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Objective: To analyze the clinical characteristics of PA patients. Methods: 330 cases of PA from January 2006 to March 2010 in the Hypertension Department of the People's Hospital of Xinjiang Uygur autonomous region were recruited in the retrospective study. The characteristics of blood pressure and serum potassium were analyzed. Results: The common symptoms of patients with PA were hypertension (100%), headache (36.67%), dizziness (33.94%), palpitation (4.85%), and limb fatigue (4.24%). The prevalence of 1, 2 and 3 stage hypertension in these subjects was 3.64%, 20.91% and 75.45%, respectively. Of all PA patients, 89.09% were young adults and 81.82% were overweight and obese. There were more male patients with PA in the overweight and obese groups compared with that of normal weight groups ( 2 = 22.82, P b 0.001). The incidence of hypokalemia was 32.12%. The concentration of serum potassium was not associated with the course ( r = 0.084, P N 0.05). Logistic regression showed that the concentration of plasma aldosterone was the independent risk factors of hypokalemia in PA patients (beta = 0.067, P b 0.001). The aldosterone-torenin activity ratio (ARR) was N 20 in 94.24% of the patients with PA. Conclusions: The incidence of PA patients with hypokalemia is low. It is important to screen PA in moderate to severe hypertension of young adults with or without hypokalemia, in particular for males who are overweight and obese. ARR N 20 is a practical index for screening PA, which will help to reduce the rate of missed diagnosis of PA. doi:10.1016/j.ijcard.2011.08.579 0302 Comparison of diagnostic accuracy of catecholamine metabolite detection for diagnosis of pheochromocytoma SHENGNENG XUEa, JUAN LEIb, SHAOLING ZHANGa a Department of Endocrine Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China b Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China Objective: The comparison of the diagnostic accuracy of catecholamine metabolite detection for the diagnosis of pheochromocytoma. Methods: From 2005 to 2009, 340 cases (45 cases of pheochromocytoma, 111 cases of adrenal cortical adenoma, 145 patients with primary hypertension and 39 healthy subjects) were chosen to measure their 24-h urine vanillylmandelic acid (VMA), 5h urine VMA/Cr, normetanephrine (NMN) and metanephrine (MN) in blood and urine. Results: (1) The sensitivity of 24-h urine VMA in diagnosing pheochromocytoma was only 73.3%, which was lower than that of the blood NMN + MN, urinary NMN + MN and the joint detection of blood and urine NMN + MN (P b 0.05). The specificity of 5 h urine VMA/Cr in diagnosing pheochromocytoma was 84.1%, which was lower than that of the 24-h urine VMA, blood NMN + MN, urinary NMN + MN and the joint detection of blood and urine NMN + MN (P b 0.01). (2) Paired 2 tests showed that the positive rate of urinary NMN + MN was higher than that of the 24-h urine VMA in diagnosing pheochromocytoma (2 = 9.091, P = 0.003). (3) The areas under the ROC curve of 24-h urine VMA, 5-h urine VMA/Cr, blood NMN + MN and urine NMN + MN were 0.884, 0.923, 0.972 and 0.985, respectively. Conclusions: Both the sensitivity and specificity of blood NMN+ MN and urine NMN + MN are high in diagnosing pheochromocytoma. They are ideal detection methods of pheochromocytoma in clinic. The diagnostic accuracy will be improved if the joint detection was done.

Epidemiology of Hypertension and Metabolic Disorders

0014 Analysis of antihypertensive drugs used of elderly hypertension in Beijing LINA MA, ZHE TANG, XIAOLING ZHANG, SHAOCHEN GUAN Xuanwu Hospital, Beijing, China Objective: To analyze the trend of antihypertensive drugs used by elderly residents with hypertension in Beijing. Methods: A group of 2832, 1828, and 2277 elderly residents aged 60 in Beijing were chosen into this study in the year 2000, 2004, and 2007 by well-established statistical sampling techniques such as cluster, stratification and random selection, and trend of antihypertensive drugs used by elderly residents with hypertension was analyzed by 2 analysis. Results: The proportion of CCB, ACEI, diuretics and -RB increased, whereas that of compound reserpine decreased. Conclusion: The aim of hypertension treatment is not only to lower blood pressure, but also to decrease the complication, so as to improve the quality of life of people with hypertension. doi:10.1016/j.ijcard.2011.08.581 0017 Cardiac structure and function in relation to central blood pressure components in Chinese YI ZHANG, YAN LI, FENGHUA DING, CHANGSHENG SHENG, QIFANG HUANG, JIGUANG WANG Shanghai Institute of Hypertension, Shanghai, China Objective: Data are limited with regard to the association of central blood pressure components with cardiac structure and function. Methods: Our study was conducted in the framework of cardiovascular health examinations for the current and retired employees of a factory and their family members. We measured central blood pressures by SphygmoCor and cardiac structure and function by echocardiography. Results: The 826 participants (mean age: 43.0 years) included 285 (34.5%) women and 184 (22.3%) hypertensive patients, of whom 78 (42.4%) took antihypertensive drugs. After adjustment for age, gender, body weight, body height, antihypertensive treatment, current smoking and alcohol intake, left atrial volume (LAV) and left ventricular mass (LVM) were significantly associated with central blood pressure components (r: 0.09 to 0.21, P 0.01), whereas left ventricular diastolic dysfunction, evaluated by E/A ratio and deceleration time of E wave (DTE), was only significantly associated with central systolic blood pressure (SBP, r=0.16 and r=0.14, P b 0.001). Furthermore, in regression models with similar adjustments, with 1-SD increase in central SBP (16.7 mmHg), E/A ratio significantly decreased by 5.51.2 % and DTE significantly increased by 4.661.22 ms (P b 0.001 for both). Sensitivity analyses in men and women separately and after exclusion of patients on antihypertensive medication were confirmatory. Conclusion: Cardiac structure was significantly and comparably associated with central blood pressure components, but left ventricular diastolic dysfunction was only significantly associated with central SBP. doi:10.1016/j.ijcard.2011.08.582 0022 Comparison of knowledge and understanding about hypertension in patients with controlled and uncontrolled hypertension: A multicenter study AYSHA ALMAS, SANIYA SERAJ, HALIMA TABANI, SAIMA LALANI, ZEHRA AZIZ SAMNI Aga Khan University, Karachi, Pakistan

doi:10.1016/j.ijcard.2011.08.580

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Abstracts

Background: Hypertension (HTN), one of the most common medical disorders, is associated with an increased incidence of allcause and cardiovascular disease (CVD) mortality. According to the National Health survey only 3% of the population has controlled hypertension. Objective: To compare knowledge and understanding about hypertension in patients with controlled and uncontrolled hypertension at three different tertiary care centers in Karachi. Methods: It was a comparative cross-sectional study conducted at The Aga Khan University hospital (AKUH), Ziauddin Hospital (ZH) and Civil Hospital, Karachi (CHK). Patients were categorized into 2 groups: controlled and uncontrolled hypertension based on their initial BP readings on presentation. All diagnosed hypertensive patients (both inpatients and outpatients) coming to a tertiary care hospital in Pakistan aged N 18 years were included. Results: A total of 447 patients were recruited. Sixty three percent were from AKUH, 14% from ZH and 23% from CHK. Fifty percent were males and mean age(SD) was 57.7(12). On comparing knowledge and understanding about hypertension in controlled vs uncontrolled HTN. Meaning of hypertension was correctly marked by controlled hypertensives compared to uncontrolled hypertensives (P b 0.001). Cutoffs for SBP were correctly identified by controlled hypertensives (P b 0.001) compared to uncontrolled HTN. Cutoffs for DBP were correctly identified by controlled HTN compared to uncontrolled HTN (P b 0.001). Understanding about BP parameter (SBP vs DBP vs both) importance was higher in controlled hypertensives (P b 0.003). Understanding about improved healthy with improved BP was higher in controlled HTN compared to uncontrolled HTN (P b 0.02). Understanding that high BP can be asymptomatic was different in controlled HTN compared to uncontrolled HTN (P b 0.001). Understanding that changing lifestyle improves BP was higher in controlled hypertensives compared to uncontrolled hypertensives (P b 0.003). Similarly knowledge that HTN is a lifelong disease (P b 0.001), antihypertensives have to be taken for life (P b 0.001) was higher in patients with controlled HTN compared to uncontrolled HTN. On conversion of the categorical knowledge attributes into quantitative values mean knowledge and understanding score was higher in patients with controlled HTN compared to uncontrolled HTN (347 vs 114) (P b 0.02). Conclusion: Knowledge and understanding about hypertension is better in patients with controlled HTN compared to uncontrolled HTN. doi:10.1016/j.ijcard.2011.08.583 0026 Analysis of genetic and environmental factors for H-type hypertension in Anqing rural community YONGHUA ZONG, LUOSHA ZHAO The First Affiliated Hospital of Zhengzhou University, Zhenzhou, China Objective: To explore related risk factors on H-type hypertension in rural areas of Anqing, Anhui. Methods: From July 2007 to October 2008, hypertensive patients from Baihu, Tanggou and Oushan towns of Anqing, Anhui, were screened with polymerase chain reaction restriction fragment length polymorphism (PCRRFLP) to detect the C677T polymorphism of N5,10-methylenetetrahydrofolate reductase (MTHFR) gene. Then based on the three types of MTHFR genotypes (CC, CT&TT), we enrolled 241 patients with hypertension in total and each genotype had a similar number of patients (n = 76, 85 and 80). Then we examined the fasting plasma Hcy level with HPLC, measured blood pressure with Standard Desktop mercury Sphygmomanometer and calculated the body mass index (BMI). A questionnaire was used to collect the lifestyle information of cigarette and/or alcohol consumption status. Results: 1) The average level of fasting plasma Hcy was significantly higher in male than female (12.8 7.2 mol/L

vs 9.7 4.7 mol/L, P b 0.01); patients with TT genotype had a significantly higher level of Hcy than those with CC or CT genotypes (P b 0.01). 2) The proportion of H-type hypertension in all the hypertension cases was up to 44.4%. H-type hypertension was much more common in male patients, which was 60.3% compared to 29.6% in female. The risk of H-type hypertension in TT genotype was pronouncedly higher than in CT and CC genotypes (OR: 3.2, 95% CI: 1.75.8, P b 0.01). 3) Multiple linear/logistic regression analysis with adjustment by multivariate didn't identify marked relevance of Hcy level or H-type hypertension risk with other environmental variables including age, alcohol drinking, cigarette smoking, BMI, and baseline DBP and SBP. Conclusion: Our present study suggested that the MTHFR C677T genetic variant with gender may be associated with a high risk of H-type hypertension, but not for drinking, smoking, age, BMI and blood pressure, in rural community of Anqing, China. doi:10.1016/j.ijcard.2011.08.584 0043 Risk factors for prehypertension in Xinjiang Uygur LEI WANG, NANFANG LI Hypertension Institute of Xinjiang, Urumqi, China Hypertension Center of The People's Hospital of Xinjiang, Urumqi, China Objective: It has been reported that prehypertension is associated with an increase in cardiovascular morbidity. The prevalence and independent risk factors for prehypertension vary by ethnic group and gender. Uygur population are the largest nationality in Xinjiang, most of them are rural. The aim of our study was to assess the risk factors for prehypertension in Xinjiang Uygur population. Methods: A cross-section study was conducted in a Xinjiang Uygur population (438 males and 716 females aged from 30 to 70 years). Binary logistic regression analysis was performed to show risk factors for prehypertension. Blood pressure levels of normotensives and prehypertensives in different body mass index (BMI) categories were compared. Results: Binary logistic regression analysis showed a significantly increasing prevalence of prehypertension with BMI after adjustment for gender, lipids profiles, waist-to-hip ratio, etc. The odds ratios for prehypertension against the lowest BMI group (separated by 24 and 28) were 1.934 and 2.490. Age was independently correlated to the increasing prevalence of prehypertension. The mean diastolic blood pressure (DBP) were significantly increased with BMI categories in either normotensives or prehypertensives (P b 0.001). The mean systolic blood pressure (SBP) was significantly increased with BMI only in normotensives (P b 0.001). Conclusions: In Xinjiang Uygurs, BMI and age were the risk factors for prehypertension, the prevalence of prehypertension significantly increase with BMI. DBP was significantly increased with BMI. These findings emphasize the importance for establishment of the obesity to efficiently control blood pressure and other cardiovascular complications. doi:10.1016/j.ijcard.2011.08.585 0068 Effects of metabolic syndrome on left ventricular hypertrophy in Chinese population: A meta-analysis NINGYIN LI, JING YU The Second Hospital of Lanzhou University, Lanzhou, China Objective: To evaluate the influence factors of left ventricular hypertrophy of metabolic syndrome (MS) in Chinese population. Methods: Cochrane Library, PubMed, EMBASE, Chinese Biomedical