66 32nd World Congress of Internal Medicine (October 24-28, 2014) WCIM 2014
PS 0078 Cardiology
Changes of Parameters of the Blood Coagulation Sys- tem in Patients with Essential Arterial Hypertension with Concomitant Microalbuminuria
Vasyl NETIAZHENKO1, Nonna NETIAZHENKO1, Anna PASTUSHYNA1, Ada LIAKHOTSKA1
Bogomolets National Medical University, Ukraine1
Background: 90 patients with arterial hypertension (grade 2) were examined: 1st group included 33 patients with microalbuminuria, 2nd group included 57 patients without microalbuminuria. Among patients prevailed age group 55-59 years (50%).
Methods: Venous blood samples were drawn from the cubital vein and were exam- ined for: 1)spontaneous platelet aggregation and platelet aggregation with inductors - ADP, epinephrine; 2)coagulation activity: Activated Partial Thromboplastin Time (aPTT), Thrombin Time (TT), Soluble Fibrin-Monomer Complexes (SFMC); 3)fi brinolytic activity:
XII-a dependent fi brinolysis; 4)anticoagulation activity: Antithrombin III, Protein C.
Results: There was not observed statistically signifi cant differences between the two study groups by level spontaneous aggregation and platelet aggregation with ADP.
However, the degree of aggregation with epinephrine in the group with MAU was 2.6 times higher than in the group without MAU (p<0,05). It was noted also change the speed of platelet aggregation with epinephrine, which in patients with MAU was high- er at 2.54 times (p<0,05). 1st group of patients exhibited acceleration of aPTT (14,4%
shorter in comparison to aPTT of the 2nd group (p=0,041)). It was found that by con- tent of SFMC observed a statistically signifi cant difference between the groups with the presence and absence of MAU. So in patients with MAU level of SFMC increased in 1.56 times relative to the comparison group. In patients with MAU inhibition of XII-a dependent fi brinolysis was 1.45 times higher than in the group without MAU.
Noteworthy that the content of natural anticoagulants was signifi cantly lower in both groups of patients.
Conclusions: Microalbuminuria in patients with arterial hypertension is associated with activation of thrombin and fi brin formation, and reduction of anticoagulation po- tential, which proves signifi cance of microalbuminuria in development of thrombotic complications in this group of patients.
PS 0079 Cardiology
Hypertension and Prehypertension in Obese Medical Students in Private University, Karawaci, Tangerang, Banten
Andree KURNIAWAN1, Theo Audi YANTO1, Nata Pratama Hardjo LUGITO1, Resa SETIADINATA1, Margaret Merlyn TJIANG1, Indra WIJAYA1, Stevent SUMANTRI1 Pelita Harapan University, Indonesia1
Background: Obesity is an important risk factor for prehypertension and hypertension, and there are sex-specifi c differences in prevalence of obesity and hypertension. There is limited data about prehypertension in young adult in Indonesia. The aim of this study was to determine whether obesity has relationships with prehypertension and hypertension.
Methods: The participants were Indonesian medical students aged 18-25 years. Sub- jects were classifi ed into three blood pressure (BP) groups; normotensive (BP below or equal to 120/80 mmHg), pre-hypertensive (BP between 120/80 mmHg to 140/90 mmHg) and hypertensive (BP above 140/90 mmHg). Obesity was evaluated by BMI above 25 kg/m2. Association of blood pressure in obese medical students was meas- ured by using odds ratio (OR).
Results: Eighty nine Indonesian medical students aged 18-25 years participated in the study. Twenty seven percent students were obese. There were 84.3% normotensive, 11.2% pre-hypertensive and 4.5% hypertensive students. Odds ratio of prehyperten- sion and hypertension compared with normotension in obese students was 7.200 (p
<0.000; 95% CI [2.103 – 24.656]).
Conclusion: Obesity is associated with prehypertension and hypertension in Indone- sian medical student.
Key words: obesity, prehypertension, medical students
PS 0080 Cardiology
Vascular Dysfunction in Newly Diagnosed Pre-Diabetic Hypertensive Patients
Mirela ANGHEL1, Elena RADU SULTANESCU1, Mihai SANDULESCU1, Anca Ioana ANGHEL2
National Institute of Aerospace Medicine, Romania1, Faculty of Medicine “Carol Davila” University, Romania2 Introduction: Hypertension is one of the most important causes of premature death worldwide. Pre-diabetic state, mainly impaired glucose tolerance (IGT), is a risk fac- tor for coronary artery disease (CAD) and sudden death. Aortic function (AD-aortic distensibility) plays a signifi cant prognostic role for cardiovascular (CV) events. The resistive index (RI) refl ects local wall extensibility and the related vascular resistance.
Methods: We enrolled 285 consecutive newly diagnosed hypertensive pre-diabetic (IGT) patients without CAD (according to ESC and EASD). All patients were evaluated by lab tests, ambulatory blood pressure monitoring, carotid Doppler ultrasound (RI), Doppler echocardiography (AD), ECG stress test for non-cardiac or atypical chest symptom, rest ECG and/or cardiac echo abnormalities. We analyzed the association between AD, RI, BP, abnormal exercise ECG, several clinical parameters and cardiac events during a mean follow-up period of 4.5 ± 0.3 years.
Results: The mean age of the population was 47.5 ± 14.6 years. Abnormal stress ECG showing inducible ischemia was noticed in 21% pts. Univariate analysis has shown the following parameters signifi cant associated with abnormal exercise testing: age (p<0.01), family history of premature CV events (p<0.02), SBP (p<0.02), dyslipidaemia (p<0.02), AD (p<0.03), carotid RI (p<0.04), and plasma glucose (p<0.04). Multi-ad- justed analysis revealed that LDL cholesterol (p<0.01), SBP (p<0.02), higher values of RI (p<0.02) and lower values of AD (p<0.03) were signifi cant independent predictors of abnormal ECG exercise test. Multivariate Cox proportional analysis revealed that abnormal stress ECG (HR=2.4, 95%CI: 1.5 – 6.1, p=0.032) and post-load glucose (2- hPG) (HR=2.7, 95%CI: 0.8 – 6.5, p=0.039) were good predictors of the cardiac events.
Conclusion: Two simple, effective markers of vascular dysfunction – aortic distensi- bility and resistive index can be extremely useful in every day clinical practice in the initial risk evaluation of newly diagnosed pre-diabetic hypertensive patients without known previous CAD.
