e322 Journal of Hypertension Vol 35, e-Supplement 2, September 2017
PP.28.23 RELATIONSHIP BETWEEN HYPERTENSION AND
GENDER IN PATIENTS WITH DIABETES MELLITUS
C. Avramescu1, M.A. Iancu1, G.N. Dediu2, C.C. Diaconu3, D. Matei4. 1UMF Carol
Davila, Family Private Practice, Bucharest, Romania, 2UMF Carol Davila, Spita-
lul Clinic de Urgenta Sf. Ioan, Bucharest, Romania, 3UMF Carol Davila, Spitalul
Clinic de Urgenta Bucuresti, Bucharest, Romania, 4UMF Carol Davila, Institutul
National pentru Sanatatea Mamei si Copilului Alessandrescu-Rusescu, Bucharest,
Romania
Objective: Most patients with tip II diabetes melittus develop hypertension dur-
ing their life. Arterial hypertension has a high impact on the incidence and preva-
lence of complications in patients with diabetes mellitus. The aim of this study
was to assess the impact of gender differences on the complications in the diabetes
mellitus patients, depending on the presence of hypertension.
Design and method: In this observational study conducted during January to De-
cember 2016, we included 129 patients with diabetes mellitus (87 men and 42
women), included in the records of a family medicine office. From these patients,
105 had hypertension (group 1) and 24 had normal blood pressure (group 2). The
following characteristics of the two groups of patients were comparatively ana-
lyzed: fasting plasma glucose, the positive family history of hypertension, prema-
ture cardiovascular disease and diabetes, and frequency of diabetes’ complications.
Results: Men were younger than women (mean age 57.75 ± 11.4 years versus
66 ± 11.7 years).The prevalence of hypertension in men was 86.20%, higher than in
women (71.42%). The comparative distribution of diabetic complications in women
and men was: diabetic retinopathy (14.28% vs 6.89%), diabetic nephropathy (7.14%
vs 13.79%) and diabetic neuropathy (21.42% vs 27.58%). The prevalence of dia-
betic nephropathy was significantly higher in patients with diabetes mellitus and
hypertension (p = 0.001). Not a single case of diabetic retinopathy or diabetic neu-
ropathy was encountered in the group of patients with diabetes and normal blood
pressure (group 2). Patients from group 1 (with diabetes mellitus and hypertension)
had a family history of premature cardiovascular disease (p = 0.012) and diabetes
(p = 0.006) statistically significantly higher than patients from group 2.
Conclusions: Both fastum glucose level and blood pressure control are impor-
tant in preventing diabetes’ complications. The presence of hypertension is a risk
factor for diabetic nephropathy, especially in men. The frequency of diabetic
retinopathy was higher in women, in our study. The family history of premature
cardiovascular disease and diabetes is a risk factor for further development of
hypertension in diabetic patients.
PP.28.24 THE BIOCHEMICAL PREDICTORS OF INITIATING
THE DEVELOPMENT OF DISORDERS OF THE
ELASTIC PROPERTIES OF VASCULAR WALL IN
PATIENTS WITH ARTERIAL HYPERTENSION AND
ABDOMINAL OBESITY
K. Avdeeva, T. Petelina, L. Gapon, N. Musikhina. Tyumen Cardiology Research
Center, Tomsk National Research Medical Center, Russian Academy of Sciences,
Tomsk, Russia, Tyumen, Russia
Objective: To identify predictors of biochemical, initiating the development of
disorders of the elastic properties of the vascular wall in patients with arterial
hypertension and abdominal obesity.
Design and method: The study included 157 patients, 21 to 75 years (mean age
47,17 ± 8,6 years). The control group included 27 healthy subjects (group 1), a
control group of 53 patients with arterial hypertension without obesity (group
2), the main group of patients with AH and AB totaled 77 patients (group 3). All
groups were matched for age, duration of hypertension, office blood pressure. Pa-
tients in all groups was conducted daily monitoring of BP; sphygmography with
the assessment: PWV-R / L- pulse wave velocity, CAVI- cardio-ankle vascular
index; R-AI - augmentation index; ABI-R/L - ankle-brachial index; parameters
of the lipid profile; lipid peroxidation; parameters endothelial dysfunction.
Results: Comparative characteristics of the main parameters in the 3d group of
patients were significantly higher daily monitoring of BP, the elastic properties
of the vascular wall and serum biochemical parameters in comparison with 1st
and 2nd groups of patients. Based on the method of generalized linear models
in group 1 were detected interaction ABI-R indicators triglycerides (p = 0.044,
standard error 5.75). In group 2, a significant interaction between levels of endo-
thelin-1 to R-AI (p = 0.043, standard error 2.57), .MDA with CAVI (p = 0.038,
standard error 3.63). In the 3d group of patients interaction MDA with index
PWV and R-AI (p = 0.006, standard error 7.27 and p = 0.027, standard error
11,19, respectively).
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
Conclusions: The identified biochemical markers - triglycerides, endothe-
lin-1, MDA; which are related to performance elastic properties of the vascu-
lar wall, emphasizing. thus, the importance of biochemical pathogenetic link
in the development process of remodeling of the vascular wall in hypertensive
patients
PP.28.25 YOUNG REVERSE DIPPER HYPERTENSION:
SHOULD ALL BE INVESTIGATED FOR OSA?
A. Alvarez-Tiu1, A. Sule1. 1Tan Tock Seng Hospital, Singapore, Singapore
Objective: To describe 2 cases of reverse dipper hypertension
Design and method: Obstructive sleep apnea (OSA) is a recognized cause of
secondary hypertension and is associated with increased cardiovascular morbid-
ity and mortality. Recurrent episodes of apnea result in hypoxia and hypercap-
nia increasing sympathetic tone, oxidative stress, inflammation and endothelial
dysfunction leading to persistent elevation of blood pressure, a phenomenon de-
scribed as non-dipping. We described 2 cases of OSA in young reverse dipper
hypertensives.
Case Report 1. An 18 years old Chinese female, BMI 37, non-smoker, non-al-
coholic, non-diabetic, pre-hypertensive, with familial history of Hypertension
(HTN) with suspected OSA was evaluated
Case Report 2. A 34 years old Malay, BMI 30, non-smoker, non-alcoholic, non-
diabetic with familial history of cardiovascular diseases. She presented with hy-
pertension stage 2 with snoring and day time sleepiness.
Results: Case Report 1:
Investigations and Laboratory Work-up: Epworth Sleepiness Scale score of 14.
Polysomnography showed moderate OSA, worse in REM, Apnea Hypopnea In-
dex 15.1. Ambulatory Blood Pressure Monitoring showed reverse dipper pattern.
Other tests were normal.
Progress: She was evaluated by Endocrinologist for obesity and Pulmonologist for
OSA. She was advised on weight, dietary and lifestyle modifications. In view of
borderline hypertension, CPAP was recommended. CPAP was initiated but patient
was non-compliant. On follow up visits with General Medicine clinic, hyperten-
sion remained uncontrolled.
Case Report 2:
Investigations and work-up: Renal Doppler ultrasound showed no renal artery
stenosis. Ambulatory Blood Pressure Monitoring showed reverse dipper pattern.
Other test were unremarkable.
Progress: Blood pressure remained controlled on Amlodipine and lifestyle modi-
fication and weight reduction.
Conclusions: Young patients with reverse dipper pattern of hypertension should
be screened for OSA to reduce risk for cardiovascular events.
PP.28.27 IS THAT OBSTRUCTIVE SLEEP APNEA
PARTICIPATES IN THE DECREASE OF THE
ANTIAGGREGANT EFFECT OF THE ASPIRIN
OBSERVED IN PATIENTS WITH DIABETES
MELLITUS
O. Ormezzano1, A.L. Borel2, R. Tamisier3, R. Marlu4, P. Faure5, B. Polack4,
P.Y. Benhamou2, J.L. Pépin3. 1Service de cardiologie, Centre Hospitalier Universitaire
A. Michallon, Grenoble, France, 2Service Endocrinologie, Centre Hospitalier
Universitaire A. Michallon, Grenoble, France, 3Clinique de Physiologie, HP2,
Centre Hospitalier Universitaire A. Michallon, Grenoble, France, 4Laboratoire
de Biologie Médicale, Centre Hospitalier Universitaire A. Michallon, Grenoble,
France, 5Département de Biochimie, Toxicologie, Pharmacologie, Centre
Hospitalier Universitaire A. Michallon, Grenoble, France
Objective: Asprin resistance is more frequent in diabetes and is associated with
a poor health outcome. Intermitent hypoxemia in patient with obstructive sleep
apnea (OSA) is associated with platelet activation. OSA is frequent in patient with
diabetes mellitus. The aim of this study was to investigate the role of the OSA in
aspirin resistance in diabetes.
Design and method: Patients with diabetes mellitus, taking aspirin for primary
prevention or stable atherothrombotic disease, underwent overnight, in-lab poly-
somnography. The following morning we used the VerifyNow aspirin system to
evaluate the efficacy of aspirin. Patients with at least an apnea-hypopnea index of
30 events/hours were diagnosed with severe OSA.
Results: The preliminary result of the fifty first consecutive patients included in
the study is presented: