Posters 18. Risk Factors In mild hypertension it seems that PP, ANS and TPR are already impaired. These CRF have poor correlation. It is desirable to treat high blood pressure and also the other cardiovascular risk factors. ~ 3 2 " ~ I N F L U E N C E O F D I F F E R E N T T R E A T M E N T ON METABOLIC RISK FACTORS IN ABDOMINAL OBESE
PATIENTS F. Dzgoeva. Russian Endocrinology Research Centre, Dm. Ulyanov 11,
11 7036 Moscow, Russia The aim of this study was to estimate the influence of mixed hypocaloric diet and metformin on some cardiovascular risk factors in patients with abdominal obesity (without NIDDM). Two groups of males (age 25-45, BMI 29-42 kg/m2) with abdominal obesity (waist-to-hip circumference ratio (WHR) > 1, waist circumference (WC) > 102 cm were examined before and after the treatment. Plasma levels of total cholesterol (TC) and LDL-cholesterol (LDL-C), triglycerides (TG), HDL-cholesterol (HDL-C); insulinemia, glycemia fasting and after 2 hours OGTT were determined at admission and after 12, 24 weeks of follow up. One group (I) - 15 patients received metformin (1000 mg per day) and the diet, the other group (II) - 13 patients received only diet. After the treatment: mean BMI decreased by 4.9% (6.6%) and 8.8% (13.65%), weight 4.7% (6.4%) and 9.8% (13.6%), WC - 6.96% (6.89%) and 7.8% (11.38%)-in groups I and II after 3 months (6 months), respectively. Lipid levels decreased: TC - 16.2% (14%) and 8.4% (14%), LDL-C - 21.5% (19%) and 13.12% (19.75%), TG - 18.7% (27.6%) and 24.19% (37.9%); fasting insulinemia 17.27% (40.7%) and 7.2% (24.5%), HDL-C increased 1.3% (9%) and 0.1% (3.9%)-in groups I and II after 3 months (6 months), respectively. The treatment by metformin and diet is more effective in the management of insulinresistance and some cardiovascular risk factors in patients with abdominal obesity (without NIDDM) after 3 months than diet alone. The treatment by diet alone results in a similar in lipid profile after 6 months period. But at the same time metformin combination with diet is better in reducing insuliuresistance, since it significantly decreases fasting insulin level.
LIPIDS AS R I S K FACTORS OF CVD D E V E L O P M E N T
P. Hlfibik, S. B2hna, J. Chaloupka, L. Opltovfi, V. Blfiha. Purkyne Military
Medical Academy, 500 01 Hradec Krdlov~, Czech Republic The Czech Republic ranks among the countries with highest prevalence of dyslipoproteinaemia and cardiovascular diseases (CVD). The study provides extensive information on selected anthropometrical and biochemical parameters, especially on those, which are generally used as risk indices for the origin and development of cardiovascular disease (CVD): body mass index (BMI), body fat percentage (b.fat), waist circumference (waist), serum concentrations of total cholesterol (Tchol), HDL- and LDL-cholesterol (HDL-chol, LDL-chol), triacylglyceroles (TAG) and the atherogenic index (AI). The nutritional status of a selected population - 6267 male members of the Czech Army - was assessed in 2000. As far as lipid parameters were concerned, increased serum levels were estimated in 34% (TAG), 58% (Tchol) and 41% (LDL-chol) of volunteers. Decreased serum levels of HDLchol were found in 17% of volunteers. An AI higher than 3.5 a.u. was calculated for 73% of all subjects in study. The results of the study proved the considerable prevalence of the overweightness and obesity in the male population group that was followed: according to the calculated BMI, 52% of volunteers were estimated to be overweight and 15% to be obese. The study concept made it possible to reveal the relationships among the anthropometrical and biochemical parameters followed. The regression analysis results document a statistically significant positive dependence among the BMI or waist values and the serum concentrations of Tchol, LDLchol, TAG and AI. A significant negative correlation was found between the HDL-chol serum concentration and the BMI or waist values.
~ROLE OF DIET AND REGULAR EXERCISE IN HYPERTENSION, GLUCOSE AND LIPIDS PROFILE R. Santos, J. Freitas, E. Castro, M.E. Macedo, A. Monteiro, M.J. Lima, E. Teixera, A.E Freitas. Centro Estudos Fung8o Autonfmica, Oporto
School Medicine, Oporto Faculty of Pharmacy, Porto, Portugal Hypertension play an importante role in atherosclerosis. A minimum level of high blood pressure is necessary for atherosclerosis to develop, in
the presence of hypercholesterolemia. Control of risk factors by changes in lifestyle or drugs are the major strategy for primary and secundary prevention of coronary heart disease and other atherosclerotic lesions. The aim of the study was the evaluation of the effect of a low caloric diet and regular aerobic exercise on systolic blood pressure, diastolic blood pressure, lipid profile, waist-to-hip circumference (W/H) ratio and weight reduction. Thirty-five obese BMI > 27 Kg/m z subjects, aged 38+12 years were studied. Anthropometrics parameters were measured before prescription of a low caloric diet adjusted to age, gender, physical activity and professional lifestyle. Implementation of aerobic exercise (40 minutes, 3 times for week) was performed as well. The average follow-up was 12+3 months. Blood pressure (BP) and heart rate (HR) parameters were calculated non-invasively during 10 minutes by Finapress arterial wave. Clinical Chemistry are done in central laboratory of hospital S. Jo~o, Porto after 12 hours fast. Weight(kg) First evaluation 81.3:t:13.9 Last evaluation 28.7--4.6** 73.54-12.8"
First evaluation Last evaluation
SBP(mmHg) DBP(mmHg) HR (bpm)
142.8--36.0 80.9--26.1 74.6--9.5 123.84-27.7" 66.4--16.7"* 68.74-9.5
139.1±1.9 4.2--0.5 138.7--1.5 4.14-0.4
T. Chol (mg/dl)
First evaluation 102.0--40.3 208.2--37.6 55.2--17.3 127.8--34.3 103.9--53.6 18.0--8.0 Last evaluation 87.14-8.9" 193.0--47.3 58.34-18.6 123.04-32.2 93.0:t-32.2 14.8--6.7 significance*p < 0.05; **p < 0.01 LOW caloric diet and regular exercise induced significant improvement in blood pressure control, weight reduction, glucose impairment and lipids profile, without any change on drug prescription. We expected to find enhanced rises in HDLc and an enhanced reduction of T. Cholesterol. We believe this arises from an improvement in hepatic function, due to a reduced alcohol ingestion, as shown by the ,/GT levels.
HYPERCHOLESTEROLEMIA, CORONARY ARTERY DISEASE AND TREATMENT IN CROATIA
M. Jembrek-Gostovic I. Helm, V. Jonke, M. Gostovic, M. Lopac Babajko, G. Krstacic. Institute for Cardiovascular Prevention and Rehabilitation,
Zagreb, Croatia Purpose: To determine risk factors in coronary artery disease (CAD) patients (pts) and their standard therapy at discharge from hospital and at discharge from Outpatient Rehabilitation Centre (ORC). Special emphasis is on pts with hypercholesterolemia. Methods: CAD pts (post-MI, post-CABG, pts with stable angina pectoffs (AP) and post-PTCA pts) who were admitted to ORC between June and November 1999, were included in the study. The analyses by age, gender and risk factors such as: hyperlipidemia (cholesterol > 5.2 mmol/1, triglicerydes > 2.31 mmol/l), diabetes and hypertension (>140/90 mmHg), was performed. Therapy of CAD and risk factors was analysed at discharge from hospital and at discharge from ORC. Results: 363 CAD pts were included in the study, 279 (77%) were men. Most of them were in the age groups 51 to 60 (33%) and 61 to 70 (35%). 55% of them had Q-wave myocardial infarction (MI), 9% had non-Q-wave MI; 50% had AP and 21% were post-CABG pts with or without prior MI. 6% were post-PTCA pts. AP was more often present in women than men (75% to 54%, respectively) and Q-wave MI was more often seen in men than women (49% to 42%, respectively). Non-Q-wave MI was more often seen in women than men (13% to 2%, respectively). Hypercholesterolemia was present in 73% of pts, hypertriglyceridemia in 40% of pts, hypertension in 63%, 36% were smokers, 34% had diabetes, and 32% had a positive family history. Therapy at discharge from hospital shows that 79% of the pts were taking aspirin, 45% statins, 43% ACE-inhibitors, 41% beta-blockers, 38% nitrates, 18% Ca-antagonists, 9% nitroglycerin, 7% diuretics, and only 3%
72nd EAS Congress