e482 Journal of Hypertension Vol 28, e-Supplement A, June 2010
Objective: To assess the cardiovascular risk (CVR) on arterial hypertensive
patients at the moment of diagnosis, by the SCORE chart calibrated for Spain.
Design and Method: Transversal, multicenter study (patients aged 4074),
first diagnosed with hypertension, enrolled by consecutive sampling in either
!
primary health care or specialists ? consultations. Arterial hypertension was
diagnosed when mean blood pressure (BP) figures after three consecutive
visits (time-frame within visits of, at least, one week) were 140 and/or 90
mmHg. Patients with a previous diagnosis of hypertension, cardiovascular
disease, type 2 diabetes, type 1 diabetes with mycroalbuminuria, chronic
kidney disease, or very high levels of one or more CVR factors (cholesterol
>320 m/dl, LDL >240 mg/dl) were excluded. CVR was classified in four
different categories: <1%; 14%; 59%; 1014% and 15%. Other collected
data was: socio-demographics, clinical and analytical, and CVR factors data.
This study was approved by an IRB (Hospital La Paz, Madrid).
Results: 324 physicians (76.5% from Primary Health Care) enrolled 1500
patients (57.8% male; mean age (
SD) 57.1
7.7). 35.7% were smokers
(46.1% male; 21.5% female; p < 0.001). Mean systolic and diastolic BP were
156.3 (
12.0)/92.5 (
8.1) mmHg, and mean total cholesterol was 217.7
(
40.3) mg/dl, with no significant gender differences in both endpoints. At
diagnosis, 53.9% of the sample presented a CVR of 14%; 25.9% of 59%;
13.5% of 1014%; and 7.3% of 15%. Mean CVR was 4.8%, median 3%.
Statistically significant differences were found in CVR figures referred to
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patient ?s gender, with a mean of 6.5% (5.4) in males and 2.5% (2.3) in
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females (p < 0.001). An increase of CVR with increasing patient ?s age
(p < 0.001) was also found.
Conclusions: Above 4 out of every 10 patients diagnosed with arterial
hypertension for the first time presented a high-very high CVR, according
to SCORE chart for Spain. Diagnosis of arterial hypertension and earlier
medical intervention on CVR factors, in these patients, will reduce the
chance of suffering CV events over the next 10 years.
PP.28.110 PREVALENCE OF ARTERIAL HYPERTENSION OF
FEMALE POPULATIONFORCED MIGRANTS OF
SUMGAIT
A. Musayeva, A. Zeynalov, A. Humbatova. Azerbaijan State Advanced Institut
for Doctors, Baku, Azerbaijan
Objective: To study the prevalence the structure of arterial hypertension
(AH) in population of the forcet miqrants of female of Sumqait.
Methods: It has investigated 952 females who were divided into 4 age
groups: aged 2029 (187), aged 3039 (287), aged 4049 (229), aged 5059
(253). Arterial hypertension was measured twice in the position sitting
after 10 minutes rest. It was difind general cholesterin (GH), gluceryls (G),
cholesterin lipoproteids of high density (CLHD), cholesterin lipoproteids of
low density (CLLD) in blood plasma. It was conducted ECHO cardiographic
investigation (ECHO-CG) with the object of left ventricle hypertrophy.
Results: Prevalence of AH formed 30,5
1,0 per cent. The age dynamics was
positive from minimal aged 2029 (7,0
1,9 per cent) to maximum aged 50
59 (64,4
12,6 per cent, p < 0,001). The structural analysis showed in the
group aged 2059 women that AH of the 1-st degree (14,2
1,1 per cent) had
been registred more often, AH of the 2-nd degree (9,6
1,0 per cent) less and
AH of 3-rd degree (6,7
0,8 per cent) still less. The concentration of general
cholesterin (GC) in blood plasma fomed - 9,80 per cent, G 5,20 per cent,
CLHD 5,80 per cent, CLLD 4 per cent. Mass of left ventricle
myocardium (MLVM) was the highest in the persons with concentric
hypertrophy (CH) of left ventricle (329
17,8). With eccentric hypertrophy
(EH) of left ventricle (275,9
13,9). Index of mass of left ventricle myo-
cardium (IMLVM) was the highest in CG (211,2
11,98 g/m) and EG
(180,1
8,9 g/m) in comparison with the criteria of LVH, FDV was marked
(119,1
3,6 ml and 51,6
5,1 ml) in the persons with CG and EG.
Conclusion: Thus high prevalence of AH was marked in the female popu-
lation, prevailed AH of the 1-st degree that showed unfavourable epidemio-
logic situation. The obtained results should take into consideration during
working out of measures in the primary and secondary prophylaxis of AH.
PP.28.111 MANAGEMENT OF HYPERTENSIVE CRISIS IN THE
EMERGENCY DEPARTMENT, AN ITALIAN
EPIDEMIOLOGICAL STUDY. PRELIMINARY DATA
L. Magrini, S. Vitali, S. Santarelli, B. De Berardinis, C. Bongiovanni, F. Tega,
E. Ferri, S. Di Somma. A.O. S.Andrea-Emergency Dept.-University of Rome La
Sapienza, Rome, Italy
Introduction: Aim of our experimental epidemiological study was to improve
the understanding of the clinical condition of acute, severe hypertension
managed in the Emergency Department (ED). We evaluated epidemiolo-
gical data of the in-hospital mortality, end-organ damage, time to achieve
controlled blood pressure. We show preliminary data collected in the period
October-December 2009.
Patients and Methods: 48 patients were studied until now (28F,20 M,mean
age 68.6yrs) arriving in ED with elevated blood pressure (BP). We recorded
anamnestic data, physical examination, blood tests, levels of BP leading to
initiation of treatment, antihypertensive medications used, time required to
achieve blood pressure control, in-hospital outcomes.
Results: mean Sistolic BP/Diastolic BP(SBP/DBP) at admission was 212.3/
105.8 mmHg(mean BP 141.3mmHg), and at pressure control (after mean
5.5 hours) was 143.7/76.5 mmHg(mean BP 98.9mmHg). Medications used
for BP control were in 93.7% of cases intravenous drugs (iv), and in a short
percentage of cases oral drugs (6.3%). Patients presented history of hyper-
tension 70.8%, diabetes 20.8%, cardiac ischemic disease 25%, chronic
cerebro-vascular disease 6.2%, chronic kidney failure 2%.
The in-hospital outcomes consist mainly in hospitalization (66.7%) for
complications, or for those cases of poor pressure control after more than
24 hours of stay in ED (8 patients). No patients died in ED. 29/48 patients
completed a 30-days follow-up, and no events have been recorded until now.
Conclusions: Preliminary data, show that hypertensive crisis is 1% of the
total visits in our ED in a period of 3 months. In ED it is treated mainly with
iv drugs, but also oral drugs are used. This indicates that ED physicians
decision making for hypertension therapy is not standardized yet. The time
required in pressure control is 5.5 hours, and this mirrors the different
behaviours of ED physicians based on individual skill and experience.
We are continuing the study to achieve a larger number of data useful to
build a sort of standardized protocol for the diagnosis and treatment of
hypertensive crisis in ED.
PP.28.112 CONTROL RATE ACCORDING TO THERAPEUTIC
OBSERVANCE IN A COHORT OF HYPERTENSIVE
PATIENTS TREATED WITH A COMBINATION OF
TELMISARTAN AND HYDROCHLOROTHIAZIDE:
PROTECT PLUS STUDY
C. Mounier-Vehier1, A. Sanchez-Ponton2, P. Delsart1, D. Miljkovic3. 1Hopi-
tal Cardiologique, Service Medecine vasculaire et Hypertension, Lille, France,
2
Biostatem, Castries, France, 3Groupe Therapeutique Cardiovasculaire/Thrombose,
Unite Affaires Medicales Boehringer-Ingelheim, Reims, France
Objectives: The purpose of this study was to compare the control rate according
to the observance assessed by the questionnaire of the French Committee of
Fight Against Hypertension (CFLHTA) including 6 questions.
Method: PROTECT PLUS is an pharmaco-epidemiologic study with
assessment of the observance. An observance was rated as good if the patient
answered NOT all the questions, average if he answered YES one or
two questions and poor if there were more than two answers YES.
Results: 3443 patients out of 4255 were included in the analysis. Observance
was good for 34.2% of the patients, average for 56.1% and poor for 9.7%. We
observed a significant difference on control rate (SBP/DBP < 140/90 mm
Hg) with 38.2%,44.8% and 48.0% of control rate for poor, average and good
observance respectively (p 0.0004). The patients having a poor observance
were more sedentary compared to the patients having a good observance. In
the same way, they were more often and significantly diabetics and dyslipi-
demic, had more abdominal obesity and consumed more alcohol than the
patients with a good observance. Poor observing had more often left
ventricular hypertrophy and microalbuminuria than good observing;
furthermore, they had significantly more history of Stroke/TIA and periph-
eral artery disease.
Conclusion: More than half of the patients was not correctly observing. One
found a significant correlation between observance and control rate of blood
pressure. Unfortunately the population of poor observing, which had
weakest control rate, was also which had the most comorbidities and more
at high-risk of developing cardiovascular events. An increased sensibilization
of this high-risk population to the therapeutic observance by educational
programs and specific follow up appear to be essential.
PP.28.113 TWENTY-YEAR TRENDS IN CARDIOVASCULAR RISK
FACTORS AMONG SWEDISH MEN: IMPACT OF
OVERWEIGHT AND OBESITY
T. Cars1, L. Lind1, M. Neovius2, J Sundstrom1. 1Uppsala University - Dept.
Medical Sciences, Uppsala, Sweden, 2Karolinska Institutet - Clinical Epidemiology
Unit, Stockholm, Sweden