Abstracts e169
respond was 85.0%. AH was defined as condition when systolic blood pressure
(SBP) was >140 mmHg and/or diastolic blood pressure (DBP) was >90 mmHg
in people who did not receive antihypertensive therapy during the examination
period and in people with BP < 140/90 mmHg who had antihypertensive therapy
during the examination or stopped taking antihypertensive medications less than
two weeks prior to the examination. The Spielberger State-Trait Anxiety Inventory
(STAI) self-estimation scale was suggested to assess TA. Mathematical data treat-
ment was conducted by a package of application programs IBM SPSS Statistics.
Results: AH prevalence in males aged 25–64 years was 48.7%. Statistically sig-
nificant differences of AH prevalence and general population value were revealed
in age groups: 25–34, 45–54 and 55–64 years. Age-adjusted value of high TA
prevalence was 36.6%, mean TA – 55.8% in males aged 25–64 years of open pop-
ulation. Together with age, high TA was also growing reaching its maximum in
the age category 55–64 years (50.0%). Mean TA was in its top in males of 25–34
years, where it reached its statistically significant maximum in comparison with
the value in the age group 55–64 years (62.1–42.5%, p < 0.001). Statistically im-
portant regularities of TA levels were defined in the groups of the examined males
with the revealed AH. Thus, AH prevalence was significantly higher in mean and
high TA compared to the values in low TA. At the same time, AH prevalence was
significantly higher in mean TA as well relating to the prevalence in high TA.
Conclusions: Consequently, the presented data on the open population of mid-
dle-urbanized Siberian city demonstrate high need in cardiovascular diseases pre-
vention in males of a workable age with TA.
CARDIOVASCULAR RISK FACTORS IN SYSTEMIC LUPUS
ERYTHEMATOSUS WITH HYPERTENSION
W. Baya, J. Anoun, I. Ben Hassine, A. Mzabi, M. Karmani, F. Ben Fredj Ismail,
A. Rezgui, C. Laouani Kechrid. Internal Medicine Department - Sahloul Univer-
sity Hospital, Sousse, TUNISIA
Objective: Systemic lupus erythematosus (SLE) is a systemic disease that affects
the young women with predilection. It is associated with a high cardiovascular
risk related to atherosclerosis accelerated by different mechanisms, thus increas-
ing morbidity and mortality during SLE.
Design and method: This is a retrospective study of the 67 patients with SLE
hospitalized at least once in the internal medicine department of Sahloul Hospital
in Sousse between January 1st, 2011 and January 1st, 2017.
Results: Twenty-four patients were found with hypertension: 22 women and 2 men.
The occurrence of hypertension was on average 5.4 [0 - 21] years after of the
diagnosis of SLE. The plausible etiology was attributable to SLE in 14 cases,
corticoid-induced in 17 cases and secondary to renal failure in 7 cases.
SLE has been evolving in our patients for an average of 12 years [3–28]. The
occurrence after the age of 40 was noted in seven cases. Lupus nephropathy was
present in 15 cases. Treatment was based on long-term corticosteroid therapy (n
= 24), synthetic anti-malarials (n = 20), immuno-suppressants (n = 18), and bio-
therapy (n = 2). Eight patients were taking non-steroidal anti-inflammatory drugs
for at least 3 years.
Several other cardiovascular risk factors were found in this hypertensive population.
Two patients were smoking. Seven were diabetic with an average evolution of 7.3
years. Obesity was noted in 12 patients. Dyslipidemia was found in 9 cases and
hyper-homocysteinemia in 6 cases. A sedentary lifestyle was reported in 23 cases.
Chronic renal failure was found in 7 patients.
The number of cardiovascular risk factors was 4.9 [2 - 8] per patient. Ten patients
had atherosclerosis. In 4 of them, it was documented by a carotid ultrasound imag-
ing. The remaining six had ischemic heart disease (n = 5) and / or cerebrovascular
accident (n = 3).
Conclusions: SLE is associated with accelerated atherosclerosis and a high risk
of developing cardiovascular disease in young patients, especially when associ-
ated with hypertension. A better understanding of the pathophysiology of hyper-
tension during SLE would improve the prognosis.
CARDIOVASCULAR RISK FACTORS IN PATIENTS AFTER LIVER
TRANSPLANTATION
M. Adamczak1, D. Gojowy1, J. Stompor1, J. Struminska1, G. Smiech1, H. Karkoszka1,
R. Krol2, A. Wiecek1. 1Medical University of Silesia - Department of Nephrology,
Transplantation and Internal Medicine, Katowice, POLAND, 2Medical University
of Silesia - Department of General, Vascular and Transplant Surgery, Katowice,
POLAND
Objective: Liver transplantation (LTx) is the only treatment of end-stage liver
cirrhosis as well as in patients with hepatic cell carcinoma. Cardiovascular com-
plications may significantly worsen the long-term outcome in patients after LTx.
Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
The aim of this study was to estimate the prevalence of selected cardiovascular
risk factors in LTx patients.
Design and method: Medical records from 130 patients aged 49.3 ± 11.9 years
(52F, 78 M) before and 2 years after LTx were analysed. The prevalence of dia-
betes mellitus, arterial hypertension, hypertriglyceridemia, hypercholesterolemia,
obesity and cigarette smoking were estimated. Among the studied population, 3
groups of the most common aetiology of liver cirrhosis (alcoholic, viral, autoim-
mune) were selected.
Results: The prevalence of diabetes mellitus before and 2 years after LTx was
18% and 48%, respectively (P < 0.001). Arterial hypertension in 24% and 70%
(P < 0.001), hypertriglyceridemia in 15% and 38% (P < 0.001), hypercholester-
olemia in 16% and 46% (p < 0.001) of patients before and 2 years after LTx were
observed, respectively. 13% and 18% of patients were obese before and 2 years
after LTx, respectively. Cigarette smoking was admitted by 24% before LTx and
10% of patients 2 years after LTx (P < 0.001). In patients with an autoimmune
cause of liver cirrhosis in comparison to patients with alcoholic disease diabetes
(38% vs 67%, P = 0.02), hypertriglyceridemia (19% vs 63%, P < 0.001), hyper-
cholesterolemia (28% vs 67%, P = 0.002) and obesity (9% vs 33%, P = 0.02)
occurred less frequently.
Conclusions: 1. Prevalence of arterial hypertension and abnormalities of glucose
and lipid metabolism increase significantly after LTx. 2. The aetiology of liver cir-
rhosis before transplantation may influence the prevalence of cardiovascular risk
factors in patients after LTx.
INITIATION OF ANTIHYPERTENSIVE THERAPY BASED ON
CURRENT HYPERTENSION GUIDELINE – DO AMERICAN AND
EUROPEAN APPROACH DIFFER?
A. Erina1, O Rotar1, S. Shalnova2, Y. Balanova2, A. Deev2, I. Chazova3,
S. Boytsov3, A. Konradi1, E. Shlyakhto1. 1 Almazov National Medical Research
Centre, Saint Petersburg, RUSSIA, 2National Research Center for Preventive
Medicine, Moscow, RUSSIA, 3Russian Cardiology Research and Production Com-
plex, Moscow, RUSSIA
Objective: New guidelines on hypertension were published by the American
Heart Association in 2017 and by the European Society of Cardiology in 2018.
The aim of the present study is to compare necessity of antihypertensive therapy
in population-based sample of the Russian Federation (RF) inhabitants according
to new American and European hypertension guidelines.
Design and method: Epidemiological survey of cardiovascular risk in regions
of RF with different geographic, climatic, economic and demographic charac-
teristics (ESSE-RF) was performed in a multi-step stratified random sample of
approximately 1600 participants in 12 regions (Volgograd, Vologda, Voronezh,
Vladivostok, Ivanovo, Kemerovo, Krasnoyarsk, Orenburg, Tomsk, Tyumen,
Saint-Petersburg and Northern Osetia-Alania). Totally 20652 participants aged
25–65 years were obsessed. All subjects signed informed consent and filled vali-
dated questionnaires regarding lifestyle, concomitant disease and medication.
Anthropometry, fasting blood sampling, blood pressure (BP) measurement were
performed. Cardiovascular risk was calculated by SCORE. According to Ameri-
can guidelines (AHA2017) hypertension stage 1 was determined when SBP =
130–139 mmHg or DBP = 80–89 mmHg. According to European guidelines
(ESH2018) high normal BP was determined when SBP = 130–139 mmHg or
DBP = 85–89 mmHg. Antihypertensive therapy is needed to be prescribed in stage
1 AHA 2017 and high normal BP ESC 2018 in case of high cardiovascular risk).
Risk was calculated according to European SCORE risk chart. We estimated the
number of Russian inhabitants needed the initiation of antihypertensive therapy
according to the new guidelines. Statistical analysis was performed using SPSS
statistics 20.
Results: Data of 20607 participants were available for analysis (7806 males
(37.9%) and 12801 females (62.1%)). Antihypertensive therapy was already taken
6324 persons (30.7%).
Conclusions: Despite American hypertension guidelines 2017 have the lower
threshold of hypertension detection comparing with European hypertension
e170 Journal of Hypertension Vol 37, e-Supplement 1, June 2019
guidelines 2018, necessity of antihypertensive therapy initiation in European
population according to SCORE high risk is comparable.
HYPERTENSION AND ANTIHYPERTENSIVE THERAPY IN HF
PATIENTS ACCORDING TO GENDER
K. Koutsampasopoulos1, K. Imprialos1, K. Stavropoulos1, I. Vogiatzis1,
A. Pittaras2, C. Grassos3, A.J. Manolis2, C. Faselis4, P. Kokkinos4, P. Pantelidis1,
K. Avranas1, M. Doumas1,4. 12nd Propedeutic Department of Internal Medicine,
Hippokration Hospital, Thessaloniki, GREECE, 2Cardiology Department, Askle-
peion Hospital, Athens, GREECE, 3Cardiology Department, KAT Hospital, Ath-
ens, GREECE, 4VA Medical Center and George Washington University, Washing-
ton, DC, USA
Objective: The relation between hypertension and heart failure (HF) is well es-
tablished. Most studies report a higher prevalence of HTN in men compared to
women, but it is not clear whether HF patients share the same gender epidemio-
logical characteristics, regarding the prevalence of hypertension. In the present
study we aim to define the prevalence of hypertension in male and female patients
with HF and to detect possible differences that may influence their therapeutic
approach.
Design and method: Patients with a clinical diagnosis of HF were evaluated in
a cross sectional study. Office systolic and diastolic blood pressure (SBP, DBP)
were measured, and previous history of hypertension was recorded as well, in both
genders. Finally, treatment with antihypertensive drugs was also recorded and a
comparison of their utilization among genders was performed.
Results: Overall, 205 men and 101 women with HF participated in the study.
Women had more frequent a history of hypertension compared to men (87.6%
vs 73.1%, p = 0.004). No statistical significant differences were noticed between
genders regarding office SBP and DBP (p = 0.279 and p = 0.728, respectively).
Men were treated more frequent with angiotensin II receptor blockers and min-
eralocorticoid receptor antagonists (p = 0.029 and p = 0.004, respectively), and
women with calcium channel blockers (p = 0.027); no difference was observed
regarding treatment with other categories of antihypertensive drugs.
Conclusions: Hypertension is highly prevalent in HF patients, especially in
women. Gender differences in antihypertensive drug treatment exist, and might
be explained by gender differences in the underline etiology of HF.
TARGET ORGANS INJURY IN PATIENTS WITH ARTERIAL
HYPERTENSION IN THE ARCTIC CONDITIONS
L. Gapon1, N. Shurkevich1, A. Vetoshkin1, D. Gubin2. 1 Tyumen Cardiology Re-
search Center, Tomsk National Research Medical Center, RUSSIAn Academy
of Sciences, Tyumen, RUSSIA, 2Tyumen State Medical University, Ministry of
Healthcare of the Russian Federation, Tyumen, RUSSIA
Objective: To define the most important factors that influence on the forming of
left ventricular (LV) myocardial hypertrophy and atherosclerotic plaque (ASP) in
common carotid arteries (CCA) in people with arterial hypertension (AH) in the
Arctic watch.
Design and method: The study involved 373 people with AH doing the Arc-
tic watch (71°N) (group 1) and 144 people with AH living in the mild climate
(57°N) (group 2); the groups matched by age 46.0 ± 6.0 (p = 0.445), office systolic
blood pressure (SBP) / diastolic blood pressure (DBP) 157.5/153.9 (p = 0.322);
106.7/100.3 (p = 0.0640). In patients standard and cosinor-analysis of 24-hour
BP monitoring, echocardiography, CCA ultrasound examination were performed;
blood lipids and risk factors (RF) were defined.
Results: Gr.1 had lower 24-hour SBP (p < 0.001), higher 24-hour DBP (p <
0.0001) than in Gr.2; 30% of AH people (Gr.1) were normotonic patients (24-hour
SBP/24-hour DBP < 130/80 mmHg). Gr.1 had elevated night SBP and night DBP,
Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
high variability of 24-hour SBP, DBP (p < 0.001) and heart rate (HR) (p < 0.001).
LV mass (LVM) and LVM index (LVMI) in Gr.1 were higher (p = 0.0002, p =
0.0024), concentric LV hypertrophy (52.5% vs 36.8%, p = 0.0014) was defined
more often due to thickness of interventricular septum and LV posterior wall (p
< 0.0001). Cosinor-analysis of 24-hour BP monitoring in Gr.1 showed lowering
of 24-hour rhythm of SBP/DBP and domination of 12-hour rhythm, 8.0-hour and
ultradian periodics in BP daily rhythm. Correlations of LVM with 24-hour BP
monitoring in Gr.1 were defined not higher than r = < 0.21 with BP chronostruc-
ture r=>0.45. Frequency of ASP in CCA was noticed 2.5 times more often in
Gr.1. Analysis of logistic regression revealed significant positive dependence of
the chance of ASP in CA lumen imaging on age, intima-media complex thickness
(IMCT), psychoemotional load and negative dependence with BP. Formula of lo-
gistic regression: ASP = –13.746 + 0.103*Age + 0.507*Overweight + 0.037*DBP
+ 0.021*SBP + 2.239*IMCT – 0.514*psychoemotional overload.
Conclusions: In the Arctic watch conditions, significant injury of target organs in
AH patients is mostly defined by disturbance of BP daily rhythm chronostructure
and risk factors typical for watch work.
TISSUE INHIBITOR OF METALLOPROTEINASES-1 DECREASE
AFTER RENAL DENERVATION AS FAVORABLE PROGNOSTIC
FACTOR FOR FUTURE CORONARY EVENTS
I. Zyubanova, V. Mordovin, S. Pekarskiy, T. Ripp, A. Falkovskaya, E. Sitkova, V.
Lichikaki, A. Baev, A. Gusakova. Cardiology Research Institute, Tomsk National
Research Medical Center, RUSSIAn Academy of Sciences, Department of Hyper-
tension, Tomsk, RUSSIA
Objective: Matrix metalloproteinases (MMP) 2 and 9 with tissue inhibitor of
metalloproteinases (TIMP) 1 were actively studied in the aspect of myocardial
early ischemia and infarctions (MI), subsequent processes of post-myocardial in-
farction left ventricular remodeling and the chronic heart failure (CHF) develop-
ment. It has been shown that elevated levels of TIMP-1 can be considered as an
independent predictor of CHF and mortality. At the same time, there are some
data demonstrated positive effects of sympathetic renal denervation (RDN) on
the extracellular matrix components changes, as well as on the processes of post-
infarction myocardial remodeling. However, the prognostic role of MMPs and
TIMP-1 in the development of coronary events (CE) (MI, the need for revascular-
ization) remains unknown.
We investigated whether MMPs and TIMP-1 changes after RDN are associated
with the risk of CE development.
Design and method: In 53 patients with resistant hypertension (RH) and isch-
emic heart disease (IHD), circulating MMPs 2 and 9, and TIMP-1 were analyzed
by ELISA before and at 12 months after RDN. All the patients were followed
prospectively for 3-years for the occurrence of coronary events (MI, need for re-
vascularization).
Results: All markers demonstrated no significant changes following RDN. Dur-
ing 3-years follow-up, 9 patients had CE (2 MI, 7 needs for revascularization).
Compared with the patients who had CE, in the other group a more pronounced
TIMP-1 decrease was observed: 98,3 (-64,2; 206,5) ng/ml in CE patients versus
-127,100 (-206,3; -57,5) ng/ml (p = 0,048). In the group without CE (n = 44)
TIMP-1 levels significantly decreased from 604,1 (441,1; 690,2) ng/ml at baseline
to 499,6 (346,2; 694,6) ng/ml at 12 month after RDN (p = 0,008). According to the
Yates corrected Chi-square test, in group with decreased TIMP-1 CE less frequent
observed (6,3% vs 33,3%, p = 0,028). Besides, TIMP-1 reduction rate correlated
inversely with the severity of coronary artery disease determined by coronary
angiography (r = ¬0,41, p < 0,05) by Spearman’s correlations analysis.
Conclusions: The present study indicates that TIMP-1 decrease after RDN could
be favorable prognostic factor for future CE within 3 years in patients with RH
and IHD.