessed by a 14-item questionnaire and physical activity by the International Physical Activity Questionnaire (IPAQ). Results: All the participants were men, with a mean age of 62.6 years (± 4.2). From these patients, mostly manual workers (54.9%), 91.7% knew they had cardiovascular risk factors. 40.3% were smokers, of which 50% expressed their intention to give up smoking in the coming months. The mean BMI was 27.4 kg/m2 and the mean waist circumference was 99 cm. 83.3% of them followed the provided guidelines recommendations with a high level of adherence to the Mediterranean diet in 10.6% of cases, and moderate in 51.8%. 61.3% of the workers reported being physically very active and active in the 7 days prior to the follow-up assessment (36.4% sufficiently active and 27.2% insufficiently active). 61.1% had hypertension and in 20% of these cases without treatment, antihypertensive treatment was prescribed. 47.2% were aware of having high cholesterol levels. 8.8% started a diet and 23.5% began lipid-lowering therapy. 16.7% were aware of having high blood sugar, so that 8.3% started a diet and 25% antidiabetic treatment. Conclusions: Our preliminary results suggest that there is a high potential for improvement in lifestyle and CVR control among patients at very high cardiovascular risk. The availability of an expert system could facilitate decision-making when providing medical advice and health care to this group of patients. An expert system could be a value-added service. 270 Factors affecting the neuropsychological status in patients with stable coronary artery disease O Trubnikova1, ? Kupriyanova1, I Tarasova1, O Maleva1, O Barbarash1 1Research Institute of Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation Topic: Risk factors: others Introduction: Recently, there is no consensus regarding the factors affecting the development of cognitive disorders in patients with stable coronary artery disease (CAD). Therefore, it is very important to investigate the clinical characteristics in these patients as possible causes of cognitive impairment. Aim: To determine the factors affecting the neuropsychological status in patients with stable CAD. Material and Methods: The analysis of clinical data, medical history and neuropsychological parameters in 40 healthy male subjects (mean age 52.7 ± 6.5) and 272 male CAD patients (mean age 55.9 ± 5.3 years) was conducted. Cognitive functions were assessed using a modified automated method «Status-PF» and a complex approach was applied to estimate a total index of neuropsychological status. Neurophysiological parameters were recoded according to the specific algorithms. There were a range from 0 to 1, if a parameter was closer to 1, it was corresponded to the value of healthy subjects of the same age, and on the contrary, closer to 0 - the farther away from the norm. Thus, the values of the total cognitive status index were divided into ranges: low cognitive status of the patient in the range of 0 to 0.34, below medium - > 0.34 to 0.51, medium -> 0.51 to 0.7 and > 0.7 to 1.0 - corresponded to the healthy subject's status. The factors that could potentially affect the cognitive state were: MMSE (Mini-Mental State Examination) score, age, body mass index, smoking, years of education, duration of CAD and hypertension, functional class of angina and chronic heart failure, the stenoses of the extracranial arteries, left ventricular ejection fraction (LVEF), the level of state and trait anxiety, lipid profile indicators. Statistical package SPSS 17.0 was used to build the regression model. Results: Total cognitive status index of healthy persons was 0.8 [0.72; 0.87], whereas it was significantly lower in CAD patients - 0.47 [0.35; 0.59] (p <0.0001). Stepwise regression analysis revealed significant factors affecting cognitive status in patients with stable CAD: age (B = -0.008; p = 0,002), years of education (B = 0.015; p = 0.033), LVEF (B = 0.004; p = 0.018), and triglycerides plasma level (B = -0.046; p = 0.003). Poorer cognitive performance was associated with older age, less years of education, reduced LVEF and increased blood plasma triglyceride concentration. Conclusion: Our findings confirm that the cognitive status in patients with stable CAD is worse than in healthy individuals of the same age. The factors that have an adverse effect on the cognition in CAD patients are age, lower education level, altered cardiac contractile function and hypertriglyceridemia. 271 Experience of application of type 2 diabetes risk scale among young people IV Tyshchenko1, OO Bondareva1 1SE Dnipropetrovsk medical academy, Dnipropetrovsk, Ukraine Topic: Risk factors: others Background/Introduction: type 2 diabetes mellitus (DM) is formed over the years. Risk factors (RF) for diabetes can affect the organism for a long time, often from the young age. Knowledge of RF can help delay or prevent the development of DM. Purpose: to estimate the prevalence of risk factors for DM among a group of medical students (S). Methods: 117 medical students of 4th year were surveyed. There was used the Finnish risk scale (FINDRISK). Body-mass index (BMI), waist circumference (waist), the daily eating of fruits, vegetables, berries (V), physical activity (PA), the presence of hypertension, hyperglycemia history, and family history of DM were assessed. In addition, the students were asked to specify gender, age in years, blood pressure level. The average age of respondents' was 20.3±0.9 yrs. Men (M) - 31.6%, women (W) - 68.4%. Results: a group of surveyed S was homogeneous in age. Most of them (82.1%, including 28 M, 68 W) had BMI of 18.5-24.9 kg/m2 (average 20.6±2.1 kg/m2), 5.1% of S (6 W) had BMI less than 18.5 kg/m2 (17.6±0,4 kg/m2), 11.1% (8 M, 5 W ) had BMI of 25.0-29.9 kg/m2 (average BMI 27.9±0,8 kg/m2), and 2 S (1.7%; 1 M and 1 W) had BMI 30 and over kg/m2. In 85.5% of S (30 M, 70 W) waist was normal size (for M up to 94 cm, for W up to 80 cm), 11.9% of S (6 M, 8 W) had a moderate increase of waist (94-102 cm for M, 80-88 cm for W) and 3 S (2.6% of all; 1 M, 2 W) had its significant increase (more than 102 cm for M and more than 88 cm for W). Regular PA was typical for 51.3% of S (26 M, 34 W), and 48.7% of them (11 M, 46 W) does no physical exercises. 65.8% of S (22 M, 57 W) ate the V regularly, and 34.2% (15 M, 25 W) - irregularly. 1 W (0.9% of S) received an antihypertensive therapy. Hyperglycemia was marked to be presented in anamnesis of 4 S (3.4% of all; 3 M, 1 W). Family history of DM was not burdened at 75.2% of S (28 M, 60 W). Heredity of the second line of kinship was burdened at 23.9% of S (9 M, 19 W), and of the first line - in 1 W (0.9% of S). 21.4% of S (6 M, 19 W) did not have any RF of DM. In 78.6% of S (31 M, 83.8% among all M, and 61 W, 76.3% among all W) we have identified one or more modifiable and non-modifiable RF of diabetes in different combinations. 6.0% of them (7 W) had only one risk factor, which was not modified, - heredity. The most frequent combination of risk factors was the next: physical inactivity and lack of vegetables in diet. According to the FINDRISK 94% of S belonged to the group of low DM risk, and 6% - to the group of slightly elevated risk. Conclusions: the risk of DM in the group of young people was low. Such widespread modifiable RF as hypodynamia and disturbance of diet quality were appeared as the most frequent. Hypertension, elevated BMI, increase of waist occurred less often. For the assessment of DM type 2 risk factors among young people it seems to be rational to modify the existing risk scales. 272 The effectiveness of attendance at a phase 3 specialised heart failure cardiac rehabilitation programme on patients cardiovascular risk factor profile N A M Fallon1, G Mckee2, R O'mahony1, M Quirke2, C Finn1, N Flynn1, p Mcgeary1, V Jones1, V Maher1 1Adelaide & Meath Hospital, Incorporating the National Children's Hospital, Dublin, Ireland 2Trinity College Dublin, School of Nursing and Midwifery, Dublin, Ireland Topic: Risk factors: others Background: Although functional capacity is reduced in heart failure (HF), the European Society of Cardiology (ESC) recommend exercise training for patients with chronic HF, with reported benefits in skeletal, muscle, respiratory, cardiovascular and physiological responses. Exercise training, particularly when combined with education and secondary prevention has been shown to reduce debilitating symptoms, and improve functional capacity and quality of life. It also significantly improves survival time, while reducing all cause and HF specific, cause of hospital admissions. Purpose: To evaluative the effectiveness of attendance at a Phase III specialised HF cardiac rehabilitation programme (CRHFP) on patient's cardiovascular risk factor profile. Methods: This retrospective study examined profile factors of patients undertaking CRHFP pre entry, and on programme completion. Patients with New York Heart Association class I to III were eligible to partake in the hospital based, multidisciplinary programme, comprising of two sessions (education and exercise) twice a week for 10 weeks. Data was collected on the first 100 patients entering the CRHFP from September 2007. Bivariate analysis was used to ascertain if there were significant changes following attendance at the CFHFP in: anxiety and depression (HADS), quality of life (Minnesota), 6 minute walking test, BP (systolic and diastolic), weight, waist circumference, body mass index, Duke Activity Status Index (DASI) and self-care (European HF behaviour scale). Repeated measures t tests, Wilcoxon rank tests and McNemar tests were used as appropriate. Significance was set at p<0.05. Results: Of the 100 patients examined, mean age was 64.5 years (range 33-83 years), 80% were male, 59% had a NYHA I classification and 73% had an ejection fraction of <40%. 85% of patients completed at least 60% of the programme. The reasons for non-completion included Illness 47% (7), no given reason 27% (4), return to work 13% (2), domestic issues 7% (1) and lack of motivation7% (1). There was a significant improvement in four of the eleven examined variables: 6 minute walk score (426 to 466 meters, effect size 0.03); systolic blood pressure (122mmHg to 115mmHg, effect size 0.01); Minnesota living with HF score (30.5 to 25.0, effect size 0.02) and HADS (participants with moderate anxiety, pre 18%, post 5%). Conclusions: In-hospital and out of hospital HF care has developed significantly, especially in acute symptom control. More recently, emphasis has been put on the long term control of other risk factors. This study adds to this body of literature indicating that attendance at a hospital based Phase III CR programme that provides supervised tailored exercise, with intensive education and support, is effective in reducing risk factors in patients with the lower grades of heart failure. In addition, this study highlighted the positive effects of exercise training on quality of life and exercise capacity. 273 Agreement of different methods for arterial stiffness assessment in population-based sample of Saint-Petersburg inhabitants A Alieva1, O Rotar1, A Orlov1, M Boyarinova1, V Solntsev2, A Konradi2, E Shlyakhto2 1Federal Almazov North-West Medical Research Centre, Epidemiology of non-communicable diseases, Saint Petersburg, Russian Federation 2Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russian Federation Topic: Risk factors: others Objective: Different diagnostic procedures of arterial stiffness are now suggested but the problem of more precise and simple evaluation is still discussed. The aim of our study was to assess harmony of arterial stiffness detection by different methods in Saint-Petersburg inhabitants. Design and methods. 452 apparently healthy participants aged 25-65 years were randomly selected from 1600 Saint-Petersburg inhabitants (a sample form ESSE-RF study). All participants signed informed consent and filled in the questionnaire regarding risk factors, concomitant diseases and therapy. Fasting lipids, glucose, anthropometry and BP measurement were performed. Cardio-ankle vascular index (CAVI) and carotid-femoral pulse wave velocity (cfPWV-V) were measured by VaSera VS-1500, carotid-femoral pulse wave velocity (cfPWV-S) was measured by SphygmoCor. Statistical analysis was performed using SPSS Statistics 20. Results: Most of patients 341 (75,4%) did not have subclinical vascular damage by both methods and only 3 patients (0,7%) had. Increased arterial stiffness detected by CAVI assessment (33 (7,3%)) was found out significantly more often in comparison with cfPWV-S assessment (21 (4,6%)), p<0,005. Spearmen?158;?s coefficient of correlation for cfPWV-S and CAVI was 0,74, coefficient of agreement "kappa" was 0,04. Spearmen?158;?s coefficient of correlation for cfPWV-S and cfPWV-V was 0,10, coefficient of agreement "kappa" was 0,06. Spearmen?158;?s coefficient of correlation for CAVI and cfPWV-V was 0,28, coefficient of agreement "kappa" was 0,03. Conclusion: There was no significant correlations between different methods of arterial stiffness assessment. Probably, applanational tonometry and volumetric sphygmography are detecting slightly different pathological mechanisms. 274 Addressing high blood pressure treatment in primary care office in Mexico. IMSS HBP collaborative group second report F Limon1, S Palomo-Pinon2 1Hospital General de Mexico, Mexico City, Mexico 2Coordinacion de Investigacion en Salud. IMSS, Unidad de Investigacion Medica en Enfermedades nefrologicas, Mexico City, Mexico Topic: Risk factors: others Cardiovascular diseases are the major cause of death in Mexico. During the last years patients attending primary care offices in Mexico is increasing, nevertheless no data is available regarding high blood pressure (HBP) treatment. In the best of our knowledge this is the major study presented in Latin America related with HBP control at primary care office. Objective: evaluate the level of control of high blood pressure patients that attend primary care offices in Mexico. Methods: A consecutive series of cases, between 2013 and 2014, patients were attending in Mexico in primary care office at the Social security system (IMSS). All participants are hypertensive patients, under treatment. BP level were determine as an average of 3 measurements. Descriptive statistic were use to describe the population. For statistical significance, proportion comparison was performed based on xi square distribution. HBP control is defined according to European guidelines. Results: 203.760 patients (64% women) were analyzed. Average age 62.8 ± 15. 53% of the population is not taking medication on a regular base. For those taken medications total number of active principles and level of control is presented on Table 1. The use of more than 2 medications is related with less blood pressure control (p<0.0001) Conclusion: The use of more than 2 medications is related with less blood pressure control at the primary care office in Mexico. The need of medical education and proper guidelines follow up is clear number of drugs Blood Pressure Total cases <140/90 >/= 140 / 90 1 84% 16% 100,0% 2 71% 29% 100,0% 3 61% 39% 100,0% More than 3 37% 63 % 100,0% number of drugs Blood Pressure Total cases <140/90 >/= 140 / 90 1 84% 16% 100,0% 2 71% 29% 100,0% 3 61% 39% 100,0% More than 3 37% 63 % 100,0% Table1. Levels of blood Pressure by number of drugs Open in new tab number of drugs Blood Pressure Total cases <140/90 >/= 140 / 90 1 84% 16% 100,0% 2 71% 29% 100,0% 3 61% 39% 100,0% More than 3 37% 63 % 100,0% number of drugs Blood Pressure Total cases <140/90 >/= 140 / 90 1 84% 16% 100,0% 2 71% 29% 100,0% 3 61% 39% 100,0% More than 3 37% 63 % 100,0% Table1. Levels of blood Pressure by number of drugs Open in new tab 275 Vitamin D deficiency and 3-Year outcomes in acute coronary syndromes M Knezevic Pravecek1, K Cvitkusic Lukenda1, B Miskic2, I Hadzibegovic1, B Vujeva1 1School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia, Department of Cardiology, General Hospital, Slavonski Brod, Slavonski Brod, Croatia 2General Hospital Slavonski Brod, School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia Department of Endocrinology, Slavonski Brod, Croatia Topic: Risk factors: others Introduction and Purpose: Vitamin D deficiency has been associated with cardiovascular disease. The aim was to determine serum concentration of 25 hydroxyvitamin D (25(OH)D) in patients with acute coronary syndrome (ACS) and to assess the prognostic role of serum vitamin D level in ACS patients during 3-year follow up. Methods: The study included 60 ACS patients hospitalized at cardiology department for ACS between March 2012 and October 2012 and 60 age- and sex-matched control patients without ACS. Standard laboratory testing and vitamin D determination were performed in all study patients. In addition, ACS patients underwent coronarography and were followed-up for 36 months of ACS for major adverse cardiac events (MACE). Results: Patients with ACS had a statistically significantly lower mean 25(OH)D level as compared with control group (35.19 nmol/L vs. 58.08 nmol/L, p<0.001). The lowest mean level of 25(OH)D was recorded in diabetic patients with ACS (30.45 nmol/L). ACS patients were divided into three subgroups according to coronarography findings: single vessel, double vessel and triple vessel CAD with respective serum levels of 25(OH)D of 36.44 nmol/L, 33.65 nmol/L and 31.70 nmol/L. During 36-month follow up, the event-free survival rate was 60% in the ACS group. The ACS patients having sustained MACE during follow up had low serum level of 25(OH)D in the acute phase; however, the difference from ACS patients without MACE during follow up did not reach statistical significance (32.64 nmol/L vs. 37.01 nmol/L). Conclusion: Patients with ACS have low vitamin D level, which is lowest in diabetic patients with ACS. However, during 3-year follow up, vitamin D failed to prove useful as a prognostic biomarker in ACS patients. Screening of cardiovascular risk factors and stress level in policewomen of pacifying police units from state government IPB Aragao1, VF Marcolla2, SA Simoes2, T Spritzer2, Pp Ferreira2, ACB Souza2, ILPB Anjos3 1Military Police From Rio de Janeiro State Government, Cardiology, Rio de Janeiro, Brazil 2Rio de Janeiro State Government, Rio de Janeiro, Brazil 3Severino Sombra University, School of Medicine, Rio de Janeiro, Brazil Topic: Risk factors: others Background: Coronary heart disease (CHD) may be clinically different in women when compared to men being underdiagnosed and treated. Worldwide, heart disease and stroke are the leading cause of death in female gender with 8.6 million deaths per year, as mentioned by literature. Objective: to identify the prevalence and self knowledge of cardiovascular (CV) and stroke risk factors in policewomen of the Pacifying Police Units (PPU). Methods: Observational and cross-sectional study, All policewomen answered an one-minute and anonymous questionnaire of 30 questions about age, stress level, tobacco smoke, hypertension, dyslipidemia, physical inactivity, obesity, diabetes and family history of CHD between 05/10/2013 and 10/10/2013. A positive answer or the lack of knowledge were equivalent to a point. Considered high risk group: two or more positive answers or the lack of knowledge. They've attended to encouraged lectures about cardiovascular risk factors. Results: Total of 32 PPU, 602 policewomen, average age 28.1 years, 31% high stress level; 7% tobacco use; hypertension 7% (lack of knowledge in 3%); 76% have already measured cholesterolemia (88% unknow the level); 76% have already measured glycemia (30% were unaware; 16% of family history of CHD and stroke; 51% unaware body mass index (BMI); BMI was calculated: 59% =25, 23% >25 and =30, 18% without weight and/or height; 53% physical inactivity; 92% denied preview CHD. 90% used to visit gynecologist but only 12% to a cardiologist. It was identified 97% with =2 points. Conclusions: High prevalence or unknoeledge of CV risk factors and stress level activity in this population. Total 602 patients (100%) Average age = 28.1 Measured glycemia 76 % Measured cholesterol 76 % Measured arterial pressure 97 % Knowledge BMI 50 % YES LACK High Glycemia 2% 30% Hypertension 7% 3% Low HDL cholesterol 9% 87% High total cholesterol 3% 59% Total 602 patients (100%) Average age = 28.1 Measured glycemia 76 % Measured cholesterol 76 % Measured arterial pressure 97 % Knowledge BMI 50 % YES LACK High Glycemia 2% 30% Hypertension 7% 3% Low HDL cholesterol 9% 87% High total cholesterol 3% 59% Open in new tab Total 602 patients (100%) Average age = 28.1 Measured glycemia 76 % Measured cholesterol 76 % Measured arterial pressure 97 % Knowledge BMI 50 % YES LACK High Glycemia 2% 30% Hypertension 7% 3% Low HDL cholesterol 9% 87% High total cholesterol 3% 59% Total 602 patients (100%) Average age = 28.1 Measured glycemia 76 % Measured cholesterol 76 % Measured arterial pressure 97 % Knowledge BMI 50 % YES LACK High Glycemia 2% 30% Hypertension 7% 3% Low HDL cholesterol 9% 87% High total cholesterol 3% 59% Open in new tab Open in new tabDownload slide 276 Aortic stiffness assessment using an innovative technique: Finger to Toe pulse wave velocity (popmetre) compared to arterial stiffness assessed by applanation tonometry: a clinical stydy H Obeid1, HK Khettab1, PB Boutouyrie1, SL Laurent1, MH Hallab2 1Paris Cardiovascular Research Center (PARCC), Paris, France 2University Hospital of Nantes, Nantes, France Topic: Risk factors: others Background: Large artery stiffness is recognized as a strong, independent marker of cardiovascular risk, mainly through aortic pulse wave velocity (PWV). pOpm糲e ® is a new non-invasive method, which estimates aortic PWV through finger-toe (FT) wave analysis. In a previous study, Alivon et al. have shown an acceptable correlation (r2 = 0.43 for PWV) between pOpm糲e ® and the reference method Sphygmocor. However this study led to the necessity to optimize the algorithm and the procedures because of the presence of several outliers involving mainly obese and elderly subjects. Materials and Methods: The pOpm糲e® has 2 photodiodes sensors, positioned on the finger and on the toe. A particular attention was drawn on positioning of the toe sensor so that the pulp was in contact with the photodiode. Different signal processing chains were applied and no cut-off value was used for pulse height. Applanation tonometry was performed for CF PWV measurements. Results: 76 subjects were included: 27 healthy subjects and 49 patients with essential hypertension aged 32 ± 7 years and 58 ± 18 years respectively. The correlation between FT PWV and CF PWV was good and significant (r2 = 0.77; p<0.0001). A better correlation was found in terms of transit time (r2 = 0.83; p<0.0001). The standard deviation of the difference was 0.87 m/s versus 6.73 ms, classifying the device as good agreement with reference (Wilkinson, ARTERY RES 2010). Conclusion: pOpm糲e® with optimized algorithm and procedure qualifies as excellent agreement with the reference technique for PWV assessement, however, outcome studies must confirm the value of this new device. 277 Sedentary behaviour and physical activity in frail, pre-frail and non-frail elderly patients with acute coronary syndrome A Ruescas-Nicolau1, V Ruiz-Ros2, Y Ezzatvar-De-Llago3, C Sastre-Arbona3, E Valero-Picher4, X Canoves-Femenia4, M Pellicer-Banuls4, F Lopez-Fornas4, p Racugno4, J Sanchis-Fores4 1University of Valencia, Department of Physiotherapy, Valencia, Spain 2University of Valencia, Nursing Faculty, Valencia, Spain 3University Hospital Clinic of Valencia, INCLIVA, Department of Cardiology, Valencia, Spain 4Department of Cardiology, Hospital Clinico Universitario, Faculty of Medicine, University of Valencia, Valencia, Spain Funding Acknowledgements: This work was supported by grants from Spain's Ministry of Economy and Competitiveness through the Carlos III Health Institute and FEDER health resear Topic: Risk factors: others Background: A strong concern is growing about whether sedentary behaviour (SB), physical activity (PA) or both are associated with the development of cardiovascular diseases, supporting the need to study more than one when assessing lifestyle. Frailty syndrome has been shown to have a prognostic value after an acute coronary syndrome (ACS) in elderly patients. Purpose: To compare PA time and sitting time among frail, pre-frail and non-frail elderly patients with acute coronary syndrome (ACS) in order to assess lifestyle activity. Methods: A cross-sectional study, including 327 patients older than 65 years hospitalised for an ACS in whom frailty was assessed at discharge (Fried score 0-5), was carried out. PA was quantified by using the Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ). Analyses of variance were used to compare sitting time and PA time among frail (= 3 points), pre-frail (= 2 points) and non-frail patients. Results: Sample characteristics and results are shown in table 1. Significant statistical differences (p<0.001) were found among groups in the studied variables. Pair-wise comparisons showed that patients with frailty spent more time sitting and less time in doing PA than non-frail and pre-frail subjects.(p<0.001). Conclusion: Among elderly patients with ACS, sedentary behaviour and PA might allow better lifestyle assessment in frail patients. Owing to differences in groups' size, these results must be interpreted with caution and future research is guaranteed. Non-frail (0 points) Pre-frail (1-2 points) Frail (3-5 points) Numbers* 24(7.13) 193(59.02) 110 (33.6) Age (years)** 76.7(6.2) 76 (6.6) 81 (6.7) Gender* Male 19(79.16) 124 (64.24) 45(40.9) Female 5(20.84) 69 (35.76) 6 5(59.1) Physical activity time (min/day)** Physical activity time 777.80(81.09) 740.51(88.71) 681.25(95.09) Sitting time 511.72(118.7) 572.17(151) 676.18(168.78) Non-frail (0 points) Pre-frail (1-2 points) Frail (3-5 points) Numbers* 24(7.13) 193(59.02) 110 (33.6) Age (years)** 76.7(6.2) 76 (6.6) 81 (6.7) Gender* Male 19(79.16) 124 (64.24) 45(40.9) Female 5(20.84) 69 (35.76) 6 5(59.1) Physical activity time (min/day)** Physical activity time 777.80(81.09) 740.51(88.71) 681.25(95.09) Sitting time 511.72(118.7) 572.17(151) 676.18(168.78) * n (%). ** Mean (DS). Open in new tab Non-frail (0 points) Pre-frail (1-2 points) Frail (3-5 points) Numbers* 24(7.13) 193(59.02) 110 (33.6) Age (years)** 76.7(6.2) 76 (6.6) 81 (6.7) Gender* Male 19(79.16) 124 (64.24) 45(40.9) Female 5(20.84) 69 (35.76) 6 5(59.1) Physical activity time (min/day)** Physical activity time 777.80(81.09) 740.51(88.71) 681.25(95.09) Sitting time 511.72(118.7) 572.17(151) 676.18(168.78) Non-frail (0 points) Pre-frail (1-2 points) Frail (3-5 points) Numbers* 24(7.13) 193(59.02) 110 (33.6) Age (years)** 76.7(6.2) 76 (6.6) 81 (6.7) Gender* Male 19(79.16) 124 (64.24) 45(40.9) Female 5(20.84) 69 (35.76) 6 5(59.1) Physical activity time (min/day)** Physical activity time 777.80(81.09) 740.51(88.71) 681.25(95.09) Sitting time 511.72(118.7) 572.17(151) 676.18(168.78) * n (%). ** Mean (DS). Open in new tab 279 Relation between High blood pressure control and basal glycemic level at primary care office in Mexico. IMSS HBP collaborative group third report Topic: Risk factors: others F Limon1, S Palomo-Pinon2 1Hospital General de Mexico, Mexico City, Mexico 2Coordinacion de Investigacion en Salud. IMSS, Unidad de Investigacion Medica en Enfermedades nefrologicas, Mexico City, Mexico Cardiovascular diseases are the major cause of death in Mexico. Mexico have the major prevalence of diabetes in Latin America. The relation between basal glycemic level and high blood pressure have not been previously reported in Mexico. In the best of our knowledge this is the major study presented in Latin America related with HBP control at primary care office. Objective: evaluate the relation between basal glycemic level and high blood pressure control on patients that attend primary care offices in Mexico. Methods:A consecutive series of cases, between 2013 and 2014, patients were attending in Mexico in primary care office at the Social security system (IMSS). All participants are hypertensive patients, under treatment. BP level were determine as an average of 3 measurements. Descriptive statistic were use to describe the population. For statistical significance, proportion comparison was performed based on sampling distribution according to a normal distribution 95% confidence. HBP control is defined according to European guidelines. Results: 203.760 patients (64% women) were analyzed. Average age 62.8 ± 15. Relation between high blood pressure and basal glycemic level is presented on Table 1. 74% of patients with basal glycemic level < 120 mg% achieve blood pressure < 140/90 compare with only 64% of patients with basal glycemic level >120 mg% (p <0.0001) Conclusion: Basal glycemic level > 120 mg% is related with less control of blood pressure independent of diabetes diagnosis. < 140/90 >/= 140/90 total Glycemic level <120 mg% 74% 26% 100% Glycemic level > 120 mg% 64% 36% 100% P value <0.0001 <0.0001 < 140/90 >/= 140/90 total Glycemic level <120 mg% 74% 26% 100% Glycemic level > 120 mg% 64% 36% 100% P value <0.0001 <0.0001 Table1. Levels of blood Pressure related with basal glycemic level Open in new tab < 140/90 >/= 140/90 total Glycemic level <120 mg% 74% 26% 100% Glycemic level > 120 mg% 64% 36% 100% P value <0.0001 <0.0001 < 140/90 >/= 140/90 total Glycemic level <120 mg% 74% 26% 100% Glycemic level > 120 mg% 64% 36% 100% P value <0.0001 <0.0001 Table1. Levels of blood Pressure related with basal glycemic level Open in new tab 280 Age-and gender-related differences in biomarker levels in patients with st-segement elevation myocardial infarction T Pecherina1, V Kashtalap2, O Barbarash2, E Zhuravleva2 1Research Institute for Complex Issues of Cardiov. Dis. - Siberian Branch RAMS Institution Scientific, Kemerovo, Russian Federation 2Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation Topic: Risk factors: others Previous studies have proved the undeniable role of some of the matrix metalloproteinases (MMPs), proinflammatory cytokines and other inflammatory markers in the pathogenesis of myocardial infarction (MI) [P. Libby, 2009, L. Nilsson 2011]. Therefore, the effects of age- and gender-related differences on biomarker levels in MI patients are actively discussed. Aim: To determine age- and gender-related differences of serum biomarker levels in patients with ST-segment elevation myocardial infarction. Materials and Methods: A prospective cohort study was conducted with 175 consecutive patients with STEMI. The mean age of all patients was 61.3 ± 8.4 years, of whom 116 (66.3%) were males and 59 (33.7%) were females. Serum concentrations of interleukin (IL-6, IL-10, IL-12), C-reactive protein (CRP), tumor necrosis factor-a (TNF-a) and MMP-1, -3, -9 (pg / ml) and blood lipid parameters were measured in all patients on days 1 and 12 of the onset of myocardial infarction with the ELISA. Results: The analysis of age- and gender-related differences in the levels of MMP in STEMI patients reported significant increases in levels of MMP-3 in males aged 65 years or older by 25.6 % on day 1 and by 31.1 % on day 12 compared to males aged < 65 years. Females also demonstrated significant differences in the levels of MMP-1, -3. Thus, the MMP-1 levels on day 1 increased 2-fold in females in the older age group compared to females aged < 65 years [2.12 (0.3; 16.9) vs. 1.24 (0.3; 19.5]). The levels of MMP-3 increased in the group of females older 65 years by 25.6% on day 1 and by 31.1 % on day 12 compared to the group of females aged < 65 years. Thus, significantly higher levels of IL-12 and IL-6 have been found in both female groups (p <0.05). However, no significant differences in the levels of CRP, TNF-a, IL-10 were present between females and males in the total group and age-subgroup analyses. The correlation analysis between inflammatory markers (CRP, TNF-a, IL-6, -10, -12) and age of the patients reported a significant inverse correlation with age and IL-10 on days 1 (r = -0.39, p = 0.001) and 12 (r = -0.41, p = 0.001) of the STEMI course. Conclusion: The age of STEMI patients over 65 years for both males and females is associated with higher levels of MMP-1 (for females) and MMP-3 (for males and females), as well as IL-6 and IL-12. 281 CAVI relates to left ventricular diastolic dysfunction in sleep apnea syndrome patient T Yamamoto1, K Shimizu2, K Shirai2 1Toho University, Graduate school of medicine, Tokyo, Japan 2Toho University Sakura Medical Centre, Internal medicine, Sakura, Japan Topic: Risk factors: others Background: Recently, a novel arterial stiffness parameter called the Cardio-Ankle Vascular Index(CAVI) has been developed which essentially reflect the stiffness of the aorta, femoral and tibial arteries. CAVI's main feature is independent of blood pressure at the measurement time. This parameter is reported the relation between atherosclerotic disease and their risk factors. Furthermore, CAVI reflects not only the organic arterial stiffness but functional stiffness. The left ventricular dilatation dysfunction expresses load on the heart, but its relationship with arterial stiffness in the sleep apnea syndrome (SAS) patient has not been fully clarified. Purpose: We evaluated the correlation between arterial stiffness and left ventricular diastolic dysfunction in SAS patients. Method: The subjects were 106 patients (81men and 25women) who were measured using polysomnography (PSG) because of their examination of cardiovascular risks. Their apnea hypopnea index (AHI) was more than 20 times par hour by PSG. We investigated the correlations between the parameters of the PSG, echocardiography and arterial stiffness using cardio-ankle vascular index (CAVI) at the same day. CAVI was measured using a Vasera 1500 (Fukuda Denshi). Arterial stiffness was measured using CAVI and left ventricular diastolic dysfunction was evaluated using echocardiography. Result: The patients characteristics follows as below. Age was 64.7(10.5) years old, body weight was 71.1(13.3) kg, body mass index was 26.3(4.0) kg/m2, CAVI was 9.1(1.1), AHI was 47.1(19.7) times par hours, ejection fraction was 61.3(14.8)%, E/e' was 13.3(4.8). We evaluated the correlations of various parameters in relation to CAVI in SAS patients. E/E' (r=0.22, p<0.05) showed significant associations with CAVI. Conclusion: It is suggested that CAVI was correlated with left ventricular diastolic dysfunction in SAS patients. 282 The importance of carotid arterial stiffness measurement in patients with ischaemic heart disease BM Bjelobrk1, MT Miljkovic2, DS Dodic1, IA Ilic1 1Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia 2Institute of cardiovascular diseases of Vojvodina, cardiology, department of hypertension, Sremska Kamenica, Serbia Topic: Risk factors: others Introduction: Arterial stiffness is one of the earliest manifestations of structural and functional changes in the wall of blood vessels. Arterial stiffness is recognized as a surrogate marker of cardiovascular disease has an independent predictive value of total and cardiovascular mortality with higher predictive value in patients with higher baseline cardiovascule Objective: To determine the existence of interconnection of arterial stiffness and risk factors of coronary heart disease and whether arterial stiffness is able to predict future cardiovascular events. Methods: The study included 51 patients of both gender who were treated for acute coronary syndrome, with one or more cardiovascular risk factors. Everyone made the morphological and functional assessment of the vascular system, measuring intima-media thickness (IMT) of the posterior wall of the common carotid arteries and measurement of local, carotid arterial stiffness using the technology RF-QAS on both sides. Results: Statistically significant correlation was between diabetes mellitus (DM) and pulse wave velocity(PWVd) (p = 0.009). The difference of mean values of systolic blood pressure (SBP), pulse pressure (PP) and IMT between patients with values pulse wave velocity index (PWVl(above and below 7.5 m / s was statistically significant (p = 0.044; p = 0.046 and p = 0.004). The difference of mean values of IMT between patients with values PWVd above and below 7.5 m / s was statistically significant (p = 0.015). Results of univariate binary logistic regression showed that DM, SBP, PP, IMT and the degree of coronary artery disease affecting the occurrence of elevated levels PWVl and PWVd. According to ROC analysis determined that PWVl and PWVd can be a good markers for the occurrence of three-vessel coronary artery disease. Conclusions: Arterial stiffness correlates with risk factors associated with atherosclerotic changes in the arterial wall and provides their early identification, irrespective of the IMT. Arterial stiffness is important in predicting future cardiovascular events and may be a marker to predict three-vessel coronary artery disease. 283 Lipid metabolism in pregnant women from standpoint of burdened heredity ME Evsevyeva1, OV Sergeeva1, AV Rusidi1, EN Fursova1, II Pokhorenko-Kolomoytseva1 1Stavropol State Medical University, Stavropol, Russian Federation Topic: Risk factors: others Relevance: hypercholesterolemia is one of the major risk factors for cardiovascular disease (CVD). At same time some authors considered increased level of Cholesterol (C) during pregnancy (P) as physiological. However, number of studies allows to consider elevated levels of C during P as predictor of future CV events. The importance of objective assessment of fluctuations of atherogenic lipids during gestation is very relevant due such reason as existing prohibition of receiving statins during pregnancy and lactation. Aim - study the dynamics of total Cl and triglycerides (T) in different trimesters of P in view of features of negative heredity for early CVD. Materials and methods: 58 individual cards of pregnants aged 21 to 38 years were analysed. Following parameters were evaluated: body mass index (BMI); family history (FH), C and T levels in each trimester of P. In view of the presence / absence of family history two groups were identified: 1st group (n = 28) - pregnants with burdened FH of early CVD and 2nd group (n = 30) – pregnants without such FH. Results: The groups were matched for age (29,8 ± 1,3 and 28,3 ± 1,5, respectively, in groups 1 and 2). Baseline BMI values in both groups did not differ in the same -23.89 ± 1.5; 23,98 ± 1,3 kg \ m2 respectively. C levels in I-trimester in both groups were normal values: 4.6 ± 0.2 and 4,7 ± 0,15mmol/l (p> 0,05). In the II-trimester the mean value of C in the group with burdened FH was significantly higher compared with the comparison group - 6.2 ± 0.3 and 5.1 ± 0.2 mmol / l, respectively. The values of the analyzed indicator in III-trimester amounted to 5,6 ± 0,4 in 1st group and 5,8 ± 0,3 mmol / l in 2nd group (p> 0,05). Dynamics of T in group with FH characterized by gradual inlarge in values with increasing gestational age. In another group with negative FH maximum value of this indicator recorded in II trimester, and improvements over baseline was 80%. Conclusions: in pregnants with history of early CVD in close relatives in the II trimester is recorded higher level of C and T levels compared with women who have not burdened heredity. Probably, significant hormonal changes that occur during P, contribute to improvement of these indicators in the presence of unfavorable heredity. It is also possible that described lipid changes can detect predisposition to their increasing in the future life of this group of women. It is need further prospective studies to address the question of possible relationship of the detected biochemical abnormalities with increased CV risk in these women in the future. 284 Nicotinic dependance and smoking cessation evaluation among healthcare workers K Mzoughi1, I Zairi1, R Ben Said1, S Hannachi1, F Ben Moussa1, S Kamoun1, S Fennira1, S Kraiem1 1Habib Thameur Hospital, Department of Cardiology, Tunis, Tunisia Topic: Risk factors: others Introduction: In Tunisia, smoking is a public health problem. While smoking is forbidden in public structures, particularly hospitals, the current legislation is not applied. Thus, Hospital's staff implication in smoking-cessation strategies remains essential. Aim: To evaluate nicotinic dependence and motivation to stop smoking among the hospital staff in order to elaborate a smoking-cessation strategy at the hospital. Methods: Transversal, descriptive study based on an anonymous self-survey given to the Hopistal staff. Tobacco dependence was assessed by the Fagerstr�est and motivation to stop by the Richmond's test. Results: R貵ltats : 51.49% of the staff answered the survey. The mean age of the respondents was of 43 ± 12 years and smoking's prevalence was of 28% among respondents. The majority of respondents were male (90.2%), 33% of respondents were nurse and 35.7% of respondents were heavy smokers (more than 20 cigarettes per day). A strong tobacco dependence, assessed by the Fagerstr�est, was observed in 32.3% of the staff, from which 79% had planned to stop smoking and 32.2% had a good motivation to stop smoking, as assessed by the Richmond test. The univariate analysis showed that male gender and age above 40 years were significantly associated with high tobacco dependence. The Fagerstr�est showed that a history of smoking superior to 10 years, a time to first cigarette less than 5 minutes after waking-up and a number of cigarettes smoked per day over 20 were significantly associated with high tobacco dependence. However, strong nicotine dependence was not associated with stressful work condition and the proper motivation to stop smoking. In a multivariate analysis, predictors strong dependence to nicotine were found to be a time to first cigarette less than 5 minutes after waking-up (p <0.0001), a number of cigarettes smoked per day over 20 (p = 0.001) and smoking during illnesss (p <0.0001). Conclusion: Extent of smoking among workers in the hospital and the high motivation to stop smoking highlight the need of a smoking-cessation strategy in the hospital associated with tobacco weaning. 285 Changes in carbohydrate metabolism depending on the functional capasity of the kidneys in nondiabetic patients KH Semegen-Bodak1, OYU Buchko1, V Bodak2 1Danylo Halytsky Lviv National Medical University, Lviv, Ukraine 2Lviv Regional Clinical Hospital, Lviv, Ukraine Topic: Risk factors: others Purpose: Identify the relationship of kidney function with lipid metabolism and the level of glycosylated hemoglobin (HbA1c) in patients with chronic kidney disease (CKD) nondiabetic origin. Materials and methods: The study involved 65 patients with nondiabetic CKD (43 men and 22 women, mean age 59,09±1,46 years). Depending on the glomerular filtration rate (GFR) the patients were divided into 3 subgroups: 1st - 27 with GFR =60 ml/min, 2nd - 18 with GFR 59-30 ml/min, 3rd - 17 with GFR <30 ml/min. Control group - 20 healthy individuals. Determined: the levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL-cholesterol), triglycerides (TG) and glycosylated hemoglobin (HbA1c). Results: In 95,2% patients of the total group had significantly higher than the target level of TC (mean value - 4,12±0,12 mmol/l). The average level of TC (mmol/l) increased with decreasing of GFR, significantly exceeding the value of the control group (p<0,001): 5,45±0,26 (1st), 5,91±0,43 (2nd), 6,37±0,56 (3rd). Increasing of the levels of LDL-cholesterol, above target values, recorded in all (100%) patients. In the total group, its value was 3,65±0,18 mmol/l, which is in 1.5 times higher than the level of control (p<0,001). LDL-cholesterol level (mmol/l) increased with the decreasing of GFR: from 3,32±0,21 (1st) and 3,77±0,34 (2nd) to 4,12±0,44 (3rd), which was significantly higher than in controls (p<0,001). The average level of TG was elevated in 64,5% of patients. With decreasing of GFR proportion of patients with hypertriglyceridemia increased from 48,1% (1st) to 66,7% (2nd) and 88,2% (3rd). The levels of TG (mmol/l) were: 1,95±0,12 (1st), 2,02±0,19 (2nd) (p<0,001, compared to the control), 2,32±0,28 (3rd) – in 1,2 (p<0,05) and in 2,7 times (p<0,001) higher than in the 1st subgroup and control, respectively. Increased levels of HbA1c =7% were recorded in 41,9% persons of the total group, and were significantly higher in the 2nd (50%) and 3rd subgroups (58,8%), compared with 1st (25,9%). In the 1st subgroup the level of HbA1c was 6,53±0,20%, in the 2nd - increased to 7,25±0,41% (p<0,05), in the 3rd reached 7,48±0,36%, which was in 1,2 times higher than the level of the 1st subgroup (p<0,01). Elevated levels of HbA1c were recorded in patients with CKD in the background of normal glucose values. Conclusion: Patients with CKD nondiabetic origin had a significant increasing of atherogenic lipid fractions (TC, LDL-cholesterol, TG) and increased levels of HbA1c on a background of normal glucose values. The combination of this disorders may significantly increase the risk of cardiovascular complications. 286 The forgotten cardiovascular risk factors in patients with ST-segment elevation myocardial infarction. what their prevalence and importance? J Lujan Valencia1, MJ Cristo Ropero1, M Butron Calderon1, N Garcia Gonzalez1, p Villar Calle1, M Almendro Delia1, JC Garcia Rubira1 1Virgen Macarena University Hospital, Sevilla, Sevilla, Spain Topic: Risk factors: others Purpose: Prevalence of classic Cardiovascular Risk Factors (CVRF) has been previously described in patients with acute myocardial infarction (AMI). However, the prevalence and importance of other CVRF less used in daily clinical practice has not been fully described in ST-segment elevation myocardial infarction (STEMI) patients. Methods: Observational and prospective study of patients admitted in our center with STEMI diagnosis from April-2015 to March-2016. We analyzed the presence of classic CVRF (hypertension, diabetes, dyslipidemia, tobacco use and obesity) as well as other less used CVRF (family history of early ischemic heart disease, sedentarism, stress, insomnia, overweight and depression) and their influence in STEMI. Results: We included 174 patients (Age: 62,82 ± 12,59 years; 20% women). The most frequent CVRF was hypertension (hypertension: 54,4%; dyslipidemia: 47,9%; active tobacco use: 47,9%; diabetes: 29,0%; obesity: 30,5% and previous tobacco use: 26,6%). The most frequent "forgotten" CVRF was stress (stress: 52,1%; overweight: 47,3%; sedentarism: 39,9%; insomnia: 35,0%; family history of early ischemic heart disease: 12,4% and depression: 4,2%). Family history of early ischemic heart disease was numerically more frequent in male patients (14,8% vs. 2,9%; p=0,06) while depression was more frequent in women (14,7% vs. 1,5%; p=0,001). Patients younger than 65 years had more stress (58,4% vs. 41,0%; p=0,03), family history of early ischemic heart disease (17,5% vs. 3,1%; p=0,005) and active tobacco use in comparison to patients older than 65 years, who had more diabetes, hypertension and previous tobacco use. Out of all the patients, only 29,1% of the patients thought they were having a AMI and only 34,4% requested assistance by the Emergency Medical Services (EMS). Median and mean patient delay times were 57 minutes (IQR: 20-135 minutes) and 124 minutes, respectively. Dyslipidemia was the only CVRF associated with a greater suspicion of having a myocardial infarction (39,7% vs. 19,2%; p=0,006) and this fact was associated with a higher probabiliy of requesting assistance by the EMS (53,5% vs. 29,1%; p=0,005). Finally, patients with dyslipidemia had a significantly lower patient delay time (Median delay time: 31,5 [18-90] min. vs. 62,5 [35-175] min.; p=0,001) without significant differences in the other CVRF. Conclusions: In patients with STEMI the prevalence of "forgotten" CVRF it's high, being stress and overweight the most frequent. However, dyslipidemia was the only CVRF associated with a higher suspicion of having an AMI and an earlier demand of medical assistance. A greater awareness of importance of the other classical and "forgotten" CVRF among the public is needed. 287 Predictors of acute kidney injury after coronary revascularization (surgical versus percutaneous revascularization) DR Shaimaa Mostafa1, HEBA Heba Mansour1, TA Tarek Aboelazem1, MY Mohamed Yousri2 1Benha Faculty of Medicine, cardiovascular medicine, Benha, Egypt 2National Heart Institute, CARDIOVASCULAR MEDICINE, Cairo, Egypt Topic: Risk factors: others Background: the strategy of selecting the revascularization protocol in patients with borderline syntax score is not clear and limited data is available about the comparison between both procedures in these patients. Aim: the study aimed to compare the incidence and predictors of acute kidney injury after revascularization either by CABG or PCI Methods: This is a prospective, observational, non-controlled study included 300 patients presented to National Heart Institute, Cairo, Egypt from December 2014 to November 2015 with Multivessel CAD and borderline syntax score legible for revascularization randomly divided into two subgroups 150 patients had PCI and 150 patients had CABG. All patients were subjected to demographic data analysis, clinical examination, echocardiography, baseline laboratory investigations and syntax score calculation. Follow up of kidney function by serum creatinine and eGFR within 48 hours. Results: both groups were of comparable age, gender, risk factors, echocardiographic parameters and SYNTAX score (P <0.05). The incidence of acute kidney injury was 22 % in CABG group, versus 9.3% in PCI group (P = 0.003). Hemodialysis was needed in one patient in CABG group vs non in PCI Group (p = 0.511). Multivariate logistic regression analysis showed that older age (P = 0.010), increased BMI (P =0.037), dilated LV (P = 0.049), lower Ejection Fraction (P = 0.049) and blood transfusion (P <0.001) were independent predictors of AKI after CABG. While amount of contrast was independent predictor after PCI (P <0.001) Conclusion: AKI is common after multivessel coronary revascularization and is more likely after CABG than after PCI. Predictors for AKI after CABG included older age, higher BMI, Dilated LV, lower EF and need of blood transfusion. Predictors for AKI after PCI included more amount of contrast. 288 Erectile dysfunction and sleep apnea syndrome are risk factors of cardiovascular diseases I Madaeva1, ON Berdina1, NV Semenova1, VV Madaev1, LI Kolesnikova1 1Scientific ?entre for Family Health and Human Reproduct, Somnological center, Irkutsk, Russian Federation Topic: Risk factors: others Introduction: Obstructive sleep apnea syndrome (OSAS) and OSAS-associated erectile dysfunction (ED) are highly prevalent in patients with cardiovascular diseases (CVD). But little is known about the association of low endogenous testosterone levels and abnormal sleep patterns in young males as a risk factor of CVD. Purpose: To examine the association between serum testosterone levels, lipid profile and nocturnal penile tumescence (NPT) during polysomnography (PSG) as a risk factor of CVD in OSAS young patients. Methods: Totally 39 men aged 23-45 years participated in the study. PSG was recorded on a GRASS-TELEFACTOR Twin PSG with amplifier for NPT-sensor. After PSG all participations were divided into two groups (28 patients with OSAS and 11 control patients). Serum of blood was used for definition lipid profile and testosterone level. Results: PSG data confirm altered pattern of NPT in OSAS patients. There was impairment of night spontaneous erection during REM sleep - retardation of the beginning and prolongation of detumescence (P<0.05). But the quantity of NPT was normal during the sleep. Lipid profile showed lower levels of antiatherogenic and increased levels of atherogenic cholesterol fractions with increased atherogenity index in OSAS patients compared controls (P < 0.05). In OSAS males also serum testosterone levels were significantly below than healthy males (P < 0.05). Relative risk for cardiovascular pathology was 4 times higher in OSAS and ED patients (RR=3,9; 95% CI 1,44-10,61). Attributive risk for OSAS and ED in regard to CVD was 66% (95% CI 44,6%-87,4%). Conclusion: ED, distortion of NPT–pattern, low serum testosterone levels and altered lipid profile are findings in OSAS young males. This association can be viewed as early predictor for cardiovascular pathology in this patients. 289 Cardiotoxicity after cancer treatment: a new frontier for cardio-prevention RA Clark1, A Mccarthy2, B Koczwara1, J Atherton3 1Flinders University, Faculty of Medicine, Nursing and Health Sciences, Adelaide, Australia 2Princess Alexandra Hospital and School of Nursing Queensland University of Technology, Brisbane, Australia 3Royal Brisbane and Women's Hospital and University of Qu, Brisbane, Australia Funding Acknowledgements: Australian National Heart Foundation Topic: Risk factors: others Background: Cardiotoxicity, which involves direct effects of the cancer treatment on heart function and structure, or may be due to accelerated development of CVD, especially in the presence of traditional cardiovascular risk factors. Purpose: This study developed and piloted a cardiotoxicity risk assessment questionnaire to quantify, for the first time the potential extent of cardiovascular and cardiotoxicity risk factors in breast cancer patients before treatment. Methods: The study was conducted in 2 phases. Phase 1 included content and face validity testing an expert panel consensus and Phase 2 pilot testing of the questionnaire in a sample of breast cancer patients (n=36) undergoing chemotherapy, at two Australian public hospital oncology clinics. Questionnaires were self administered, in the presence of a research assistant, during patient waiting time for third or fourth cycle of chemotherapy. Results: Mean age of the female participants was 54.8 years. Family history CVD risk factors included hypercholesterolaemenia and myocardial infarction. Participant reported their own CVD risk factors including diabetes 2.8%, hypertension 19.8%, hypercholesterolaemenia 11% and sleep apnoea 5%. Lifestyle CVD risk factors included no participants eating the recommended 5 vegetables per day and 78% not eating the recommend 2 fruits per day; 13% reported being current smokers and 75% regular consumers of alcohol, 75% reported being moderately active, 24% had little to no social support and 30% recorded high to very high K10 depression scores and sleeping less than the national average (6.7 hours v. 7.3 hours per night). 61% were overweight or obese. Unwillingness to under take lifestyle changes high Alcohol consumption 88%; Dietary habits 44%; Good emotional/mental health strategies 72%; Improve physical activity 61%; quit smoking 68% learn more about heart health 78% and loose weight 50%. Conclusion(s): This study is an important first step towards evidence-based and personalized assessment, prevention and management of treatment-associated cardiac burden after breast cancer. 290 Efficacy of a cardiovascular prevention program in patients with obstructive sleep apnoea syndrome S Masnaghetti1, C Proserpio1, AM Lucioni1, F Maslowsky1, O Mentasti1, S Sarzi Braga1 1ics maugeri, cardiology, tradate, Italy Topic: Risk factors: others Background: OSAS is a cardiovascular risk (CR) factor related to metabolic syndrome (MS); OSAS pts need a cardiovascular prevention program (CPP) to reduce global CR. Aim: To improve CR factors control in OSAS pts attending a primary CPP. Method: OSAS pts (AHI > 5) with 2 more CR factors were considered. They were evaluated at baseline and 1 yr (clinical history, weight, waist circumference, BMI, blood pressure, EKG, metabolic evaluation, Euro QoL). Therapy and counselling on diet and physical activity were administered according to guidelines. The program was carried out with pulmonologists. Results: We enrolled 76 pts, 75% male, mean age 61±10 yrs 82% hypertensive, 17% smokers and 38% former smokers, 25% affected by chronic obstructive pulmonary disease, 54% dyslipidemic 54%, 1/3 diabetic, all pts in nocturnal ventilatory non-invasive support (CPAP). Enrollement and 1 year data are reported in Table 1. Conclusion: Primary CPP improves risk factors control in high-risk OSAS pts, allows body weight and BMI reduction, improves joint cardio-pulmonary management, decreases prevalence of MS, improves quality of life, are easy to carry out and cost-effective, should be considered in National Health Policy Variables Enrollement 1 year follow-up p value Weight (kg) 98 ± 18 95 ± 18 0.002 Waist circumference (cm) 118 ± 12 117 ± 12 NS BMI (kg/m 2) 35 ± 6 34 ± 5 0.000 Systolic blood pressure (mmHg) 141 ± 19 140 ± 17 NS Diastolic blood pressure (mmHg) 84 ± 9 82 ± 10 NS Total cholesterol (mg/dl) 200 ± 44 190 ± 36 0.04 LDL cholesterol (mg/dl) 125 ± 39 114 ± 33 0.021 LDL cholesterol in diabetics pts (mg/dl) 115 ± 37 101 ± 34 0.049 HDL cholesterol (mg/dl) 44 ± 11 47 ± 10 0.001 Triglycerides (mg/dl) 157 ± 92 135 ± 58 0.019 Uricemia (mg/dl) 7.6 ± 6.9 5.7 ± 1.1 NS Glycemia (mg/dl) 111 ± 23 114 ± 34 NS CRP (mg/dl) 0.47 + 0.44 0.69 + 1.56 NS Euro QoL 71 ± 15 77 ± 14 0.003 Physical activity (%) 14 18 NS Self-defined pressure control (< 135/85 mmHg) (%) 11 61 NS Metabolic syndrome NCEPT-ATP III criteria (%) 89 67 0.000 Variables Enrollement 1 year follow-up p value Weight (kg) 98 ± 18 95 ± 18 0.002 Waist circumference (cm) 118 ± 12 117 ± 12 NS BMI (kg/m 2) 35 ± 6 34 ± 5 0.000 Systolic blood pressure (mmHg) 141 ± 19 140 ± 17 NS Diastolic blood pressure (mmHg) 84 ± 9 82 ± 10 NS Total cholesterol (mg/dl) 200 ± 44 190 ± 36 0.04 LDL cholesterol (mg/dl) 125 ± 39 114 ± 33 0.021 LDL cholesterol in diabetics pts (mg/dl) 115 ± 37 101 ± 34 0.049 HDL cholesterol (mg/dl) 44 ± 11 47 ± 10 0.001 Triglycerides (mg/dl) 157 ± 92 135 ± 58 0.019 Uricemia (mg/dl) 7.6 ± 6.9 5.7 ± 1.1 NS Glycemia (mg/dl) 111 ± 23 114 ± 34 NS CRP (mg/dl) 0.47 + 0.44 0.69 + 1.56 NS Euro QoL 71 ± 15 77 ± 14 0.003 Physical activity (%) 14 18 NS Self-defined pressure control (< 135/85 mmHg) (%) 11 61 NS Metabolic syndrome NCEPT-ATP III criteria (%) 89 67 0.000 Open in new tab Variables Enrollement 1 year follow-up p value Weight (kg) 98 ± 18 95 ± 18 0.002 Waist circumference (cm) 118 ± 12 117 ± 12 NS BMI (kg/m 2) 35 ± 6 34 ± 5 0.000 Systolic blood pressure (mmHg) 141 ± 19 140 ± 17 NS Diastolic blood pressure (mmHg) 84 ± 9 82 ± 10 NS Total cholesterol (mg/dl) 200 ± 44 190 ± 36 0.04 LDL cholesterol (mg/dl) 125 ± 39 114 ± 33 0.021 LDL cholesterol in diabetics pts (mg/dl) 115 ± 37 101 ± 34 0.049 HDL cholesterol (mg/dl) 44 ± 11 47 ± 10 0.001 Triglycerides (mg/dl) 157 ± 92 135 ± 58 0.019 Uricemia (mg/dl) 7.6 ± 6.9 5.7 ± 1.1 NS Glycemia (mg/dl) 111 ± 23 114 ± 34 NS CRP (mg/dl) 0.47 + 0.44 0.69 + 1.56 NS Euro QoL 71 ± 15 77 ± 14 0.003 Physical activity (%) 14 18 NS Self-defined pressure control (< 135/85 mmHg) (%) 11 61 NS Metabolic syndrome NCEPT-ATP III criteria (%) 89 67 0.000 Variables Enrollement 1 year follow-up p value Weight (kg) 98 ± 18 95 ± 18 0.002 Waist circumference (cm) 118 ± 12 117 ± 12 NS BMI (kg/m 2) 35 ± 6 34 ± 5 0.000 Systolic blood pressure (mmHg) 141 ± 19 140 ± 17 NS Diastolic blood pressure (mmHg) 84 ± 9 82 ± 10 NS Total cholesterol (mg/dl) 200 ± 44 190 ± 36 0.04 LDL cholesterol (mg/dl) 125 ± 39 114 ± 33 0.021 LDL cholesterol in diabetics pts (mg/dl) 115 ± 37 101 ± 34 0.049 HDL cholesterol (mg/dl) 44 ± 11 47 ± 10 0.001 Triglycerides (mg/dl) 157 ± 92 135 ± 58 0.019 Uricemia (mg/dl) 7.6 ± 6.9 5.7 ± 1.1 NS Glycemia (mg/dl) 111 ± 23 114 ± 34 NS CRP (mg/dl) 0.47 + 0.44 0.69 + 1.56 NS Euro QoL 71 ± 15 77 ± 14 0.003 Physical activity (%) 14 18 NS Self-defined pressure control (< 135/85 mmHg) (%) 11 61 NS Metabolic syndrome NCEPT-ATP III criteria (%) 89 67 0.000 Open in new tab © The European Society of Cardiology 2017 This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © The European Society of Cardiology 2017
TI - Risk factors: others
JO - European Journal of Preventive Cardiology
DO - 10.1177/2047487317703529
DA - 2017-04-01
UR - https://www.deepdyve.com/lp/oxford-university-press/risk-factors-others-4ZZsWNKiD6
SP - S51
EP - S65
VL - 24
IS - 1_suppl
DP - DeepDyve
ER -