PM314 Association of muscle strength with markers of cardiovascular risk in young adults
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Objectives: The aim of our study was to assess by echocardiography the EAT in overweight and obese children and its relationship to cardiometabolic risk factors, insuline resitance, NAFLD markers and hyperuricemia. Methods: In 25 (mean age 13.0 2.3) overweight and obese subjects and 24 lean controls, blood pressure (BP), WC, fasting plasma glucose and insulin, lipids, uric acid and hepatic enzymes were estalished and EAT thickness measured by transthoracic echocardiography. Results: In overweight and obese subjects, EAT was significantly higher compared to normal weight children. Overweight and obese children had significantly higher body mass index (BMI), WC, BP, triglycerides (TAG), low-density lipoprotein and total cholesterol, hepatic enzymes alanine aminotransferase (ALT) and g-glutamyl transferase, and lower high-density lipoprotein cholesterol (HDL-C). EAT correlated significantly with BP, TAG, uric acid, HDL-C, apoprotein B and ALT. Correlation coefficients were similar or better than for WC, but similar or lower than for BMI. Conclusion: EAT thickness in children is associated with an unfavorable cardiometabolic risk profile including biochemical signs of NAFLD and hyperuricaemia, but is not a stronger indicator than BMI. Disclosure of Interest: None Declared PM313 From the Couch to the Cuff: The Relationship between Physical Activity levels and Blood Pressure in Older Australians Alan Pierce*, Walter P. Abhayaratna Academic Unit of Internal Medicine, Canberra Hospital, Canberra, Australia Introduction: National Physical Activity Guidelines recommend that older Australians undertake 30 minutes of moderate intensity physical activity (PA) on most days of the week. However, the evidence to support these guidelines is lacking. In particular, there is little evidence to support the claim adherence to these guidelines results in better control of CVD risk factors such as systemic hypertension in the long-term. Objectives: We sought to identify the relationship between PA levels amongst older Australians and changes in blood pressure (BP) over time. Specifically, we evaluate whether recommended PA levels suggested in the National guidelines have an effect upon future BP. It is hypothesised that achieving adequate levels of PA recommended by the Australian National Guidelines will be protective against the changes in BP associated with ageing. Methods: In a population-based prospective cohort study, PA levels were assessed using the Active Australia Survey. Brachial blood pressure was measured in accordance with National Heart Foundation guidelines. The effects of PA on systolic BP (SBP), diastolic BP (DBP) and pulse pressure (PP) after a median follow-up period of 7 years were assessed. Results: Of the 1302 participants (69 9 years; 53% women), 609 (46.8%) had hyper- tension at baseline. At follow-up assessment, SBP, DBP and PP increased by 16.9 21.5 mmHg, 3.4 11.6 mmHg and 13.5 18.2, respectively. In bivariate analysis, baseline PA (p<0.05) and change in PA time from baseline to follow-up had an inverse relationship with SBP and PP at follow-up and positive relationship with DBP. After adjustment for age and gender, the association between baseline PA time and SBP (p¼0.63), DBP (p¼0.63), and PP (p¼0.30) was attenuated. While not significant statistically, those who engaged in “insufficient” and sufficient” PA levels at baseline had an attenuated increase in SBP (p¼0.49) and PP (p¼0.14), and an attenuated decrease in DBP (p¼0.12) with ageing. Conclusion: In this population-based sample of older Australians, the positive effects of baseline PA and change in PA over time on future SBP, DBP and PP were attenuated by the effects age and gender. There was no evidence that adherence to current National Physical Activity Guidelines was associated with lower levels of BP in the future. Disclosure of Interest: None Declared PM314 Association of muscle strength with markers of cardiovascular risk in young adults Robinson Ramírez-Vélez* 1 , Hector R. Triana-Reina 2 1 Facultad de Cultura Física, Deporte y Recreacion, Universidad Santo Tomas, Bogota, 2 Departamento de Educación Física y Deporte, Universidad del Valle, Meléndez, Cali, Colombia Introduction: Physical fitness is one of the strongest predictors of individual future health status. Together with cardiorespiratory fitness (CRF), muscular strength has been increasingly recognized in the pathogenesis and prevention of cardiovascular disease. Objectives: To assess the association between muscle strength and early cardiovascular risk (CVR) markers in young adults. Methods: Cross-sectional study including 176 university students, 18-30 years old, from Cali, Colombia. Body mass index and fat percentage were calculated, and waist circum- ference, grip strength by dynamometry, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and CRF by VO 2max were measured as CVR markers. A multivariate logistic regression analysis was used to assess associations between muscle strength and CVR markers. Results: Inverse correlations were found between muscle strength and adiposity (r¼-.317; P¼.001), waist circumference (r¼-.309; P¼.001), systolic blood pressure (r¼-.401; P¼.001), and mean arterial pressure (r¼-.256; P¼.001). Subjects with lower levels of muscle strength had a 5.79-fold (95% CI 1.57 to 9.34; P¼.008) risk of having higher adiposity levels (25%) and a 9.67-fold (95% CI¼3.86 to 19.22; P<.001) risk of having lower CRF values for VO 2max (31.5mL$kg$min -1 ). Conclusion: In young adults, muscle strength is associated to early manifestations of CVR. It is suggested that muscle strength testing is added to routine measurement of VO 2max and traditional risk factors for prevention and treatment of cardiovascular risk. Disclosure of Interest: None Declared PM316 Depression, Chronic Stress, Or Both, And Cardiovascular Risk Factors: A Cross Sectional Study Among Urban Subjects In India Rajeev Gupta* 1 , Sonia Suchday 2 , Krishnakumar Sharma 3 , Balkishan Gupta 4 , Vijay Achari 5 , Jitendra Singh 6 , Anil Bhansali 7 , Arthur Asirvatham 8 , Rajababu Panwar 9 , Prakash Deedwania 10 1 Medicine, Fortis Escorts Hospital, Jaipur, India, 2 Ferkauf Graduate School of Psychology, Albert Einstein College of Medicine, New York, United States, 3 Fortis Escorts Hospital, Jaipur, 4 SP Medical College, Bikaner, 5 Patna Medical College, Patna, 6 Government Medical College, Jammu, 7 Postgraduate Institute of Medical Education and Research, Chandigarh, 8 Madurai Medical College, Madurai, 9 Rajasthan University of Health Sciences, Jaipur, India, 10 University of California San Francisco, Fresno, United States Introduction: Association of psychological factors with cardiovascular risk has not been well reported from low and lower-middle income countries such as India. Objectives: To determine association of depression, chronic stress, or both with cardio- vascular risk factors we performed a population-based study in India. Methods: Study was performed at eleven cities in India using population-based cluster sampling. Overall 6198 subjects were recruited, details of psychological factors were available in 5234 (84.4%, men 2891, women 2343). Subjects were evaluated for socio- demographic, lifestyle, anthropometric and biochemical factors. Prevalence of depression or stress (work, home or financial for 12 months) was determined using validated criteria. Cardiovascular risk factors were defined according to standard guidelines. Associations were determined using X 2 test and logistic regression. Odds ratios (OR) and 95% confi- dence intervals (CI) were calculated. Results: Age-adjusted prevalence (%, 95% CI) in men and women, respectively, was depression 23.5 (21.9-25.0) and 24.7 (23.1-26.3), home-related stress 56.0 (54.2-57.8) and 60.5 (58.5-62.5), work-related stress 46.3 (44.5-48.1) and 36.5 (34.5-38.4), financial stress 54.4 (52.6-56.2) and 55.5 (34.5-38.4), all three in 30.7 (29.0-32.4)and 23.8 (22.1- 25.5), and all three with depression in 11.3 (10.1-12.4) and 7.8 (6.7-8.9). In subjects with depression vs without, prevalence was significantly greater for physical inactivity (men 46.6 vs 36.4, women 51.9 vs 45.5), high waist-hip ratio (men 80.2 vs 67.2, women 88.5 vs 83.4), low HDL cholesterol (men 37.7 vs 32.3, women 58.1 vs 52.0), and diabetes (men 17.5 vs 15.5, women 14.5 vs 12.4) (p<0.05). There was no signif- icant difference in smoking, overweight/obesity, hypertension, high total cholesterol or high triglycerides. Subjects with various forms of stress had greater prevalence of physical inactivity, truncal obesity, low HDL cholesterol, diabetes and metabolic syndrome (ORs 1.22-2.19, p<0.05). Subjects with all three stressors with depression had greater prev- alence of physical inactivity, low HDL cholesterol and metabolic syndrome (ORs 1.36- 2.27, p<0.05). Conclusion: Depression, chronic stress, or both are associated with decreased physical activity and greater truncal obesity, low HDL cholesterol and diabetes. This association can explain greater cardiovascular risk in these subjects. Disclosure of Interest: None Declared PM317 Lipoprotein(a) and CETP in South Asians and Caucasians at risk for cardiovascular disease Reyhana Yahya 1 , Henk Roeters Van Lennep* 1 , Sjaam Jainandunsing 1 , Rajiv Biharie 1 , Jeanette Touw 1 , Marieke Boon 2 , Patrick Rensen 2 , Felix de Rooy 1 , Eric Sijbrands 1 , Adrie Verhoeven 1 , Jeanine Roeters van Lennep 1 , Monique Mulder 1 1 vascular medicine, Erasmus Medical Centre, Rotterdam, 2 endocrinology, Leiden University Medical Center, Leiden, Netherlands Introduction: People of South Asian (SA) origin develop obesity, metabolic syndrome, Type 2 Diabetes Mellitus (T2D) and as a consequence cardiovascular disease (CVD) at an earlier age than people of Caucasian (Cau) origin. SA display more severe dyslipidaemia than Cau with higher levels of Lipoprotein(a) (Lp(a)). Lp(a) is an independent risk factor for CVD, but the underlying mechanisms remain unclear. Plasma Lp(a) levels are mostly genetically determined, but can also be affected by specific environmental factors and some drugs. SA have higher levels of Lp(a) than other ethnicities. SA are also more prone to develop obesity, metabolic syndrome, T2D, more severe dyslipidaemia and CVD than Cau. Once the have developed T2D, they have a higher morbidity and mortality than other ethnicities. Objectives: to assess whether Lp (a) is related to CVD risk in SA and Cau at risk for (T2D) Methods: We recruited in total 31 SA and 42 Cau T2D patients and their normoglycemic and pre-diabetic relatives, based on an Oral Glucose Tolerance Test. Lipoprotein profile including Lp(a) and Cholesteryl Ester Transfer Protein (CETP) levels were determined in fasting plasma. Results: Lp(a) (after log transformation) strongly correlated with age in both SA (r¼0.459;p¼0.009) and Cau (r¼0.315;p¼0.042) even after correction for fasting glucose levels. CETP correlated negatively with age (r¼-0.394;p¼0.001) in Cau but not in SA. Lp(a) inversely correlated with CETP (r¼0.241;p¼0.04), in the total population but no longer after correction for age. Conclusion: Although Lp(a) levels are assumed to be stable over life-time, we found that Lp(a) significantly increased with age and fasting glucose. Lp(a) inversely correlated with CETP, which disappeared when corrected for age. Our data are suggestive of an interaction between Lp(a) and CETP which is in line with the observation that CETP-inhibitors reduce Lp(a) levels. Disclosure of Interest: None Declared e126 GHEART Vol 9/1S/2014 j March, 2014 j POSTER/2014 WCC Posters POSTER ABSTRACTS
Transcript of PM314 Association of muscle strength with markers of cardiovascular risk in young adults
POST
ERABST
RACTS
Objectives: The aim of our study was to assess by echocardiography the EAT in overweightand obese children and its relationship to cardiometabolic risk factors, insuline resitance,NAFLD markers and hyperuricemia.Methods: In 25 (mean age 13.0 � 2.3) overweight and obese subjects and 24 lean controls,blood pressure (BP), WC, fasting plasma glucose and insulin, lipids, uric acid and hepaticenzymes were estalished and EAT thickness measured by transthoracic echocardiography.Results: In overweight and obese subjects, EAT was significantly higher compared tonormal weight children. Overweight and obese children had significantly higher body massindex (BMI), WC, BP, triglycerides (TAG), low-density lipoprotein and total cholesterol,hepatic enzymes alanine aminotransferase (ALT) and g-glutamyl transferase, and lowerhigh-density lipoprotein cholesterol (HDL-C). EAT correlated significantly with BP, TAG,uric acid, HDL-C, apoprotein B and ALT. Correlation coefficients were similar or betterthan for WC, but similar or lower than for BMI.Conclusion: EAT thickness in children is associated with an unfavorable cardiometabolicrisk profile including biochemical signs of NAFLD and hyperuricaemia, but is not astronger indicator than BMI.Disclosure of Interest: None Declared
PM313
From the Couch to the Cuff: The Relationship between Physical Activity levelsand Blood Pressure in Older Australians
Alan Pierce*, Walter P. AbhayaratnaAcademic Unit of Internal Medicine, Canberra Hospital, Canberra, Australia
Introduction: National Physical Activity Guidelines recommend that older Australiansundertake 30 minutes of moderate intensity physical activity (PA) on most days of theweek. However, the evidence to support these guidelines is lacking. In particular, there islittle evidence to support the claim adherence to these guidelines results in better control ofCVD risk factors such as systemic hypertension in the long-term.Objectives: We sought to identify the relationship between PA levels amongst olderAustralians and changes in blood pressure (BP) over time. Specifically, we evaluate whetherrecommended PA levels suggested in the National guidelines have an effect upon future BP.It is hypothesised that achieving adequate levels of PA recommended by the AustralianNational Guidelines will be protective against the changes in BP associated with ageing.Methods: In a population-based prospective cohort study, PA levels were assessed usingthe Active Australia Survey. Brachial blood pressure was measured in accordance withNational Heart Foundation guidelines. The effects of PA on systolic BP (SBP), diastolic BP(DBP) and pulse pressure (PP) after a median follow-up period of 7 years were assessed.Results: Of the 1302 participants (69 �9 years; 53% women), 609 (46.8%) had hyper-tension at baseline. At follow-up assessment, SBP, DBP and PP increased by 16.9 � 21.5mmHg, 3.4 � 11.6 mmHg and 13.5 � 18.2, respectively. In bivariate analysis, baseline PA(p<0.05) and change in PA time from baseline to follow-up had an inverse relationshipwith SBP and PP at follow-up and positive relationship with DBP. After adjustment for ageand gender, the association between baseline PA time and SBP (p¼0.63), DBP (p¼0.63),and PP (p¼0.30) was attenuated. While not significant statistically, those who engaged in“insufficient” and sufficient” PA levels at baseline had an attenuated increase in SBP(p¼0.49) and PP (p¼0.14), and an attenuated decrease in DBP (p¼0.12) with ageing.Conclusion: In this population-based sample of older Australians, the positive effects ofbaseline PA and change in PA over time on future SBP, DBP and PP were attenuated by theeffects age and gender. There was no evidence that adherence to current National PhysicalActivity Guidelines was associated with lower levels of BP in the future.Disclosure of Interest: None Declared
PM314
Association of muscle strength with markers of cardiovascular risk in young adults
Robinson Ramírez-Vélez*1, Hector R. Triana-Reina21Facultad de Cultura Física, Deporte y Recreacion, Universidad Santo Tomas, Bogota,2Departamento de Educación Física y Deporte, Universidad del Valle, Meléndez, Cali, Colombia
Introduction: Physical fitness is one of the strongest predictors of individual future healthstatus. Together with cardiorespiratory fitness (CRF), muscular strength has beenincreasingly recognized in the pathogenesis and prevention of cardiovascular disease.Objectives: To assess the association between muscle strength and early cardiovascular risk(CVR) markers in young adults.Methods: Cross-sectional study including 176 university students, 18-30 years old, fromCali, Colombia. Body mass index and fat percentage were calculated, and waist circum-ference, grip strength by dynamometry, systolic blood pressure, diastolic blood pressure,mean arterial pressure, and CRF by VO2max were measured as CVR markers. A multivariatelogistic regression analysis was used to assess associations between muscle strength andCVR markers.Results: Inverse correlations were found between muscle strength and adiposity (r¼-.317;P¼.001), waist circumference (r¼-.309; P¼.001), systolic blood pressure (r¼-.401;P¼.001), and mean arterial pressure (r¼-.256; P¼.001). Subjects with lower levels ofmuscle strength had a 5.79-fold (95% CI 1.57 to 9.34; P¼.008) risk of having higheradiposity levels (�25%) and a 9.67-fold (95% CI¼3.86 to 19.22; P<.001) risk of havinglower CRF values for VO2max (�31.5mL$kg$min-1).Conclusion: In young adults, muscle strength is associated to early manifestations of CVR.It is suggested that muscle strength testing is added to routine measurement of VO2max andtraditional risk factors for prevention and treatment of cardiovascular risk.Disclosure of Interest: None Declared
e126
PM316
Depression, Chronic Stress, Or Both, And Cardiovascular Risk Factors: A CrossSectional Study Among Urban Subjects In India
Rajeev Gupta*1, Sonia Suchday2, Krishnakumar Sharma3, Balkishan Gupta4, Vijay Achari5,Jitendra Singh6, Anil Bhansali7, Arthur Asirvatham8, Rajababu Panwar9, Prakash Deedwania101Medicine, Fortis Escorts Hospital, Jaipur, India, 2Ferkauf Graduate School of Psychology, AlbertEinstein College of Medicine, New York, United States, 3Fortis Escorts Hospital, Jaipur, 4SPMedical College, Bikaner, 5Patna Medical College, Patna, 6Government Medical College, Jammu,7Postgraduate Institute of Medical Education and Research, Chandigarh, 8Madurai MedicalCollege, Madurai, 9Rajasthan University of Health Sciences, Jaipur, India, 10University ofCalifornia San Francisco, Fresno, United States
Introduction: Association of psychological factors with cardiovascular risk has not beenwell reported from low and lower-middle income countries such as India.Objectives: To determine association of depression, chronic stress, or both with cardio-vascular risk factors we performed a population-based study in India.Methods: Study was performed at eleven cities in India using population-based clustersampling. Overall 6198 subjects were recruited, details of psychological factors wereavailable in 5234 (84.4%, men 2891, women 2343). Subjects were evaluated for socio-demographic, lifestyle, anthropometric and biochemical factors. Prevalence of depressionor stress (work, home or financial for�12 months) was determined using validated criteria.Cardiovascular risk factors were defined according to standard guidelines. Associationswere determined using X2 test and logistic regression. Odds ratios (OR) and 95% confi-dence intervals (CI) were calculated.Results: Age-adjusted prevalence (%, 95% CI) in men and women, respectively, wasdepression 23.5 (21.9-25.0) and 24.7 (23.1-26.3), home-related stress 56.0 (54.2-57.8)and 60.5 (58.5-62.5), work-related stress 46.3 (44.5-48.1) and 36.5 (34.5-38.4), financialstress 54.4 (52.6-56.2) and 55.5 (34.5-38.4), all three in 30.7 (29.0-32.4)and 23.8 (22.1-25.5), and all three with depression in 11.3 (10.1-12.4) and 7.8 (6.7-8.9). In subjectswith depression vs without, prevalence was significantly greater for physical inactivity(men 46.6 vs 36.4, women 51.9 vs 45.5), high waist-hip ratio (men 80.2 vs 67.2,women 88.5 vs 83.4), low HDL cholesterol (men 37.7 vs 32.3, women 58.1 vs 52.0),and diabetes (men 17.5 vs 15.5, women 14.5 vs 12.4) (p<0.05). There was no signif-icant difference in smoking, overweight/obesity, hypertension, high total cholesterol orhigh triglycerides. Subjects with various forms of stress had greater prevalence of physicalinactivity, truncal obesity, low HDL cholesterol, diabetes and metabolic syndrome (ORs1.22-2.19, p<0.05). Subjects with all three stressors with depression had greater prev-alence of physical inactivity, low HDL cholesterol and metabolic syndrome (ORs 1.36-2.27, p<0.05).Conclusion: Depression, chronic stress, or both are associated with decreased physicalactivity and greater truncal obesity, low HDL cholesterol and diabetes. This association canexplain greater cardiovascular risk in these subjects.Disclosure of Interest: None Declared
PM317
Lipoprotein(a) and CETP in South Asians and Caucasians at risk for cardiovasculardisease
Reyhana Yahya1, Henk Roeters Van Lennep*1, Sjaam Jainandunsing1, Rajiv Biharie1,Jeanette Touw1, Marieke Boon2, Patrick Rensen2, Felix de Rooy1, Eric Sijbrands1,Adrie Verhoeven1, Jeanine Roeters van Lennep1, Monique Mulder11vascular medicine, Erasmus Medical Centre, Rotterdam, 2endocrinology, Leiden UniversityMedical Center, Leiden, Netherlands
Introduction: People of South Asian (SA) origin develop obesity, metabolic syndrome,Type 2 Diabetes Mellitus (T2D) and as a consequence cardiovascular disease (CVD) at anearlier age than people of Caucasian (Cau) origin.SA display more severe dyslipidaemia than Cau with higher levels of Lipoprotein(a)
(Lp(a)). Lp(a) is an independent risk factor for CVD, but the underlying mechanismsremain unclear. Plasma Lp(a) levels are mostly genetically determined, but can also beaffected by specific environmental factors and some drugs. SA have higher levels of Lp(a)than other ethnicities. SA are also more prone to develop obesity, metabolic syndrome,T2D, more severe dyslipidaemia and CVD than Cau. Once the have developed T2D, theyhave a higher morbidity and mortality than other ethnicities.Objectives: to assess whether Lp (a) is related to CVD risk in SA and Cau at risk for (T2D)Methods: We recruited in total 31 SA and 42 Cau T2D patients and their normoglycemicand pre-diabetic relatives, based on an Oral Glucose Tolerance Test. Lipoprotein profileincluding Lp(a) and Cholesteryl Ester Transfer Protein (CETP) levels were determined infasting plasma.Results: Lp(a) (after log transformation) strongly correlated with age in both SA(r¼0.459;p¼0.009) and Cau (r¼0.315;p¼0.042) even after correction for fasting glucoselevels. CETP correlated negatively with age (r¼-0.394;p¼0.001) in Cau but not in SA.Lp(a) inversely correlated with CETP (r¼0.241;p¼0.04), in the total population but nolonger after correction for age.Conclusion: Although Lp(a) levels are assumed to be stable over life-time, we found thatLp(a) significantly increased with age and fasting glucose. Lp(a) inversely correlated withCETP, which disappeared when corrected for age. Our data are suggestive of an interactionbetween Lp(a) and CETP which is in line with the observation that CETP-inhibitors reduceLp(a) levels.Disclosure of Interest: None Declared
GHEART Vol 9/1S/2014 j March, 2014 j POSTER/2014 WCC Posters
