Yang Xi

Morning blood pressure surge varies with age and gender in hypertensive individuals.

Many studies revealed that most cardio-cerebrovascular events were closely related to morning blood pressure surge (MBPS). The aim of our study was to investigate the relationship of MBPS with age and gender in hypertensive individuals, morning blood pressures of a total of 1100 cases with primary hypertension were analyzed. In our study, the morning systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP) of hypertensives with MBPS were all higher (P<0.01). MBPS values were correlated with age (r=0.061, P<0.05). In hypertensive individuals with MBPS, morning SBP and PP increased while morning DBP decreased (P<0.01) as patients aged. Morning DBP and MAP of female patients were lower while morning PP was higher (P<0.01). These results indicated that MBPS was associated with both age and gender in hypertensive individuals.

Effect of renin-angiotensin system on arterial function in persons with acute mountain sickness.

architecture in man. Br Heart J 1981;45:248–63. [14] Bogaert J, Rademakers FE. Regional nonuniformity of normal adult human left ventricle. Am J Physiol Heart Circ Physiol 2001;280:H610–20. [15] Choi HF, Rademakers FE, Claus P. Left-ventricular shape determines intramyocardial mechanical heterogeneity. Am J Physiol Heart Circ Physiol 2011;301:H2351–61. [16] Stollberger C, Gerecke B, Finsterer J, Engberding R. Refinement of echocardiographic criteria for left ventricular noncompaction. Int J Cardiol 2013;165:463–7.

Effects of Anxiety and Depression on Arterial Elasticity of Subjects With Suboptimal Physical Health.

The authors investigated the effects of suboptimal health status (SHS; high‐normal blood pressure, blood glucose, and blood lipids) on arterial elasticity in subjects with or without anxiety or depression.

OS 03-08 EFFICACY OF TELMISARTAN 40 MG (T40) AND HYDROCHLOROTHIAZIDE 25 MG (H25) MONOTHERAPY IN HIGH SODIUM INTAKE PATIENTS WITH MILD TO MODERATE HYPERTENSION (THAT STUDY): A MULTICENTER RANDOMIZED DOUBLE-BLINDED PARALLEL CONTROLLED TRIAL.

Objective: To compare the BP lowering effect of ARBs and thiazide diuretics in high sodium intake patients with mild to moderate hypertension. Design and Method: This research was a multicenter randomized double-blinded parallel controlled trial. Eligible participants were randomly divided into T40 and H25 groups, with 3 follow-ups, scheduled on the 15th, 30th and 60th day to compare the difference of average BP decrease, blood pressure control rates, FBG (fast blood glucose), hypokalemia and other adverse events between two groups after intervention. Results: 1333 participants were enrolled from 14 county hospitals in high-salt-intake area of China in 2014, with average sodium intake of 5893 mg per day. Baseline characteristics were well balanced between groups. In general, SBP/DBP reduction in T40 group was 12.5/8.0, 14.3/9.1 and 12.8/7.2 mmHg at 15 days, 30 days and 60 days of follow-up, respectively, while the counterparts in H25 group was 11.0/5.8, 13.6/7.1 and 11.5/5.3 mmHg, respectively. BP reduction in T40 group was greater than that in H25 group at 3 follow-up visits, but with only statistical significance for DBP. When controlled by gender, age, body mass index and baseline BP, subgroup analysis showed that DBP reduction was still higher in T40 group than that in H25 group (P < 0.001) regardless of the amount of urine sodium excretion and pulse pressure (PP). SBP reduction was positively related to increasing urine sodium and PP level for patients in both groups, but increased faster with increasing PP in H25 group than that in T40 group (P = 0.0238 for group*PP). Compared with T40, patients in H25 group showed more hypokalemia (T:0.4% vs H:4.5%, P < 0.001). Conclusions: Telmisartan 40 mg showed better DBP lowering effect and less hypokalemia than HCTZ 25 mg among high sodium intake patients with mild to moderate hypertension. Effect superiority of HCTZ among patients with large pulse pressure might exist and needs further test. Figure. No caption available.

PS 17-37 URINARY SODIUM AND LEFT VENTRICULAR HYPERTROPHY IN CHINESE HYPERTENSIVE PATIENTS

Objective: The relationship between sodium and target organ damages still remains uncertain. This study was to determine the association between the urinary sodium and left ventricular hypertrophy in Chinese patients with essential hypertension. Design and method: We studied 597 adults with essential hypertension in China. 24-hour urinary sodium were used to estimate the sodium intake. We assessed the relationship between urinary sodium and left ventricular hypertrophy. The urinary sodium was quartering into four categories [24h urinary sodium (11.61–80.60mmol/d; 81.30–120.80 mmol/d; 120.90–169.96 mmol/d; 170.30–537.2 mmol/d)].BP was analyzed as two categories: well-controlled (BP measured by 24h ABPM < 130/80 mmHg) and poor-controlled(BP ≥ 130/80 mmHg ≥ 130/80 mmHg). Results: The mean urinary sodium was 133.59 ± 71.73 mmol/d, ranging from 11.61–537.20 mmol/d. The mean LVM index was 83.37 ± 19.78 mmol/d, ranging from 42.84–191.01 mmol/d. When analyzed sodium alone, the relationship between sodium and LVM index was like a J-shape curve (mean LVM index in each categories: 83.05 ± 17.53,79.97 ± 17.22,83.75 ± 19.59,86.64 ± 23.70, p = 0.048). When sodium and BP were analyzed jointly, the effect of sodium was not significant (p = 0.069), while BP had a significant effect on LVM index (p = 0.026.) But in patients without CAD, both BP and sodium were significant (p for sodium = 0.032, p for BP = 0.009). The relationship remained J-shape curve. Regression analysis showed that urinary sodium(OR 1.0003, p = 0.024), 24h mean arterial pressure (OR 1.038,p < 0.0001), CAD(OR 2.016, p = 0.019), smoking (OR 4.925, p < 0.0001) were the risk factor for left ventricular hypertrophy after adjusting baseline statistics including age, sex, BMI, smoking, drinking, diabetes, FBG, HbA1c, TC, TG, HDL-C, LDL-C, 24h mean arterial pressure and 24h urinary potassium. Conclusions: The relationship between sodium and LVM index maybe J-shaped in Chinese adults with hypertension. The prevention of left ventricular hypertension calls for intervention to control BP, to abandon smoking, to maintain a suitable sodium intake and to avoid the occurrence of CAD.

Ps 17-77 A Randomized, Double-blind And Double-dummy, Multiple-dose, Positive And Parallel Comparative, Multicenter Clinical Trial Of Allisartan Evaluate Efficacy And Safety In Patients With Mild To Moderate Essential Hypertension

Objective: The objective of the study was to evaluate the efficacy, safety and tolerability of 3 dose regimens (80 mg, 160 mg or 240 mg qd) of allisartan in patients with mild to moderate essential hypertension. Design and method: The trial was designed as a multicenter, randomized, double-blind and double-dummy, positive and parallel comparative, dose-ranging study to evaluate the efficacy and safety of allisartan compared to losartan after 8 weeks treatment in patients with essential hypertension (90mmHg ⩽ msDBP < 110 mmHg and 140 mmHg ⩽msSBP < 180 mmHg). The trial enrolled 283 subjects. After 2 weeks of placebo run-in period, subjects were randomized to Allisartan 80 mg group, Allisartan 160 mg group, Allisartan 240 mg group or Losartan 50 mg group by1:1:1:1, who were treated for 8 weeks. Results: There were 279 subjects in full analysis set. Efficacy result: Mean sitting diastolic blood pressure (msDBP) and systolic blood pressure(msSBP) of the four groups were reduced significantly after 8 weeks. There were no differences on the decrease of blood pressure among four groups, the P value of msSBP and msDBP was 0.3706 and 0.2626. There were no differences on the proportion of patients achieving msSBP and msDBP responses (< 140 mmHg or a reduction of ≥ 20 mmHg from baseline; and < 90 mmHg or a reduction ≥ 10 mmHg from baseline) among four groups, the P value was 0.3252. Safety results:No SAE was reported. The overall incidence of adverse events was low during the study. The most commonly reported AEs were dizzy, headache, nausea and abnormal liver function. There were no differences on AEs among four groups, the P value was 0.5939. Conclusions: The study showed that all 3 doses of allisartan were efficacious and safe in treating Chinese patients with essential hypertension. Allisartan can reduce systolic and diastolic blood pressure significantly. Allisartan is well tolerated and has better safety.

PS 06-21 THE INCIDENCE OF CARDIOVASCULAR RISK FACTORS/CLINICAL CONDITIONS AMONG CHINESE HYPERTENSIVE OUTPATIENTS: A CROSS-SECTIONAL SURVEY

Objective: Across China, there are an estimated 270 million people at present suffering from hypertension. We aimed to investigate the incidence of cardiovascular risk factors/clinical conditions, blood pressure (BP) control status among Chinese cardiac outpatients. Design and Method: This multicenter cross-sectional survey was carried out from July 2014 to January 2015. The subjects were consecutively recruited from 119 hospitals in China. The subjects’ data was inputted into the database with touch screen integrated machines. The incidence of cardiovascular risk factors/clinical conditions, blood pressure control status was calculated. Results: 173598 outpatients’ data meeting inclusion criteria was involved in the statistical analysis. There were 111501 hypertensive (64.2%, mean age 59 ± 12 years old) and 62097 non-hypertensive (35.8%, mean age 48 ± 14 years old) patients. In hypertensive outpatients, overweight/obesity was found in 64.5%, physical inactivity in 46.5%, diabetes in 26.4%, dyslipidemia/high cholesterol in 33.1%, atrial fibrillation in 15.4%, stroke or transient ischemic attack in 12.0%. And the BP control (< 140/90 mmHg) rate was 31.0% in hypertensive patients, while 45.8%, 16.9% and 6.4% of patients were in patients with Grade 1, 2, and 3 hypertension, respectively. Meanwhile, in hypertensive patients there were 51.3% (57162/111501) without diabetes or dyslipidemia, 15.6% (17428/111501) with diabetes, 22.4% (24933/111501) with dyslipidemia, and 10.7% (11978/111501) with both. The proportion of hypertensive patients who complicated with diabetes, dyslipidemia or both had a positive relationship with age (F = 1007.899, P < 0.001) or obesity (BMI or abnormal waist) (&khgr;2 = 2080.144, P < 0.001). And it had significant difference between different regions (&khgr;2 = 1514.972, P < 0.001). Conclusions: The incidence of cardiovascular risk factors/clinical conditions was high while the BP control rate was low among Chinese cardiac outpatients.

5C.07: A METHOD TO ESTIMATE 24-HOUR SODIUM EXCRETION THROUGH SPOT URINE SAMPLES AND ITS APPLICATION VALUE FOR TARGET-ORGAN DAMAGE ASSESSMENT.

Objective: 24-h urine sodium excretion is considered the most reliable method to evaluate the salt intakes. However, this method is cumbersome. So we want to develop formulas to estimate 24-h urinary sodium excretion using spot urinary samples in Chinese hypertensive population and explore the application value of this method in salt intake assessment and target organ damage. Design and method: 1. We enrolled 510 cases of hospitalized patients with hypertension, 2/3 of them were arranged randomly to formula group to develop a new formula and the remainings were used to test the performance of the formula. All participants were instructed to collect a 24-h urine sample, a second morning voiding urine sample (SMU), and a post-meridiem urine sample in the late afternoon or early evening, prior to the evening meal (PMU). All samples were sent to measure sodium and creatinine concentration.2. We compared the differences of office blood pressure, 24-hour ambulatory blood pressure and left ventricular hypertrophy, vascular stiffness and urine protein among groups of different sodium intake. Results: 24hour sodium excretion formulas was obtained using SMU and PMU respectively, which have good cosistency. The difference between the estimated and measured values in sodium excretion is 12.66mmol/day (SMU) and 9.41mmol/day (PM), to be equal to 0.7 g (SMU) and 0.6 g (PM) salt intake. Comparing with Kawasaki and Tanaka method, the new formula shows the lower degree of deviation, and higher accuracy and precision. Blood pressure of high urinary sodium group is higher than that in low urinary sodium group (P < 0.05). Left ventricular hypertrophy and urinary albumin/creatinine aggravated with the salt intake increase, this has eliminated the influence of other factors. All of morphologies of the relationship between ambulatory arterial stiffness index, pulse wave velocity and carotid intima-media thickness with quartiles of sodium intake resembled a J-shaped curve. Conclusions: In Chinese hypertensive population, the formulas to estimate 24-h urinary sodium using spot urinary samples spot urine are considered useful for estimating the mean level of population salt intake, and have a role in evaluating target organ damage.

ASSA13-14-5 Relationship Between Tissue Advanced Glycation End-Products with Artery Elasticity in Hypertensive Patients

Objective To evaluate the relationship between tissue advanced glycation end-products with artery elasticity in hypertensive patients with or without diabetes mellitus (DM) and coronary artery disease (CAD). Methods A total of 157 patients were enrolled, HBP group included 62 hypertensive patients, HBP+DM group included 42 hypertensive patients with DM, HBP+DM+CAD group included 53 hypertensive patients with DM and CAD. NBP group included 32 healthy persons. Carotid-femoral pulse wave velocity (cf-PWV, Complior, France) and tissue AGE (Diagnoptics, The Netherlands) were measured in all enrolled persons. Results 1. The levels of skin autofluorescence (AF) in groups with hypertension were significantly higher than in NBP group (NBP < HBP < HBP+DM < HBP+DM+CAD, P < 0.01). Compared with hypertensive patients without complications, the levels of skin AF in groups with DM and CAD were significantly higher (HBP < HBP+DM < HBP+DM+CAD, P < 0.01). 2. The levels of cf-PWV in groups with DM and CAD were significantly higher than in NBP group (NBP < HBP+DM < HBP+DM+CAD, P < 0.05, P < 0.01). Compared with hypertensive patients without complications, the levels of cf-PWV in groups with DM and CAD were significantly higher (P < 0.01). 3. The results of multivariate stepwise regression analysis indicated that the level of skin AF had strong effect on cf-PWV. Conclusions The level of tissue AGE in hypertensive patients was higher than healthy persons, which was more significant in hypertensive patients complicated with DM and CAD. The level of tissue AGE correlated with the abnormality of arterial elasticity, the higher level of tissue AGE might play important role in evaluating vascular risks.

THE INFLUENCE OF SERUM ENDOGENOUS SECRETORY ADVANCED GLYCATION END-PRODUCTS RECEPTOR ON ARTERIAL ELASTICITY IN PATIENTS WITH CORONARY ARTERY DISEASES: PP.31.242

Objective: To analyze the influence of serum endogenous secretory advanced glycation end-products receptor (esRAGE) and cardiometabolic risk factors on arterial elasticity in patients with coronary artery disease(CAD). Methods: 180 patients with CAD diagnosed by coronary angiography were enrolled in. Arterial elasticity parameters(cf-PWV,ba-PWV)and cardiometabolic risk factors (waist circumference,blood pressure,blood glucose, plasma lipids and serum insulin) were measured in all patients. The relationship of serum esRAGE,cardiometabolic risk factors and arterial elasticity were analyzed. Results: Patients with more than 3 types of cardiometabolic risk factors had higher cf-PWV,ba-PWV and lower esRAGE than that with less risk factors(P£ 1/4 0.05). Logcf-PWV was positively related to age,blood pressure and logHOMA;ba-PWV was positively correlated with age and blood pressure. Both of cf-PWV and ba-PWV were negatively correlated with esRAGE. Multi-factor regression analysis showed age,SBP and esRAGE associated independently with cf-PWV. Age and SBP associated independently with ba-PWV. Conclusion: Cardiometabolic risk factors could induce arterial elasticity abnormality. Lower circulating esRAGE level played an important role in the decreasing of arterial elasticity in patient with CAD.