The prevalence of mental disorders in patients with coronary heart disease and type D personality Eur J Prev Cardiol. June 12, 2019; pp. S71–S127

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Poster Session 2
P422
The prevalence of mental disorders in patients with coronary heart disease and type
D personality
T Toril Dammen
1
, C Papageorgiou
2
, E Sverre
3
, J Munkhaugen
3
1
University of Oslo, Oslo, Norway,
2
Priory Hospital, Liverpool, United Kingdom of Great Britain
& Northern Ireland,
3
Drammen Hospital, Drammen, Norway
Funding Acknowledgements: University of Oslo
Topic: Depression and Heart Disease
Introduction: The distressed (Type D) personality is a risk indicator for multiple health out-
comes in patients with coronary heart disease (CHD), including mortality, morbidity and
emotional distress. Knowledge of the prevalence of mental disorders according to the
DSM-criteria in an unselected sample of Type D patients is scarce and the report of the
specific disorders and if these patients receive treatment have yet not been reported.
Purpose: To estimate the prevalence of psychiatric axis I and axis II disorders and describe the
proportion of patients receiving treatment.
Methods: The sample comprised consecutive patients hospitalized with myocardial infarction
and/or coronary revascularization in 2011-14 who participated in the cross-sectional
Norwegian Coronary Prevention (NOR-COR) study 2-36 months later. In all, 52 eligible
consecutive patients <65 years who scored positive for type D personality as assessed with
DS-14 were invited to this pre-planned sub-study, and 47 (90.4%) consented to participate. All
patients underwent structured clinical interviews for psychiatric state disorders (SCID-I) and
personality disorder (SCID-II) conducted by an experienced research psychiatrist. All results
were rated by an independent research psychologist. Information about current treatment for
mental disorders and sociodemographic data were obtained by patient self-report.
Participation in cardiac rehabilitation was obtained from participation lists.
Results: Mean age was 52.5 (SD 8.0) years, 21.3% were female, 96% were Caucasian, 74.4%
were married/cohabitant, and 52,3% were currently working. Only 25.5% had participated in
cardiac rehabilitation. Eight out of ten patients suffered from at least one symptom/axis I
disorder. As shown in the Table, at least one affective disorder or anxiety disorder was found
in 70.2% and 61.7% of the patients. Major depressive disorder (MDD) (59.6%), social
phobia (40.4%), and generalized anxiety disorder (29.8%) were the most common disorders.
At least one personality disorder was reported by 38.2% of the patients and avoidant (19.1%),
paranoid (19.1%) and obsessive compulsive (17.0%) personality disorders were most com-
monly occurring. Only 8 out of 38 patients (21%) with an axis I disorder reported treatment
with Serotonin reuptake inhibitors (SSRI)and none reported psychological treatment. Only
six (21.4%) of 32 with current major depressive disorder reported SSRI use.
Conclusion: Psychiatric disorders are very prevalent in CHD patients with type D
personality<65 years. These disorders seem to be unrecognized and untreated in most
patients. Our results therefore emphasize the importance of screening for type D personality
as a potential risk marker for psychiatric disorders in CHD patients. Furthermore, better
recognition and access to psychological and pharmacological treatment for these disorders
appears crucial to improve psychological well-being and prevent subsequent cardiac events.
P423
The gender-related discrete role of depressive symptomatology on 10-year first and
recurrent cardiovascular disease incidence.
M Kouvari
1
, D B Demosthenes B Panagiotakos
1
, C Chrysohoou
2
,
E Georgousopoulou
1
, V Notara
1
, D Tousoulis
2
, C Pitsavos
2
1
Harokopio University, Athens, Greece,
2
University of Athens Medical School, First Cardiology
Clinic, School of Medicine, Athens, Greece
Funding Acknowledgements: Hellenic Cardiology Society (HCS2002) and the Hellenic
Atherosclerosis Society (HAS2003)
Topic: Depression and Heart Disease
Background/Introduction: Brain and heart interplay is discussed in healthy yet even more in
cardiac population with inconclusive evidence regarding gender-related interactions.
Purpose: The gender-specific effect of depressive symptomatology on 10-year first and recur-
rent cardiovascular disease (CVD) events was evaluated.
Methods: The samples of two cohorts, ATTICA (2002-2012, n=845 subjects free-of-CVD)
and GREECS (2004-2014, n=2,172 subjects with acute coronary syndrome (ACS)) with
baseline psychological assessments (Zung Self-Rating Depression Scale and Centre of
Epidemiological Studies-Depressive symptoms scale, respectively) were used.
Results: ACS as well as free-of-CVD women scored significantly higher for depressive symp-
tomatology. Men exhibited women against first (19.7% vs. 11.7%, p<0.001) and subsequent
CVD events (38.8% vs. 32.9%, p=0.016) while in participants with depressive symptoms a
men-to-women first and recurrent CVD event rate ratio below -1- was noticed. Multivariate
analysis revealed that depressive symptomatology remained an independent aggravating
factor for first (Hazard Ratio (HR)=2.72, 95% Confidence Interval (95%CI) 1.50, 9.12,
p=0.01) and recurrent (HR=1.31, 95%CI 1.01, 1.69, p<0.001) CVD events only in
women. Mediation analysis in women revealed that 35% (23%, 44%) of excess first-CVD-
event risk of depressive symptoms was attributed to conventional risk factors. The respective
number for recurrent CVD events was 46% (23%, 53%); different patterns of ranking regard-
ing the mediating effect corresponding to each adjustment factor was observed for free-of-
CVD and ACS women.
Conclusions: The present work augments prior evidence that psychological stressors possess
important drivers of CVD onset/progression in women giving rise to research towards uni-
dentified paths.
P424
The impact of preventive counseling with subsequent remote support in patients
with high cardiovascular risk on their awareness of the healthy diet principles
N Pogosova
1
, AI Yusubova
1
, YM Yufereva
1
, AV Karpova
2
, AK Ausheva
1
1
National Medical Research Center of Cardiology, Moscow, Russian Federation,
2
National Center
for Preventive Medicine, Moscow, Russian Federation
Topic: Nutrition, Malnutrition and Heart Disease
Introduction: Awareness of the basic principles of healthy diet is essential for primary preven-
tion.
Purpose: To assess the impact of preventive counseling with focus on diet modification on the
awareness of the basic principles of healthy diet in patients (pts) with high/very high cardio-
vascular (CV) risk in Health centers (institutions targeting preventive healthcare within the
Russian healthcare system).
Methods: This is a prospective randomized controlled study of pts aged 40 to 65 years with
high/very high CV risk (5% according to the Systematic Coronary Risk Evaluation scale
[SCORE]) and any 2 criteria for metabolic syndrome. Pts were randomized into 2 groups in
1:1 ratio. The intervention group received comprehensive preventive counseling with focus on
diet modification followed by remote counseling by phone every two weeks for the first 3
months after enrollment (a total of 6 sessions). The control group received usual care in
Health centers which also included basic preventive counseling. A specially designed ques-
tionnaire was used to evaluate the awareness of the basic principles of healthy diet. Follow-up
was 12 months.
Results: A total of 100 pts (women - 80%, aged 59.854.47 years) were randomized. At
baseline 71% pts had high and 19% - very high CV risk. The groups were well balanced
according to demographic and clinical features. Baseline awareness of healthy diet principles
was very low in both groups, and both groups experienced significant improvement at 1 year
of follow-up. The awareness at 12 months was significantly greater in the intervention group
vs control for sufficient fruit/vegetable and fish consumption and for regular energy-controlled
eating (p<0.05 for all).
Conclusion: Comprehensive preventive counseling with focus on diet modification followed by
remote preventive counseling by phone provided a significant improvement in awareness of
the basic principles of healthy diet in pts with high/very high CV risk.
Abstracts S71

P425
Effect of mediterranean diet on the blood fatty acid profile of patients with coronary
disease
M Manuela Amato
1
, MG Giroli
1
, V Cavalca
1
, JP Werba
1
, A Bonomi
1
, L Vigo
1
,
P Rise
2
, E Tremoli
1
, F Veglia
1
1
Cardiology Center Monzino IRCCS, Milan, Italy,
2
University of Milan, Department of
Pharmacological and Biomolecular Sciences, Milan, Italy
Funding Acknowledgements: This work was supported by a grant from the Italian
Ministry of Health RF-2011-02352056
Topic: Nutrition, Malnutrition and Heart Disease
Introduction: Observational and interventional studies showed a possible role of the
Mediterranean diet (MD) in the prevention of cardiovascular disease; the blood fatty acid
(FA) profile has been associated with cardiovascular risk and its modification, induced by diet,
could be a mediator of the positive effects of MD.
Purpose: To assess whether MD is able to favorably modify the blood FA profile in patients
with coronary heart disease (CHD).
Methods: RISMeD (Randomized Intervention Study on Mediterranean Diet): Parallel groups,
open-label study.
Interventions: Intensive MD vs. conventional low-fat diet (LFD) for 3 months. 130 patients
(30-75 years) with a recent history of coronary revascularization were randomized after clin-
ical stabilization (>60 days after coronary bypass or stenting). At baseline and after 3 months
of treatment, anthropometric data, routine biochemical variables, C-reactive protein (hs-
CRP) and blood fatty acid percent composition were determined. MD adherence was assessed
by the Mediterranean Diet Adherence Screener (MEDAS), a 14-item tool developed and
validated for the Spanish PREDIMED trial.
Results: 120 patients (58 MD, 62 LFD) completed the study. After 3 months of treatment
many FA varied significantly (Table) and both diets significantly reduced the blood concen-
tration of saturated FA (p<.0001). Putative favorable changes of blood o3 (p=.026) and of
the unsaturation index (p=.032) were significantly larger with MD than with LFD; notably,
the results were not modified after adjustment for weight loss. Also 20:4n-6 (arachidonic acid)
increased more with MD than with LFD (p=.049) but this change was not paralleled by an
increase of hs-CRP. The change of MEDAS score correlated with changes of many FA:
inversely with 16:0 (R= -0.21, p=.02), and with 22:5 n-6 (R= -0.25 p=.007), and positively
with total o3 (R= 0.19, p=.03) and 20:5 n-3 (R=0.28, p=.002).
Conclusions: In summary, MD modifies the blood fatty acids profile of patients with CHD
more effectively than LFD, and MD adherence correlates with the increase of total o3.
Clinical Trial.gov Identifier- NCT02578329
FA variations after diet intervention
ALL LFD MD ALL LFD MD
16:0 -0.772.86* -0.652.81 -0.892.94* 20:4n-6 0.281.93 -0.011.96 0.61.86*§
18:0 -0.581.29* -0.451.07* -0.711.49* 22:6n-3 0.110.91 -0.030.92 0.270.89*
16:1 -0.150.53* -0.190.58* -0.10.48 Total saturated -1.553.81* -1.253.66* -1.883.98*
18:1 0.933.33* 1.143.31* 0.73.36 Total polyunsaturated 0.643.96 0.174.14 1.143.73*
20:3n-9 -0.050.13* -0.070.14* -0.030.11 Unsaturation Index 2.3514.38 -0.0614.46 4.9213.9*§
18:2n-6 0.752.76* 0.912.74* 0.582.8 Total omega 3 -0.061.6 -0.321.48 0.221.67§
mean % SD; * p<0.05 vs. baseline; § p<0.05 MD vs. LFD
P426
Olive consumption and risk of atrial fibrillation on a young spanish cohort
P Pablo Bazal
1
, A Gea
1
, C De La Fuente-Arrillaga
1
, MT Barrio-Lopez
2
,
MA Martinez-Gonzalez
1
, M Ruiz-Canela
1
1
University of Navarra, Preventive Medicine &Public Health, Pamplona, Spain,
2
Hospital
Monteprincipe, Grupo HM, Electrophysiology Laboratory and Arrhythmia Unit, Madrid, Spain
On Behalf of: SUN
Topic: Nutrition, Malnutrition and Heart Disease
Background: The PREDIMED trial found a protective effect of extra-virgin olive oil con-
sumption on atrial fibrillation (AF) development in a high cardiovascular risk old population.
No other studies have been published assessing this effect afterwards. We analysed the asso-
ciation between olive oil consumption and AF in the "Seguimiento Universidad de Navarra"
(SUN) cohort study.
Methods: We excluded participants with prevalent AF at baseline and without information
about olive oil consumption. Olive oil consumption was self-reported by participants in 2
questions included in a validated food frequency questionnaire (FFQ). This consumption
referred to the use of olive oil for cooking or crude olive oil itself and it was updated after
10 years of follow-up. We performed multivariable Cox regression models adjusting for age,
sex and AF risk factors (hypertension, body mass index, diabetes, sleep apnoea, physical
activity, cardiovascular disease and alcohol consumption).
Results: A total of 18118 participants were included, 60.4% were women and the mean age
was 37.6 years (SD 12.1). After a median follow-up of 10.3 years, 94 AF cases were confirmed
by a cardiologist. No significant association was found between higher olive oil consumptions
and AF risk. Taking the lowest consumption of olive oil (mean 3.6 grams/day) as reference,
the Hazard Ratio (95% confidence interval) for AF was 1.21 (0.71-2.05), for low-moderate
consumption (mean 9.6 g/d), 1.28 (0.72-2.27) for moderate-high consumption (mean 18.6 g/
d), and 1.31 (0.74-2.32) for high consumption of olive oil (mean 33.1 g/d).
Conclusion: We found no association between olive oil consumption and AF in a cohort with
young-adults university-graduates from Spain.
(mean: 3.6 g/d)
Low-moderate
(mean: 9.6 g/d)
Moderate-high
(mean: 18.6 g/d)
High
(mean: 33.1 g/d)
Number cases 24 29 19 22
Total 5,210 5,211 3,177 4,426
Crude 1. (reference) 1.17
(0.68-2.02)
1.22
(0.68-2.2)
1.25
(0.71-2.18)
Age, sex adjusted 1. (reference) 1.22
(0.71-2.1)
1.31
(0.73-2.32)
1.43
(0.81-2.51)
Multivar. Adjusted 1. (reference) 1.21
(0.71-2.05)
1.28
(0.72-2.27)
1.31
(0.74-2.32)
Table 1 AF incidence risk (HR, 95% CI) according to different categories of olive oil inta-
keadjusted for age, sex, body mass index, physical activity, diabetes, arterial hypertension,
sleep apnea, height, alcohol consumption and cardiovascular disease: previous diagnosis of
coronary artery disease or cerebrovascular stroke and adherence to Mediterranean diet.
P427
Substitution of liquid dairy and risk of incident type 2 diabetes mellitus in the EPIC-
NL cohort
L E T Linda Vissers
1
, JM Stuber
1
, WMM Verschuren
2
, JMA Boer
2
, YT Van Der
Schouw
1
, I Sluijs
1
1
University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care , Utrecht,
Netherlands (The),
2
National Institute for Public Health and the Environment (RIVM),
Bilthoven, Netherlands (The)
Topic: Nutrition, Malnutrition and Heart Disease
Background: Identifying modifiable risk factors for type 2 diabetes mellitus (T2DM) is essen-
tial to improve prevention strategies. Higher consumption of dairy products, in particular
yogurt, has been associated with a lower risk of T2DM. In a Danish population, consumption
of whole-fat yogurt instead of milk, buttermilk or skimmed yogurt has been associated with a
lower risk of T2DM.
Objective: To investigate associations of liquid dairy product substitutions with T2DM inci-
dence.
Methods: 35,900 participants of the European Prospective Investigation into Cancer and
Nutrition-Netherlands (EPIC-NL) cohort were included. Information on liquid dairy con-
sumption (skimmed milk, skimmed fermented milk, buttermilk, whole-fat milk, whole-fat
yogurt) at baseline (1993-1997) was obtained by a single validated food frequency question-
naire. Potential T2DM cases were identified by self-report or linkage to the hospital discharge
registry, and validated by consulting the general practitioner. Multivariable Cox proportional-
hazard regression models were applied to investigate the association between substitution
of portions (200 gram) of liquid dairy product and risk of incident T2DM.
Results: During 15 years follow-up, 1,466 validated incident cases of T2DM occurred. After
adjustment for demographic and cardiovascular risk factors, replacing whole-fat milk
(HR:0.87, 95%CI:0.56-1.36), buttermilk (HR:0.79, 95%CI:0.52-1.21) skimmed milk
Abstract Number: P424
The effects of preventive counseling
Intervention group p Control group p P for differences between groups at 12 months p
Baseline, % p At 12 months, % p Baseline, % p At 12 months, % p
Sufficient fruit and vegetable
consumption (500 g per day) p
8.0 p 90.0* p 12.5 p 70.0* p <0.05
Sufficient fish consumption
(2 times per week) p
2.0 60.0* p 10.4 p 40.0* p <0.05
Eating 3-4 meals per day p 16.0 66.0* p 16.7 p 42.0* p <0.05
Restriction of deep fried foods 4.0 54.0* p 10.4 p 50.0* p ns
Salt restriction 2.0 44.0* p 10.4 p 48.0* p ns
Restriction of saturated fats 10.0 68.0* p 16.7 p 70.0* p ns
Restriction of refined sugars 8.0 40.0* p 18.7 p 42.0* p ns
*p<0.001 for change vs baseline within group; ns = nonsignificant
S72 EuroPrevent Congress Abstracts June 2019

(HR:0.78, 95%CI:0.51-1.19) or skimmed fermented milk (HR:0.89, 95%CI:0.57-1.39) with
whole-fat yogurt was not associated with risk of T2DM, nor was replacing whole-fat milk
(HR:0.98, 95%CI:0.80-1.19) or buttermilk (HR:0.89, 95%CI:0.76-1.03) with skimmed fer-
mented milk, replacing whole-fat milk (HR:1.12, 95%CI:0.93-1.35) or skimmed fermented
milk (HR:1.15. 95%CI:0.98-1.33) with skimmed milk, or replacing whole-fat milk (HR:1.10,
95%CI:0.93-1.30) and skimmed milk (HR:0.98, 95%CI:0.90-1.08) with buttermilk.
Conclusion: Modelled substitutions within the group of liquid dairy products were not asso-
ciated with risk of T2DM among a Dutch population, in contrast with findings from a
previous Danish cohort. Wide confidence intervals for the whole-fat yogurt substitutions
suggested low statistical power. To further elucidate these findings, the associations between
dairy substitution and diabetes risk should be investigated in other populations, preferably
with a wider consumption range of whole-fat yogurt.
P428
Usefulness of GLIM criteria, a new international definition for malnutrition, for pre-
dicting prognosis in patients with cardiovascular disease
Y Yoshifumi Kootaka
1
, K Kamiya
2
, N Hamazaki
3
, R Matuzawa
3
, K Nozaki
3
,
T Ichikawa
3
, S Uchida
1
, K Aida
1
, M Yamashita
1
, T Nakamura
1
, E Maekawa
4
,
M Tojo
2
, A Matunaga
2
, T Masuda
2
, J Ako
4
1
Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan,
2
Kitasato
University, School of allied health sciences department of rehabilitation, Sagamihara, Japan,
3
Kitasato University Hospital, rehabilitation, Sagamihara, Japan,
4
Kitasato University School of
Medicine, Cardiovascular Medicine, Sagamihara, Japan
On Behalf of: kitasato University
Topic: Nutrition, Malnutrition and Heart Disease
[Background] It is well known that malnutrition causes dysfunction and decreased quality of
life and is related to prognosis. However, The definition of malnutrition differed for each
region. therefore, in September 2018, a new international standard for malnutrition—the
Global Leadership Initiative on Malnutrition i.e.GLIM criteria—was
announced.Currently’studies examining the relationship of malnutrition to prognosis using
GLIM criteria in patients with cardiovascular disease (CVD) are lacking.
[Objective] We examined the relationship between malnutrition, as defined by GLIM criteria,
and prognosis in patients with CVD.
[Method] The study included 627 patients aged 65 years who were admitted to our institutions
for CVD treatment.We investigated the following parameters according to GLIM criteria: (1)
low body mass index (BMI; BMI <18.5 kg/m2and age <70 years, BMI <20 kg/m2and age >70
years), (2) low appendicular skeletal muscle mass index (males <7.0 kg/m2’females <5.4 kg/m2),
(3) reduced food intake (<50% of energy requirements >1 week), and (4) the existence of
inflammatory status. According to GLIM definition of malnutrition, we defined a patient as
malnourished if either one of (1) or (2) and either (3) or (4) applied. The endpoint was all-cause
mortality. Cox proportional hazard analysis and KaplanMeier survival curves were used for
statistical analysis. Multivariate analysis was conducted with adjustments for age, sex, diabe-
tes,smoking history, hypertension,dyslipidemia, and heart failure.
[Results] Of 627 patients (mean age 75.3 6.6 years’210 females), 161 were classified as mal-
nourished based on GLIM criteria. Overall, 162 deaths occurred during the follow-up period of
1.30 years (interquartile range: 0.22.4 years).KaplanMeier survival curves followed by log-
rank test demonstrated that all-cause mortality increased significantly in malnourished patients
(Figure 1).Risk of death significantly increased in patients classified as malnourished based on
GLIM criteria [hazard ratio (HR) 1.31’95% confidence interval (CI): 1.04 to 1.63’p <0.02];
these patients were significantly associated with increased mortality (HR 1.29’95% CI: 1.02 to
1.61’p <0.04)even after adjusting for age and sex. Furthermore, malnutrition was significantly
associated with increased mortality (HR 1.34’95% CI: 1.03 to 1.73’p <0.03) despite adjustments
for diabetes and smoking history, hypertension and dyslipidemia, and heart failure.
[Conclusion] Use of GLIM criteria to diagnose malnutrition enables risk stratification in
patients with CVD.
Survival curve on GLIM criteria
P429
The healthy diet index and intake of dietary antioxidants are related to educational
level in Polish adults: a nationwide study
M E Zujko
1
, A Waskiewicz
2
, AM Witkowska
1
, K Zujko
3
, D Szczesniewska
2
,
T Zdrojewski
4
, K Kozakiewicz
5
, W Drygas
6
1
Medical University of Bialystok, Department of Food Biotechnology, Bialystok, Poland,
2
Institute
of Cardiology, Department of Epidemiology, Cardiovascular Disease Prevention and Health
Promotion, Warsaw, Poland,
3
Medical University of Bialystok, Students‘ Scientific Group at
Department of Food Biotechnology, Bialystok, Poland,
4
Medical University of Gdansk,
Department of Prevention and Education, Department of Hypertension and Diabetology, Gdansk,
Poland,
5
Medical University of Silesia, 3rd Department of Cardiology, Upper Silesian Centre of
Cardiology, Katowice, Poland,
6
Medical University of Lodz, Department of Social and Preventive
Medicine, Lodz, Poland
On Behalf of: WOBASZ Investigators
Funding Acknowledgements: Institute of Cardiology Grant No. 2.17/I/16, Medical
University of Bialystok Grant No. N/ST/ZB/17/003/3317
Topic: Nutrition, Malnutrition and Heart Disease
Background: In the pathogenesis of cardiovascular diseases (CVD) an important role play
modifiable risk factors, such as diet, physical activity, stress, smoking and alcohol consump-
tion. Epidemiological studies found an inverse association between the intake of healthy diet,
antioxidant-rich food (antioxidant vitamins, polyphenols), and the risk of CVD. It is well
known that the educational level may determine dietary habits and food choice.
Purpose: The objective of this study was to determine the association between the healthy diet
index (HDI), dietary total antioxidant capacity (DTAC) and dietary polyphenol intake (DPI),
and educational level in Polish adults.
Methods: Subjects (12927, 6963 women and 5964 men) were participants of the Multi-centre
National Population Health Examination Surveys, WOBASZ (20032005) and WOBASZ II
(20132014), two largest population-based cross-sectional studies carried out in Poland by the
National Institute of Cardiology in Warsaw. Daily food consumption was estimated using a
24-hour dietary recalls. DTAC and DPI were calculated by multiplying the daily consumption
of individual food items by antioxidant potential of foods (measured by FRAP - ferric redu-
cing antioxidant potential method) and polyphenol contents (measured by Folin-Ciocalteu
assay) in these food items. HDI was calculated using 7 components: percentages of energy
intake from saturated fatty acids, polyunsaturated fatty acids (PUFAs), mono- and disacchar-
ides, and protein; intakes of cholesterol (mg/day), fruits and vegetables combined (g/day), and
dietary fiber (g/day). The HDI ranged from 0 (the least healthy diet) to 7 (the healthiest diet).
Results: In the analyzed group significantly higher (p=0.007) HDI was observed in the women
with higher educational level (HDI=3.27) in comparison to secondary (HDI=3.21) and
primary (HDI=3.13) educational level. Both DTAC and DPI were significantly higher
(p<0.0001) in women with higher educational level (12.56 mmol and 2004 mg, respectively)
in comparison to secondary (12.36 mmol and 1979 mg, respectively) and primary (11.30 mmol
and 1861 mg, respectively) educational level. Such associations were not found for men. The
major dietary contributors to the DTAC in the studied group were: beverages (tea, coffee),
fruits (apples), vegetables (potatoes, cabbage, beetroots), and next: cereals, nuts and seeds,
and chocolates. Higher educational level was associated with higher intake of nuts and seeds,
and chocolates in the women and in the men. Conclusions. This study demonstrated that
higher healthy diet index, and both higher dietary total antioxidant capacity and dietary
polyphenol intake are associated with higher educational level in Polish women.
P430
Macronutrients, successful aging and cardiometabolic burden: a combined analysis
of two epidemiological studies
A Foscolou
1
, S Tyrovolas
1
, AL Matalas
1
, E Magriplis
1
, L Sidossis
1
, C Chrysohoou
2
,
L Rallidis
1
, C Pitsavos
2
, D B Demosthenes B Panagiotakos
1
1
Harokopio University, Athens, Greece,
2
University of Athens Medical School, First Cardiology
Clinic, School of Medicine, Athens, Greece
Funding Acknowledgements: Hellenic Cardiology Society (HCS2002) and the Hellenic
Atherosclerosis Society (HAS2003)
Topic: Nutrition, Malnutrition and Heart Disease
Background/Introduction: The role of nutrition on human health is well established. However,
the role of specific macronutrients, i.e., carbohydrates (CHO) or proteins (PRO), on successful
aging and human health is not fully specified.
Purpose: The aim of the present work was to evaluate the association between specific macro-
nutrients (PRO and CHO) with successful aging and health status of Greek adults.
Methods: 1128 individuals from the epidemiological ATTICA study and 2300 individuals
from the epidemiological MEDIS study, over 50 years old, were voluntarily enrolled.
Dietary habits were assessed through food frequency questionnaires, while CHO or PRO
consumption was considered low or high when CHO- or PRO gram consumption was
below or above the median, respectively. Successful aging (SAI) was evaluated using a vali-
dated index composed of 10 health-related social-, lifestyle- and clinical characteristics, while a
cumulative score (range 0-4) indicating the overall burden of classical cardiometabolic risk
factors (i.e., obesity, diabetes, hypertension, hypercholesterolemia) was used.
Results: Positive correlation between protein and carbohydrate consumption with successful
aging (r = 0.270, p<0.001 and r = 0.280, p<0.001, respectively) was observed. Moreover, for
both ATTICA and MEDIS studies’ participants, for every 1 g/day increase in energy adjusted
carbohydrate and protein intake, an increase of 0.177 units and 0.156 units, respectively, in the
SAI was observed (p<0.001). The prevalence of hypertension and diabetes was lower among
people who consumed high PRO and low CHO diet compared to other combinations of PRO
and CHO diets (p<0.001). Finally, those who consumed a diet high in PRO and CHO had less
Abstracts S73

cardiometabolic risk factors (1.421.0) compared with those who consumed a diet low in
PRO and high in CHO (1.751.0) (p<0.01).
Conclusions: High PRO diets seem to be beneficial for older adults in terms of quality of life,
successful aging and health.
P431
Olive oil consumption, health status and successful aging of a Mediterranean popu-
lation: a combined analysis of two epidemiological studies
A Foscolou
1
, E Critselis
1
, AL Matalas
1
, L Rallidis
1
, C Chrysohoou
2
, C Pitsavos
2
,
L Sidossis
1
, D B Demosthenes B Panagiotakos
1
1
Harokopio University, Athens, Greece,
2
University of Athens Medical School, First Cardiology
Clinic, School of Medicine, Athens, Greece
Funding Acknowledgements: Hellenic Cardiology Society (HCS2002) and the Hellenic
Atherosclerosis Society (HAS2003)
Topic: Nutrition, Malnutrition and Heart Disease
Background/Introduction: The health benefits of olive oil consumption remain unrivaled when
compared to those of other oils. However, the association between exclusive olive oil and
health status or successful aging is not fully clarified.
Purpose: The aim of this work was to evaluate the association between exclusive use of olive
oil, health status and successful aging of the Greek population.
Methods: 1128 individuals from the epidemiological ATTICA study and 2300 individuals
from the epidemiological MEDIS study, permanent residents of Greece and over 50 years
of age, were voluntarily enrolled. Dietary habits were assessed through food frequency ques-
tionnaires. Exclusive use of olive oil was defined as the exclusive consumption of olive oil
without consumption of other fats (e.g., butter, margarine, seed oil etc.). Participants were
divided into three groups: a) abstain from olive oil, b) consumption of olive oil and other fats,
and c) exclusive use of olive oil. Clinical and lifestyle characteristics were also evaluated.
Finally, successful aging was evaluated using a validated index composed of 10 health-related
social-, lifestyle- and clinical characteristics.
Results: The prevalence of hypertension (79%, p = 0.02) and diabetes (20%, p = 0.05) was
lower among those who consumed exclusively olive oil compared to those who did not use
olive oil or consumed other fats, while the prevalence of hypercholesterolemia was lower to
exclusive olive oil consumers compared to those who consumed other fats (48% vs 57%, p
<0.001). In addition, the successful aging score was higher for those who consumed only olive
oil (3.1 1.4) compared to non-consumers of olive oil (2.9 1.3) and consumers of other fats
(3.0 1.0) (p = 0.05). Moreover, adjusting for age, sex and smoking habits, the exclusive use
of olive oil in the diet compared to the absence of olive oil from a diet was positively associated
with successful aging (b SE: 0.33 0.09, p <0.001).
Conclusions: The exclusive use of olive oil in the diet as a form of fat can be the ideal
nutritional choice for ensuring quality of life and good health for older people.
P433
Potato intake and risk factors for the metabolic syndrome and cardiovascular dis-
ease in a large Norwegian cohort (The HUNT Study).
T Moholdt
1
, BL Devlin
2
, TIL Nilsen
1
1
Norwegian University of Science and Technology, Trondheim, Norway,
2
Australian Catholic
University, Melbourne, Australia
Funding Acknowledgements: Funded by the Alliance for Potato Research &Education
(APRE)
Topic: Nutrition, Malnutrition and Heart Disease
Background: Epidemiological studies are scarce and equivocal regarding evidence for associa-
tions between habitual potato intake and obesity, type 2 diabetes and cardiovascular disease
(CVD). Overall potato consumption associates with measures of adiposity, however, few
studies have explicitly stated the preparation method of potatoes.
Purpose: Our aim was to investigate the associations between habitual intake of boiled pota-
toes and components of the metabolic syndrome and CVD risk factors in a large Norwegian
population.
Methods: We included 49,932 participants in the third survey of the Nord-Trøndelag Health
Study, Norway (HUNT3, 2006-2008). The participants answered questions about their habi-
tual intake of various food groups, and our primary exposure variable was the frequency of
boiled potato intake, as assessed by the question "How often do you normally eat boiled
potatoes?" We categorised potato intake into four frequencies; 1)<once/week, 2) 1-3 times/
week, 3) 4-6 times/week, and 4) once/day. We estimated the mean difference in BMI, waist
circumference (WC), systolic and diastolic blood pressure, total cholesterol, triglycerides and
HDL cholesterol according to potato consumption, adjusted for age, sex, CVD, physical
activity, smoking, alcohol and intake of vegetables and pasta/rice. We also estimated the
adjusted odds ratio (OR) for adverse levels of the above-mentioned CVD risk factors accord-
ing to potato consumption.
Results: Compared to individuals who consumed potatoes<once/week, those with potato
intake 4-6 times/week had a 0.4 (95% confidence interval [CI], 0.2-0.6) kg/m2 higher BMI
and a 1.3 (95% CI, 0.8-1.8) cm higher WC. The OR for having a BMI 25 kg/m2 was 1.20
(95% CI, 1.09-1.32) in individuals who consumed potatoes 4-6 times/week, compared to those
eating potatoes<once/week, whereas the corresponding OR for high WC (> 88 cm for
women/ > 102 cm for men) was 1.23 (95% CI, 1.12-1.36). Individuals who consumed pota-
toes 4-6 times/week had 0.10 (95% CI, 0.05-0.15) mmol/L higher total cholesterol than those
who consumed potatoes<once/week and an OR of 1.14 (95% CI, 1.02-1.26) for total choles-
terol 6 mmol/L. They also had an OR of 1.24 (95% CI, 1.13-1.27) for triglycerides 1.7
mmol/L compared to those eating potatoes<once/week. Compared to individuals who
consumed potatoes<once/week, those who consumed potatoes 4-6 times/week and once/
day had an OR for the metabolic syndrome of 1.21 (95% CI, 1.07-1.37) and 1.19 (1.05-1.36),
respectively, whereas those who consumed potatoes 1-3 times/week had an OR of 1.09 (95%
CI, 0.96-1.24).
Conclusions We observed associations between habitual consumption of boiled potatoes and
adverse levels of some, but not all, components of the metabolic syndrome and CVD risk
factors. Since this was a cross-sectional study, we are not able to determine any cause-effect
and future studies should assess the longitudinal associations between the intake of potatoes
and CVD risk.
P434
Increase omega-3 index in older adults to reduce heart rate during sleep and activ-
ity: a small daily supplement of fish oil is all you need.
PL Mclennan
1
, R Anthony
1
, MA Brown
1
, KL Walton
2
, GE Peoples
1
1
University of Wollongong, Centre for Human and Applied Physiology, School of Medicine,
Wollongong, Australia,
2
University of Wollongong, Wollongong, Australia
Topic: Nutrition, Malnutrition and Heart Disease
Background: A low omega-3 index (linked to low fish consumption) is associated with elevated
cardiovascular risk. Elevated heart rate (HR) is also an independent risk factor for cardio-
vascular mortality and morbidity, in both healthy individuals and heart disease patients, at
least in part by reducing cardiac oxygen consumption. Animal studies demonstrate dietary fish
oil reduces: HR; oxygen consumption; and arrhythmia vulnerability, while regular fatty fish
consumption or high dose fish oil supplements reduce HR in epidemiology, physiology labora-
tory and clinical trials.
Purpose: Can low supplemental intake of fish oil raise omega-3 index and reduce cardiac
parameters of cardiovascular risk in older adults?
Methods: Physically fit, healthy older adults (701 y) were randomised to receive 2g/d of
either DHA-rich fish oil (FO; n=9) (delivering 560mg/d DHA and 140mg/d EPA), or high
oleic sunflower oil (control; n=8) (1700mg/d oleic acid) for 16w. Omega-3 index (% red blood
cell EPA+DHA) was measured before and after supplementation. Participants wore an
ambulatory ECG monitor overnight and while completing a series of physical fitness tests,
including speed walking over 400m indoors. Heart rate and heart rate variability (HRV) were
measured during rest (including overnight sleep), exercise states and recovery.
Results: Omega-3 index was significantly increased after FO supplement (meanSEM, con-
trol: pre 6.10.3, post 5.90.2; FO: pre 6.00.2, post 8.30.4). Mean sleeping HR overnight
was not significantly different (control: pre 622, post 602; FO: pre 602, post 572,
P=0.28). Mean overnight HR nadir (10 min average) was significantly decreased by FO
(control: -0.21.0; fish oil: -3.81.2 bpm, P<0.05) without changes in HRV (p>0.05).
Mean steady-state HR during 400m walk was reduced (control: pre 1202, post 1242;
FO: pre 1222, post 1152 bpm, P<0.01) without change in walking speed (control: pre
1.550.06, post 1.580.07; FO: pre 1.590.05, post 1.590.06 m/s). There were no changes in
strength or physical fitness measures.
Conclusions: A daily DHA-rich fish oil supplement, equivalent to two meals of fatty fish per
week, elevated the omega-3 index in older adults. This was associated with lower heart rate
during sustained physical activity (unaltered walking speed suggests improved oxygen effi-
ciency) and during sleep (unaltered autonomic activity suggests lower intrinsic heart rate). A
supplemental DHA-rich fish oil, in low doses, can reduce heart rate in older adults, with
implications for reduced cardiovascular risk and prevention of cardiac events.
P436
Ouzo consumption and the risk of hypertension in middle-aged men and postme-
nopausal women.
P Panagiotis Sdrevanos
1
, P Brika
1
1
Xanthi Heart Center, Cardiology Department of General Hospital of Xanthi, Xanthi, Greece
Topic: Nutrition, Malnutrition and Heart Disease
Background: Heavy alcohol intake increases the risk of hypertension, but the relationship
between light to moderate alcohol consumption and incident hypertension remains contro-
versial.
Purpose: Our primary outcome was the effect of different Greek alcoholic beverage Ouzo
consumption categories on the long-term risk of developing hypertension
Methods: We analyzed the dose-response relationship between average daily ouzo consump-
tion and the risk of hypertension among 1535 postmenopausal women and 1600 middle aged
men,50 to 70 years of age. At base line, all the participants were free of diagnosed cardiovas-
cular disease,diabetes melitus and cancer. The level of alcohol consumption was assigned to
categorical groups: light,moderate and heavy and it was based on the amount of alcohol in
grams per day (g/d). Based on their daily ouzo intake, men were categorized into 7 drinking
categories based on increments of 10 g/d of alcohol consumption: abstainers (nondrinkers),
<10 g/d, 10 to 20 g/d, 20 to 30 g/d, 30 to 40 g/d, 40 to 50 g/d, and >50 g/d. Similarly, women
were categorized into 5 groups: abstainers (nondrinkers), <10 g/d, 10 to 20 g/d, 20 to 30 g/d,
and 30 to 40 g/d.Our primary outcome was the effect of different alcohol consumption
categories on the long-term risk of developing hypertension.The whole study had a duration
of 5 years with every 3 month control of the participants (24-Hour Ambulatory Blood
Pressure Monitoring).
Results: Compared with nondrinkers, men with alcohol consumption with <10 g/d and 11 to
20 g/d had a trend toward increased risk of hypertension respectively, whereas a significantly
increased risk of hypertension was found with heavy alcohol consumption of 31 to 40 g/d and
>50 g/d. Among women, the results indicated protective effects at <10 g/d and a trend toward
decreased risk of hypertension with alcohol consumption 11 to 20 g/d, whereas a significantly
S74 EuroPrevent Congress Abstracts June 2019

increased risk of hypertension was indicated with heavy alcohol consumption of 21 to 30 g/d
and 31 to 40g/d
Conclusions: Heavier ouzo consumption >20g/d is associated with the risk of development of
hypertension in both women and men. With regards to light to moderate ouzo consumption
(<20 g/d), women had a reduced risk of hypertension, while men had an increased risk of
hypertension. The protective effect of ouzo in women is modest and cannot support ouzo
consumption as a protective measure.
P437
Compositional changes in the cholesterol ester fatty acid profile when comparing a
diet high in dairy products, to diets high in meat or grain.
L E T Vissers
1
, S Soedamah-Muthu
2
, YT Van Der Schouw
1
, NPA Zuithoff
1
,
JM Geleijnse
3
, I Sluijs
1
1
University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care , Utrecht,
Netherlands (The),
2
Tilburg University, Tilburg, Netherlands (The),
3
Wageningen University
UR, Wageningen, Netherlands (The)
Funding Acknowledgements: I Sluijs was supported by a personal Dr. Dekker postdoc-
toral grant (2015T019) from the Netherlands Heart Foundation
Topic: Nutrition, Malnutrition and Heart Disease
Background: A higher dairy product intake is suggested to increase blood concentrations of
C15:0 (pentadecanoic acid), C17:0 (margaric acid), and C14:0 (myristic acid). The odd-chain
FAs C15:0 and C17:0 have in turn been associated to a lower risk of cardiometabolic diseases.
However, it remains uncertain to what extent the observed correlations are attributable to
dairy product intake, since RCTs have thus far used ad libitum dietary interventions and did
not take into account that a FA profile is compositional.
Objective: To characterize the plasma cholesterol ester FA profile after a diet high in dairy
products.
Design: In a randomized multiple cross-over study, 13 men and 17 women aged 22 4 years
with a BMI of 21.6 2.2 kg/m2 and habitual energy intake of 12.4 1.8 MJ/day received 3
isocaloric intake controlled intervention diets (dairy, grain or meat) in random order. Fat
intake was aimed to be 30en%/day (SFA <10en%/day). For this post-hoc analysis, FA profile
in plasma cholesterol esters was measured using gas chromatography, and individual FA
concentrations were transformed using a centered log ratio. We performed a linear mixed
model per transformed FA, adjusting for period, diet order and the interaction term between
diet and period. We additionally adjusted for alcohol intake (g/day) in a second model.
Results: Total fat intake per intervention diet was 31.0 0.9 en%/day (dairy), 31.5 0.6
en%/day (meat), and 28.4 1.2 en%/day (grain), respectively. The dairy diet led to higher
relative concentrations of C15:0 (bmeat-0.27, 95%CI -0.37,-0.17; bgrain-0.16, 95%CI -0.25,-
0.06). Furthermore, in comparison to the meat diet, the dairy diet led to higher relative C14:0
concentrations (b-0.36, 95%CI -0.37,-0.17). C17:0 did not differ between diets.
Conclusions: The plasma FA profile after the dairy diet was characterized by an abundancy of
C15:0. Concentrations of C14:0 were also higher after the dairy diet, but only when compared
to the meat diet. C17:0 did not differ between diets. This may be due to an effect of FA
metabolism. Future studies should investigate whether C15:0 concentrations in the blood are
causally related to risk of cardiometabolic diseases.
P438
Evaluation of prevalence and magnitude of supplementation with vitamins and
minerals in the adult Polish population
A Anna Waskiewicz
1
, D Szczesniewska
1
, A Cicha-Mikolajczyk
1
, M Zujko
2
, A Pajak
3
,
M Kwasniewska
4
, K Kozakiewicz
5
, A Tykarski
6
, T Zdrojewski
7
, W Drygas
4
1
Institute of Cardiology, Warsaw, Poland,
2
Medical University of Bialystok, Bialystok, Poland,
3
Jagiellonian University Medical College, Krakow, Poland,
4
Medical University of Lodz, Lodz,
Poland,
5
Medical University of Silesia, Katowice, Poland,
6
Poznan University of Medical Sciences,
Poznan, Poland,
7
Medical University of Gdansk, Gdansk, Poland
Topic: Nutrition, Malnutrition and Heart Disease
Background: Use of dietary supplements is widespread and can contribute substantially to
total nutrient intake. However, it also generates some potential risks in the case of unreason-
able and excessive use of such products.
Purpose: To estimate patterns of supplement use among subjects with different socio-demo-
graphic and health status as well as doses of vitamins and minerals taken from supplements in
the adult Polish population.
Methods: Within the frame of the National Multicenter Health Survey (WOBASZ II), a
random sample of the whole Polish population aged 20-75 years was screened during the
years 2013-2014. Socio-demographic status and medical history were performed according
to study protocol. Dietary supplement use was assessed in 5285 subjects and compared with
Recommended Dietary allowances (RDA).
Results: In Poland the use of dietary supplements was reported by 10,1% men and 17,8%
women. The frequency of taking selected vitamins and minerals and their average dose
(among supplement users of a selected nutrient) is shown in Table 1
Prevalence of supplements use was significantly dependent on the place of residence (commu-
nities size: small, medium and large); men: 8.7%, 9.3% and 12.8%, women: 14.8%, 19.4% and
20.2% respectively; level of education (primary, secondary and higher); men: 8.7%, 9.2% and
12.8%, women: 14.8%, 19.4% and 20.2% and income (net per person in the family: 500
PLN, 501-1000 PLN, 1000 PLN); men: 5.2%, 7.3% and 13.8%, women; 12.3%, 15.3% and
20.9%.
Marital status, or diseases like diabetes, CVD, and hypertension were not associated with
frequency of taking supplements.
Conclusions: The prevalence of supplementation in the Polish population was at a medium
level and was dependent on gender and most of the socio-demographic factors.
The average doses of most vitamins from supplements exceed RDA, and minerals was below
this level.
P439
A global analysis of associations between fine particle air pollution and blood pres-
sure, lipids, and glucose in patients with coronary heart disease of the Survey of
Risk Factors (SURF) study
MZ Zhao
1
, GH Hoek
2
, MS Strak
2
, DEG Grobbee
1
, IG Graham
3
, KKG Klipstein-
Grobusch
1
, IV Vaartjes
1
1
University Medical Center Utrecht, Utrecht, Netherlands (The),
2
Institute for Risk Assessment
Sciences, Environmental epidemiology, Utrecht, Netherlands (The),
3
Trinity College Dublin,
Dublin, Ireland
Funding Acknowledgements: Netherlands Organisation for Scientific Research (NWO;
0.22.005.021); Dutch Heart Foundation (’Facts and Figures’)
Topic: Environmental and Occupational Aspects of Heart Disease
Background: Studying the associations between particulate air pollution and cardiovascular
risk factors on a global scale is challenging and rarely done. We aimed to determine the
associations of long-term exposure to particles smaller than 2.5mm (PM2.5) with systolic
and diastolic blood pressure (SBP/DBP), lipids (total, low-density, and high-density choles-
terol), and glucose using existing data from 10 countries in Europe, Asia, and the Middle-East.
Methods: Cardiovascular risk factor data were obtained from the SUrvey of Risk Factors
(SURF) for coronary heart disease (CHD) patients. Annual average PM2.5 concentrations
were estimated using recent global WHO PM2.5 maps combining satellite and surface mon-
itoring data for the location of the 71 participating centers. Associations of PM2.5 with risk
factors were assessed by mixed-effect generalized estimation equation models adjusted by sex,
age, exercise, and smoking. We assessed whether additional adjustment for country affected
associations.
Results: 8392 patients (30% women) were included. Globally, an increase of 10 g/m3 in
PM2.5 was significantly associated with decreased BP and increased glucose. No associations
were found with lipids. After controlling for country, an increase of 10 g/m3 in PM2.5 was
associated with decreased BP and increased LDL (SBP: -0.45mmHg, 95% CI: -0.85, -
0.06;DBP: -0.47mmHg, 95% CI: -0.73, -0.20;LDL: 0.04mmol/L, 95%CI: 0.01, 0.08). The
association with glucose attenuated (0.08mmol/L, 95% CI: -0.23, 0.16).
Conclusion: Global associations of PM2.5 and cardiovascular risk factors can be determined
linking risk factor and geospatial air pollution data but the sensitivity of effect estimates to
adjustment for country stress the need for multiple centers per country. After country adjust-
ment, PM2.5 was associated with small increases in LDL and small decreases in BP.
Association of PM2.5 and risk factors
SURF Global SURF Europe
PM
2.5
(g/m3) Mean 38.134.5 15.85.7
SBP (mmHg) Changes (95%CI) -0.45(-0.85, -0.05) -1.3 (-6.70, 4.11)
DBP (mmHg) Changes (95%CI) -0.47 (-0.73, -0.20) -1.13 (-3.52, 1.30)
TC (mmol/L) Changes (95%CI) 0.02 (-0.03, 0.07) -0.11 (-0.93, 0.71)
LDL (mmol/L) Changes (95%CI) 0.04 (0.01, 0.08) -0.02 (-0.53, 0.50)
HDL (mmol/L) Changes (95%CI) 0.01 (-0.01, 0.03) -0.04 (-0.14, 0.22)
Glucose (mmol/L) Changes (95%CI) -0.08 (-0.24, 0.07) 0.0001 (-0.43, 0.43)
SBP: systolic blood pressure; DBP: diastolic blood pressure; TC: total cholesterol. Changes in
cardiovascular risk factors were assessed by 10 g/m3 increased in PM2.5. Adjustments
include gender, age, exercise, smoking habit, and country.
P440
Environmental noise and arterial stiffness in the context of hypertension
M Rojek
1
, M Rajzer
1
, W Wojciechowska
1
, P Skalski
2
, T Pizon
3
, D Czarnecka
1
1
Jagiellonian University Medical College, 1st Department of Cardiology, Interventional
Electrocardiology and Arterial Hypertension, Krakow, Poland,
2
Institute of Aviation, Warsaw,
Poland,
3
University Hospital of Krakow, Department of Observational and Internal Medicine,
Krakow, Poland
Abstracts S75

Funding Acknowledgements: This research was supported by Jagiellonian University
Medical College [grant number K/ZDS/005566].
Topic: Environmental and Occupational Aspects of Heart Disease
Introduction: Environmental noise has a documented influence on the development of hyper-
tension and its complications. Hypertension and aging are the main reasons for the of arterial
stiffness progression, phenomena with a remarkably unfavorable impact on the prognosis.
Aim: The aim of our study was to assess the impact of long-term exposure to aircraft noise on
blood pressure profile and selected subclinical organ damage of hypertension with special
emphasis on arterial stiffness.
Material and methods: We conducted an observational study near Krakow, Poland. In the
group of people living in the area exposed to high aircraft noise levels,> 60 dB Lden, and in
the unexposed group, <55dB Lden, we carried out questionnaire survey, we measured BP
values from office (SBP, DBP) and 24h ABPM settings (SBP and DBP for 24h, night and day
time) as well as carotid-femoral pulse wave velocity (PWV) from pulse wave analysis. Further
on, we compared groups within considered parameters and fitted linear regression models to
assess the impact of individual variables on PWV.
Results: The exposed (n=101) and unexposed (n=100) group did not differ in terms of age
(53.9 8.2 vs. 53.6 8.5 yrs, p = 0.90), BMI (27.2 4.3 vs 27.7 4.7 kg/m2, p = 0.41),
gender ratio (64% vs 71% women, p = 0.39) and prevalence of hypertension (52.5% vs 50%,
p = 0.83). Office and nighttime DBP values were significantly higher in the group exposed to
environmental noise (88.3 11.4 vs 79.8 8.6, p <0.001, 66.6 9.5 vs 63.6 7.3, p = 0.01).
The remaining BP parameters analyzed did not differ between the groups.
We observed significantly higher values of the PWV index in the exposed group (10.3 1.8 vs
9.4 1.4 m/s, p <0.001), and the differences were particularly marked among normotensives.
In this group, the typical age-related increase in PWV was blunted. The 40-year-olds presented
the PWV level equal to those of the second decade older. The degree of PWV increase was
dependent on the subjective aircraft noise annoyance assessment.
In the linear regression model including exposure to noise, age, SBP and DBP, the first
variable was an important predictor of the increase in arterial stiffness index (b= 0.26, R2
of the model = 0.36, p <0.001).
Conclusions: Long-term exposure to aircraft noise in the place of residence is associated with
accelerated development of arterial stiffness, even in the group of people without hyperten-
sion. The association of pulse wave velocity increase with the degree of perceived noise
annoyance may suggest that underlying pathomechanism is the stress reaction of the organism
to sound stimuli.
P441
Association of some parameters of stress at work and metabolic syndrome clusters
in males of open urban population
EV Akimova
1
, EI Gakova
1
, AM Akimov
1
, VV Gafarov
2
, VA Kuznetsov
1
1
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Tyumen, Russian
Federation,
2
Research Institute of Therapy and Prevention, Novosibirsk, Russian Federation
Topic: Environmental and Occupational Aspects of Heart Disease
Background: Unfavorable external factors having stress impact at work are acting together
with internal factors such as anxiety, depression, anger, etc. Their mutual negative role can get
worse in case of changing eating behavior, smoking and alcohol leading high-stress lifestyle. It
creates the ground for cardiovascular diseases such as metabolic syndrome.
Purpose: To determine association of stress at work prevalence with metabolic syndrome (MS)
clusters in open urban population males aged 25-64 years.
Methods: Cross-sectional epidemiology study was conducted based on representative sample
of the voting lists of males aged 25-64 years from one of the administrative regions of Tyumen.
Criteria of MS IDF (2005) and stress at work according to the questionnaire of World Health
Organization MONIKA- Psychosocial «Knowledge and attitude to health» were used.
Results: As per criteria of IDF (2005), MS prevalence (three and more MS components) in
males aged 25-64 of open urban population complied 15.0%. Three MS components in open
urban population were defined in 17.3% of males aged 25-64 years, four MS components in
2.9% of males and five components in 0.1% of males. Regarding parameters of stress at
work in the groups with MS, in case of «changes of load at work within the last 12 months»,
people with a 3-component MS cluster (combination of abdominal obesity (AO), hypertrigly-
ceridemia (HTG), arterial hypertension (AH) significantly more rare did additional work in
comparison with the control group (people without MS). Differences on this parameter were
statistically significant. The majority of answers «I don’t like it at all» was given to the
question «Do you like your work?» by the respondents with MS (clusters of AO, HTG,
AH and AO, hypoCL HDLP, AH) compared to the control group (no MS). During the
last year, responsibility at work decreased in the control group with MS clusters: AO,
HTG, hypoCL HDLP and AO, AH, hyperglycemia. The majority of males with MS clusters:
AO, HTG, hypoCL, HDLP and AO, hypoCL HDLP, AH estimated their responsibility at
work as non-significant during the last year. The differences were statistically important
relatively to the control group (no MS).
Conclusion: The groups with MS clusters (combination of AO, HTG and hypoCL HDLP or
AO, HTG and AH) were mostly subjected to stress at work from all people with MS.
P443
High-intensity interval training improves cerebrovascular endothelial function and
modulates p66Shc gene expression in cardiovascular risk patients: a randomized
controlled trial
L Lukas Streese
1
, AW Khan
2
, A Deiseroth
1
, S Hussain
2
, R Suades
2
, F Cosentino
2
,
H Hanssen
1
1
University of Basel, Department of Sport, Exercise and Health, University of Basel, Basel,
Switzerland,
2
Karolinska Institute, Cardiology Unit, Department of Medicine Solna, Stockholm,
Sweden
Funding Acknowledgements: Swiss National Science Foundation, Nora van Meeuwen-
Ha
¨fliger Stiftung, Swedish Research Council, Swedish Heart and Lung Foundation
Topic: Physical Inactivity and Exercise
Background: Endothelial dysfunction determines cardiovascular (CV) disease progression and
vascular aging. Retinal vessels are part of the cerebrovascular bed and flicker-light induced
retinal endothelial dilatation is a new diagnostic tool for CV risk assessment. The mitochon-
drial adaptor p66Shc is a known modulator of vascular aging and oxidative stress. The role of
exercise as a determinant of cerebrovascular endothelial function and regulator of p66Shc
expression has not been examined to date.
Purpose: The study aimed to investigate the effects of exercise on retinal endothelial function
as well as the regulation of p66Shc gene expression and oxidative stress in older patients with
CV risk.
Methods: Eighty-four older and previously sedentary CV risk patients (aged 586 years) were
randomized into a 12-week high-intensity interval training (HIIT) or control group (CG).
Retinal endothelial function was measured by flicker light-induced maximal arteriolar
(ADmax) dilatation as well as area under the arteriolar flicker curve (AFarea) using a retinal
vessel analyzer. Plasma 3-nitrotyrosine (3-NT) was measured by ELISA as a marker of
oxidative stress. Gene expression of p66Shc and DNA methylation were assessed in mono-
nuclear cells by RT-qPCR and Methylminer qPCR. Microvascular and circulating biomar-
kers as well as maximal oxygen uptake (VO2max) were assessed before and after HIIT.
Results: Both ADmax (p=0.018) and AFarea (p=0.016) increased significantly after HIIT
compared to CG. There was a significant association between ? change VO2max and ? change
ADmax and AFarea (R2=0.073, p=0.026; R2=0.08, p=0.019, respectively). HIIT increased
methylation status of p66shc promoter and induced a downregulation of p66Shc expression,
which was associated with lower 3-NT levels.
Conclusions: This is the first intervention trial to demonstrate that exercise has the potential to
reverse cerebrovascular endothelial dysfunction in patients with CV risk. Dynamic retinal
vessel analysis seems to be a valid diagnostic tool to detect treatment effects of exercise in
the microvasculature. Exercise-induced reprogramming of DNA methylation on p66Shc gene
promoter may represent a putative mechanistic link whereby exercise protects against age-
related oxidative stress.
P444
Latent profiles of sedentary time, exercise and cardiorespiratory fitness in adults,
and the associations with metabolic and percieved health
JEH Jane Eh Salier Eriksson
1
, E Ekblom-Bak
1
, V Blom
1
, LK Kallings
1
, O Ekblom
1
,
E Hemmingsson
1
, B Ekblom
1
, G Andersson
2
, P Wallin
2
, A Stenling
3
, M Lindwall
4
1
The Swedish School of Sport and Health Sciences, Stockholm, Sweden,
2
HPI Health Profile
Institute, Stockholm, Sweden,
3
Umea University, Umea, Sweden,
4
University of Gothenburg,
Gothenburg, Sweden
Topic: Physical Inactivity and Exercise
Introduction: Sedentary time, exercise and cardiorespiratory fitness are independently asso-
ciated with health and disease risk, but do also tend to cluster. How they interact within-
persons to create naturally occurring patterns, or profiles, in adult populations has not been
studied.
Purpose: To identify naturally occurring patterns/latent profiles of sedentary time at work
and in leisure time, exercise and VO2max in a large population of adult men and women of
different ages, and to study how these associate with metabolic and perceived health
and symptoms.
Methods: 64.970 participants aged 18-75 years (42% women) from a nationwide occupational
health service screening between January 2014 and April 2018 were included. Exercise fre-
quency (Never, Sometimes, 1-2 times/week, 3-5 times/week or 6 times/week) and time spent
sedentary at work and in leisure time (Almost all time, 75%, 50%, 25% of the time or Almost
no time) were self-reported. VO2max was estimated from a submaximal cycle test. Latent
profile analysis was used to group individuals in different classes based on their individual
patterns of sedentary time, exercise and VO2max.
Results: The best fitting solution of the latent profile analysis produced 6 profiles (Figure 1).
Characteristics of the profiles and the associations with the outcomes are presented in Table 1.
Conclusions: Based on individual scores on sedentary time, exercise and fitness, six distinct
latent profiles were identified. These profiles illustrate the complex and heterogeneous inter-
play of sedentary time, exercise and fitness and were also systematically related to metabolic
health and perceived health symptoms, with large variations between the different profiles.
Abstract Number: P444
Table 1.
Profile 1 Profile 2 Profile 3 Profile 4 Profile 5 Profile 6
Women and mean age 33%, 43.2 39%, 44.2 43%, 44.1 45%, 44.4 45%, 37.0 37%, 34.6
High qualified job 20% 63% 29% 72% 78% 33%
Non-smokers 75% 83% 85% 89% 91% 84%
Healthy diet 57% 58% 75% 74% 84% 82%
BMI>30 1.00 (0.94-1.07) 1.00 (reference) 0.65 (0.61-0.69) 0.53 (0.50-0.56) 0.02 (0.01-0.03) 0.05 (0.03-0.07)
BPsys>=140 or BPdia>=90 mmHg 1.20 (1.12-1.28) 1.00 (reference) 0.93 (0.88-0.99) 0.83 (0.78-0.88) 0.37 (0.33-0.42) 0.47 (0.40-0.56)
Very often/often percieved Neck/Back pain 1.08 (1.01-1.15) 1.00 (reference) 0.80 (0.75-0.85) 0.70 (0.66-0.74) 0.56 (0.51-0.62) 0.54 (0.47-0.61)
Very often/often percieved overall stress 0.75 (0.70-0.81) 1.00 (reference) 0.48 (0.44-0.51) 0.60 (0.57-0.64) 0.61 (0.56-0.68) 0.43 (0.37-0.49)
Very often/often sleeping problems 1.03 (0.92-1.14) 1.00 (reference) 0.79 (0.72-0.87) 0.76 (0.69-0.83) 0.58 (0.50-0.68) 0.59 (0.47-0.75)
Very poor/poor global health 0.81 (0.74-0.89) 1.00 (reference) 0.28 (0.26-0.32) 0.31 (0.28-0.33) 0.13 (0.11-0.16) 0.09 (0.06-0.13)
Characteristics (top) and sex- and age adjusted OR (95% CI) for the association with dichotomized outcomes (bottom). BP=Blood pressure
S76 EuroPrevent Congress Abstracts June 2019

Figure 1
P445
Effects of active commuting on exercise capacity, cardiovascular risk, body com-
position and quality of life: results of a randomized-controlled study
VA Rossi
1
, B Reich
2
, MD Fernandez Lapuente De Battre
2
, P Stutz
3
, B Zagel
3
,
M Loidl
3
, CM Schmied
1
, J Niebauer
2
, D Niederseer
1
1
University Hospital Zurich, Department of Cardiology, Zurich, Switzerland,
2
Paracelsus Private
Medical University, Salzburg, Austria,
3
University of Salzburg, Z_GIS, Salzburg, Austria
On Behalf of: GISMO (Geographical Information Support for Healthy Mobility)
Funding Acknowledgements: BM-VIT, Austrian Ministry for Transport, Innovation and
Technology
Topic: Physical Inactivity and Exercise
Background:Sedentary lifestyle is a major modifiable risk factor for cardiovascular diseases
and triggers substantial costs due to early retirement and the inability to participate in the
work force. Active commuting has been proposed to at least in part overcome these problems;
however, convincing data to support this recommendation are sparse.
Purpose:To investigate the health effects of active commuting.
Methods: 73 subjects (age: 469 years, 38% males) were 2:1 randomized to an intervention
group (IG, n=51) or control group (CG, n=22). Depending on the distance to the work
place, IG participants either traveled by a combination of public transport and walking and/or
cycling (n=25), or they commuted by walking and/or cycling only (n=26). The CG was asked
to commute as usual. Exercise capacity, body composition, everyday physical activity, quality
of life, and cardiovascular risk factors were assessed at baseline and after a study period of one
year.
Results: Groups did not differ significantly at baseline. Daily self-reported commuting details
were verified by GPS-tracking. Subjects randomized to IG changed their commuting habits,
whereas CG did not (%time of commuting: IG: walking/cycling/public transport: 93%, car:
7%, CG: walking/cycling/public transport: 54%, car: 46%, p<0.001). Time to commute did
not differ significantly. Percentage of age-predicted exercise capacity (IG: 14525 to 15531,
p<0.001; CG: 14225 to 13625%, p=0.058; IG vs. CG: p=0.003) improved significantly in
IG and remained unchanged in CG, whereas everyday physical activity (IG: 37564150 to
70926192, p<0.001; CG: 52515076 to 56094470 MET-min/week, p=0.539; IG vs. CG:
p=0.067) improved significantly in IG and remained unchanged in CG, however the differ-
ence between groups only showed a statistical trend. In IG but not in CG subjects lost body
fat (% of body weight: IG: 34.57.7 to 33.27.8%, p=0.003; CG: 35.09.1 to 34.87.4%;
p=0.428; IG vs. CG: p=0.496), however no significant difference between groups was
achieved. Cardiovascular risk profile assessed by HeartScore in these relatively healthy sub-
jects remained essentially unchanged in both groups (p>0.05 for both groups). In quality of
life assessment (SF-36), general health (p=0.008), vitality (p=0.003) and mental health
(p=0.012) changed significantly in IG, whereas no significant changes were noted in CG
(p>0.05, IG vs. CG: all p<0.001). No serious adverse events occurred during the study.
Conclusion: Our results indicate that active commuting to work may counteract certain down-
sides of a sedentary lifestyle without prolonging the time-period of the commuting to work
substantially.
P446
Physical activity and risk of all-cause mortality in patients with coronary artery dis-
ease after coronary stenting
GS Pushkarev
1
, VA Kuznetsov
1
1
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy
of Scienc, Tomsk, Russian Federation
Topic: Physical Inactivity and Exercise
Background: The association between physical activity and lowered risk of all-cause mortality
and cardiovascular disease has been suggested in patients with coronary artery disease (CAD).
Purpose: To assess the effect of physical activity on the risk of all-cause mortality in patients
with CAD after coronary stenting.
Methods: The study included 977 patients with CAD (741 men and 236 women, mean age
58.69.4 years) who underwent coronary stenting. Mean duration of follow-up was 12.01.8
months. International Physical Activity Questionnaire (IPAQ) Short Forms was used to assess
physical activity. According to the IPAQ Short Forms, there were defined three categories of
physical activity: low, moderate and high.
The relationship between mortality and physical activity was evaluated using Cox propor-
tional hazards model. Hazard ratio (HR) and 95% confidence intervals (CI) were calculated
after adjustment for the following confounders: age, gender, systolic and diastolic blood
pressure, body mass index, smoking status, alcohol abuse, total cholesterol, severity of
heart failure and presence of acute coronary syndrome at admission and severity of coronary
lesions by SYNTAX score.
Results: Low physical activity was observed in 39.5% of patients, moderate physical activity in
32.1% of patients and high physical activity in 28.4% of patients. During the prospective
study period 24 patients (2.5%) died. After adjusting for all confounding factors, risk of all-
cause mortality was significantly higher in patients with low physical activity: HR=4.60 (95%
CI 1.02 20.7) compared to patients with high physical activity. The multivariate HR for
patients with moderate physical activity was 2.93 (95% CI 0.60 14.4).
Conclusion: Low physical activity was independently associated with higher risk of all-cause
mortality in patients with CAD after coronary stenting.
P447
Cardiorespiratory Fitness is associated with right ventricular geometry and function
in the general population - SHIP (Study of Health in Pomerania)
J Christine Drzyzga
1
, M Bahls
1
, H Voelzke
2
, R Buelow
3
, R Ewert
1
, S Glaeser
4
,
SB Felix
1
, M Doerr
1
, MRP Markus
1
1
University Medicine of Greifswald, Department Internal Medicine B , Greifswald, Germany,
2
University Medicine of Greifswald, Community Medicine , Greifswald, Germany,
3
University
Medicine of Greifswald, Institute of Diagnostic Radiology and Neuroradiology, Greifswald,
Germany,
4
Vivantes Clinics for Health, Vivantes Klinikum Spandau, Berlin, Germany, Berlin,
Germany
Funding Acknowledgements: German Center of cardiovasculare desease (DZHK)
Topic: Physical Inactivity and Exercise
Background: Higher cardiorespiratory fitness (CRF) is associated with a reduced risk for
cardiovascular disease (CVD) and morbidity. While previous research has explored the asso-
ciation between CRF and left ventricular (LV) structure and function, very little information
is available for its association with right ventricular (RV) parameters. Most studies have
focused on young male athletes. To improve our understanding of the clinical relevance of
CRF for RV remodeling, we studied the association between CRF and RV structure and
function in a large adult general population cohort.
Methods: We used cross-sectional data of 2,844 subjects from the population-based, prospec-
tive Study of Health in Pomerania (SHIP). A symptom-limited cardiopulmonary exercise test
(CPET) was performed according to a modified Jones protocol. Two-dimensional, M-Mode
and Doppler echocardiography and cardiac MR imaging on a 1.5-T MR system were per-
formed to determine a variety of RV structural and functional parameters. We used linear
regression models adjusted for age, sex (not when stratified by sex), body fat mass, height,
systolic blood pressure, use of antihypertensive medication, glycated hemoglobin, use of
hypoglycemic medication, smoking status and estimated glomerular filtration rate to relate
CRF with RV parameters.
Results: The median age of the sample was 51 (25th quartile: 40 and 75th quartile: 62) years,
and 52% were women. A total of 2,844 subjects had echocardiographic data and 941 indivi-
duals also underwent cardiac MRI. A one liter higher in VO2 peak was associated with a 1.2
(95%-CI 0.7 to 1.7, p<0.001) mm greater RV end-diastolic diameter, a 1.4 (95%-CI 0.9 to 1.9,
p<0.001) mm larger RV end-diastolic outflow tract diameter and a 0.84 (95%-CI 0.46 to 1.22,
p<0.001) mm greater tricuspid annular plane systolic excursion. In addition, a one liter higher
VO2 peak was associated with a 23.5 (95%-CI 18.7 to 28.4, p<0.001) ml larger RV end-
diastolic volume and a 13.0 (95%-CI 9.8 to 16.2, p<0.001) ml greater RV end-systolic volume.
There was no association between VO2 peak and lateral early and late tricuspid annular peak
diastolic velocity ratio and RV ejection fraction.
Conclusions: Our results indicate a significant association between CRF and RV remodeling.
Whether the same physiological mechanisms as previously described for the LV are also
responsible for this association is unclear. Further research is warranted to explore the clinical
relevance of the RV.
P448
Proteostasis, inflammatory and vasoactive biomarkers in patients with hyperten-
sion: effect of exercise training
M Manuel Teixeira
1
, M Gouveia
1
, A Duarte
2
, M Ferreira
2
, M Simoes
2
, M Conceicao
2
,
G Silva
3
, S Magalhaes
4
, R Ferreira
5
, A Nunes
1
, S I Vieira
1
, F Ribeiro
6
1
University of Aveiro, Department of Medical Sciences and Institute of Biomedicine iBiMED,
Aveiro, Portugal,
2
Unidade Cuidados na Comunidade Cubo Ma
´gico da Sau
´de, Oliveira do Bairro,
Portugal,
3
Ca
ˆmara Municipal de Oliveira do Bairro, Oliveira do Bairro, Portugal,
4
University of
Aveiro, Department of Medical Sciences and iBiMED and Aveiro Institute of Materials 
CICECO, Aveiro, Portugal,
5
University of Aveiro, Department of Chemistry, Aveiro, Portugal,
6
University of Aveiro, School of Health Sciences and Institute of Biomedicine iBiMED,
Aveiro, Portugal
Topic: Physical Inactivity and Exercise
Background: Physical exercise is a consensual and well-established strategy to control blood
pressure. Nonetheless, its effects on protein homeostasis in individuals with hypertension are
not clearly defined.
Aims: This study aimed to evaluate the effects of regular exercise on inflammatory, oxidative
stress and vasoactive markers in circulation, as well as protein homeostasis and quality of life
in individuals with hypertension. Furthermore, we intended to correlate quality of life with the
Abstracts S77

levels of the above-mentioned biomarkers.
Methods: A total of 20 individuals with hypertension were recruited and divided into 2 groups
of 10: a group who regularly participated in physical exercise in the past year ("EH", age: 68.3
4.2 years), and an age-matched group without regular exercise practice in the past year
("H", age: 67.7 5.1 years). Clinical data, daily physical activity (IPAQ), quality of life (SF-
36v2), adhesion to Mediterranean diet (MEDAS Questionnaire) and blood pressure were
evaluated. Proteostasis and vasoactive markers were assessed in plasma using immunoblotting
techniques (western blot or slot-blot) and Attenuated total reflectance Fourier-transform
infrared spectroscopy (ATR-FTIR). The levels of ubiquitin, Hsp70, IL-6, C-reactive protein,
TWEAK, IL-10, eNOS, endothelin-1, MMP-2, TIMP-2, connexin 43 and superoxide dismu-
tase (SOD) were analysed by western blot or slot-blot.
Results: Significant higher levels of eNOS (p=0.011), Cx43 (p=0.020), TIMP-2 (p=0.038)
and SOD-3 (p=0.001), with a fold increase of 1.2, 2.1, 1.3 and 1.2, respectively, were found in
the EH group. The overall quality of life (60.1 4.3 vs. 53.2 5.9, p=0.009), as well as
mental health (59.4 7.9 vs. 50.7 7.2, p=0.024) was significantly higher in the EH group. A
strong inverse correlation was observed between the quality of life (total score of the SF-36)
and the levels of IL-6 (r=-0.510, p=0.026). The levels of IL-6 are significantly higher in the H
group (p=0.014), with a 1.5-fold increase in comparison with the EH group, and partial least
squares regression (PLS-R) analysis of FTIR data showed a high correlation between the
levels of IL-6 and the spectra in 1500-900 cm-1 region. We found that high levels of IL-6
correlate with peaks associated to collagen and low levels correlate to peaks associated to
carotenes. Principal component analysis (PCA) showed a good discrimination between the
two groups in the 1500-900 cm-1 region (fingerprint region) and 1700-1600 cm-1 region
(Amide I band of proteins). Furthermore, the H group showed peaks that are related with
anti-parallel b-sheet, while EH group showed peaks related to b-sheet and a-helix.
Conclusion: Regular exercise participation reduced the circulating levels of the inflammatory
biomarkers, increased the antioxidant defences and the levels of the vasodilator biomarkers
and improved proteostasis and quality of life in individuals with hypertension.
P449
Breaks in sedentary time are associated with cardiometabolic health markers in
overweight adults
T Tanja Sjoros
1
, H Vaha-Ypya
2
, A Savolainen
1
, H Sievanen
2
, T Vasankari
2
,
J Knuuti
1
, K Kalliokoski
1
, IHA Heinonen
1
1
Turku PET Centre, Turku, Finland,
2
UKK Institute, Tampere, Finland
Funding Acknowledgements: Juho Vainio Foundation, Finnish Cultural Foundation,
Hospital District of Southwest Finland, The Diabetes Research Foundation Finland
Topic: Physical Inactivity and Exercise
Introduction: A low level of physical activity (PA) has been identified as an important pre-
dictor of poor health and all-cause mortality. Unfortunately, the majority of the world’s
population do not meet the current guidelines for PA. However, an emerging evidence
shows that not only moderate-to-vigorous physical activity (MVPA) but also informal light
physical activity (so called non-exercise activity), that replaces sedentary activities, likely also
plays a role in health promotion. Recently, there has been a growing interest in objectively
assessing sedentary behaviour (SB) instead of MVPA in the prevention of obesity and meta-
bolic diseases.
Methods: We examined the associations between cardiometabolic health markers and SB and
PA in an overweight (BMI 31.6, SD 4) working aged population (n = 98, 22 men; age 58, IQR
7) with high risk for metabolic syndrome and low self-reported PA levels. SB and PA were
measured for 4 weeks (mean 25 days SD 4) with hip-worn accelerometers using validated
mean amplitude deviation (MAD) and angle for postural estimation (APE) algorithms.
Fasting plasma glucose, insulin, triglycerides, total, LDL and HDL cholesterol and HbA1c
from venous blood samples were analysed using standard assays. Body mass index, waist
circumference and blood pressure were measured prior to accelerometry. The associations
were examined by Pearson’s correlation analysis adjusted for age and sex.
Results: Our analysis shows no association between cardiometabolic health markers and
sedentary time. MVPA was significantly associated with lower fasting insulin levels (r = -
0.23, p = 0.027) and body mass (r = -0.24, p = 0.019) as well as smaller waist circumference
(r = -0.22, p = 0.031). In consistency, daily step count was similarly associated with insulin
(r= -0.26, p = 0.011), body mass (r = -0.32, p = 0.0015), waist (r = -0.27, p = 0.0083), and
also BMI (r= -0.23, p=0.022). Breaks in sedentary time were associated with lower body
mass (r= -0.24, p=0.021), BMI (r = -0.24, p = 0.020), smaller waist circumference (r = -
0.32, p = 0.0015) and lower resting heart rate (r = -0.24, p = 0.021). Similarly, time spent
standing was also associated with lower resting heart rate (r = -0.23, p = 0.027). Only light
physical activity had associations with the lipid profile; light PA was associated with higher
HDL-cholesterol (r = 0.26, p = 0.010).
Conclusions: In conclusion, it seems that in overweight adults at high risk for metabolic
syndrome breaks in sedentary time are associated with cardiometabolic health indicators,
whereas total sedentary time has no associations to any of the measured health markers.
However, MVPA, light PA and daily steps were also associated to better metabolic health,
overall suggesting that muscle activity is crucially important in cardiometabolic health
promotion.
P450
Fear of movement in patients referred to cardiac rehabilitation.
P Keessen
1
, I Den Uijl
2
, N Ter Hoeve
2
, B Visser
1
, C Latour
1
, M Sunamura
2
,
HT Jorstad
3
, WJM Scholte Op Reimer
3
, RA Kraaijenhagen
4
, HJG Van Den Berg-
Emons
5
1
Amsterdam University of Applied Sciences, ACHIEVE - Amsterdam Centre for Innovative Health
Practice, Amsterdam, Netherlands (The),
2
Capri Cardiac Rehabilitation, Rotterdam, Netherlands
(The),
3
Academic Medical Center of Amsterdam, Amsterdam, Netherlands (The),
4
Cardiovitaal
Cardiac Rehabilitation, Amsterdam, Netherlands (The),
5
Erasmus Medical Centre, Rotterdam,
Netherlands (The)
Funding Acknowledgements: NWO Grant, RAAK-PRO grant
Topic: Physical Inactivity and Exercise
Introduction: Patients with kinesiophobia (fear of movement) avoid physical activity.
Avoidance of physical activity is linked to adverse cardiac events and thus needs to be
targeted. However, there is no contemporary measurement tool to assess kinesiophobia in
cardiac patients. Therefore data on prevalence of kinesiophobia are lacking in patients attend-
ing Cardiac Rehabilitation (CR). The Tampa Scale for Kinesiophobia (TSK-NL Heart) is a 17
item questionnaire using a 4 point Likert scale (score range 17 to 68 points) to measure
kinesiophobia).
Purpose: To study the test-retest reliability and construct validity of the TSK-NL Heart and to
assess the distribution of kinesiophobia in patients.
Methods: Patients referred for CR were asked to fill in the TSK-NL Heart and the Cardiac
Anxiety Questionnaire (CAQ). After five days patients filled in the TSK-NL Heart for the
second time. Test-retest reliability of the TSK-NL Heart was assessed with the Interclass
Correlation Coefficient (ICC) and construct validity with the Spearman Rank Correlation
Coefficient (r) by correlating the TSK-NL Heart with the CAQ. The distribution of kinesio-
phobia in cardiac patients was assessed by determining the median score with range and
quartiles (Q1-4) since there is no well validated cut off point of the TSK-NL Heart.
Nevertheless, recent studies have used a score >37 as an indication for Kinesiophobia.
Results: We included 116 patients in this study with a median age of 64, 5 years old who were
mainly referred for CR after a PCI procedure for STEMI. Substantial agreement was found
for the overall ICC of the TSK (ICC = 0.67; p = <0.001). With regard to construct validity,
a moderate strong correlation was found between the TSK and CAQ (r= 0.57; p = <0.001).
Scores of the TSK-NL Heart ranged from 26 to 56 points with a median patient score of 39.
Q1 = 26-33, Q2 = 33-39, Q3 = 39-44, Q4 = 4456.
Conclusion: The TSK-NL Heart has substantial test-retest reliability and a moderate to strong
correlation with the CAQ suggesting construct validity. The scores on CAQ and the TSK
indicate that cardiac anxiety and fear of movement is present in a large proportion of cardiac
patients. Further research is necessary to investigate the impact of kinesiophobia on objec-
tively measured physical activity and to develop treatment strategies for kinesiophobia in
cardiac patients
P451
A cross-sectional analysis of physical activity patterns, aerobic capacity and per-
ceptions about exercise among male farmers in the mid-west region of ireland
T Trisha Loughman
1
, G Flaherty
2
, A Houlihan
3
, D Dunne
3
1
National University of Ireland, Galway, Ireland,
2
National University of Ireland, School of
Medicine, Galway, Ireland,
3
National Institute of Preventive Cardiology, Galway, Ireland
Topic: Physical Inactivity and Exercise
Background and
Aims: In Ireland, farmers have been identified as a high-risk population, with higher rates of
cardiovascular disease (CVD) and overall mortality, compared with the general population.
This contrasts with trends from previous decades. Yet, little research exists as to why farmers
are now at increased risk. Farming has always been considered a physically active lifestyle.
However, the increased use of machinery may mean that farmers are not completing as much
physical activity (PA) as before. This study aimed to investigate PA patterns, aerobic
capacity and perceptions about exercise among Irish farmers.
Design: A cross-sectional quantitative study.
Methods: PA levels were assessed using activPAL? micro monitors for a duration of seven
consecutive days. Aerobic capacity was measured using a validated sub-maximal exercise test,
to calculate Metabolic Equivalent Task (MET) levels. The Exercise Benefits and Barriers Scale
(EBBS) questionnaire was used to explore perceived benefits and barriers towards exercise.
Results: Farmers (n=28) completed a mean (standard deviation (SD)) of 16,452 (5,170) steps
and 124(43) minutes of moderate-vigorous intensity physical activity (MVPA) daily. The
volume of MVPA was largely accumulated in bouts lasting <10 minutes, with only 17.89%
completing any bouts 10minutes throughout the week. Mean (SD) daily waking sitting time
was 8.26 (1.6) hours. Farmers were aerobically fit with all farmers, who undertook the exercise
test (n=20), having a predicted MET max >10. Participants (n=23) had positive perceptions
about exercise with a mean (SD) total EBBS score of 132(14).
Conclusions: Farmers are aerobically fit and have positive perceptions about exercise. They
complete a large volume of PA, based on steps and minutes of MVPA. However, farmers’ PA
patterns are not optimal for CVD prevention. Farmers risk could be reduced by sitting less
and completing MVPA bouts 10minutes, in line with current guidelines.
S78 EuroPrevent Congress Abstracts June 2019

P452
Level of education affects cardiorespiratory fitness in healthy men and women
M Chang
1
, HY Lee
1
, DH Lee
1
, JS Kim
1
, JE Chae
1
, MH Lee
1
1
Catholic University of Korea, Seoul, Korea (Republic of)
Topic: Physical Inactivity and Exercise
Background: The objective of this study was to evaluate the relationship between educational
level as a
surrogate marker of socioeconomic status and the risk of developing cardiovascular risk
factor and cardiorespiratory fitness (CRF).
Metods: Study subjects were 1,089 healthy adults (658 men and 431 women) who underwent
health check-up in our Hospital. Education level was categorized into four groups: (1) post-
graduate, (2) college graduate, (3) high-school graduate, and (4) middle-school graduate. CRF
was assessed by cardiopulmonary exercised testing (CPX), biceps strength, hand grip strength,
and bioelectrical impedance analysis.
Results: The post-graduate group had significantly higher peak VO2 (27.46.5 mL/Kg/min),
peak expiratory flow (101.017.4 m/s), biceps strength (31.711.3 kg), hand grip strength
(70.117.9 kg) and skeletal muscle (29.45.3 kg) than other groups (all p<0.001).
Conclusion: Educational level was significantly related to all aspect of CRF in healthy adults.
Further educational programs are needed to promote public health and prevent cardiovas-
cular disease.
P454
Time of sitting in prediction of CVD events - Findings from PURE Poland study
D Dagmara Gawel-Dabrowska
1
, ABR Alicja Basiak-Rasala
1
, MK Maciej
Karczewski
2
, KPZ Katarzyna Poltyn-Zaradna
1
, MW Maria Wolyniec
1
, AS Andrzej
Szuba
3
, KZ Katarzyna Zatonska
1
1
Wroclaw Medical University, Department of Social Medicine, Wroclaw, Poland,
2
Wroclaw
University of Environmental and Life Sciences, The Faculty of Environmental Engineering and
Geodesy, Departament of Mathematics, Wroclaw, Poland,
3
Wroclaw Medical University,
Division of Angiology, Wroclaw, Poland
Funding Acknowledgements: Polish Ministry of Science and Higher Education (grant no.
290/W-PURE/2008/0)
Topic: Physical Inactivity and Exercise
Background:Up to date epidemiological evidence indicate, that sedentary behavior is an inde-
pendent risk factor associated with cardiovascular and overall morbidity and mortality in
adults. In PURE Poland baseline study, we also found time of sitting an independent risk
factor of cardiovascular diseases (CVD). Many studies have consistently demonstrated a
reduction in mortality in CVD associated with higher levels of aerobic fitness. In spite of
these facts Polish national physical activity guidelines don’t specifically emphasize health risks
related to nonexercise behavior, they usually address the need to improve physical activity in
general.
Purpose:The aim of the study was to investigate if time of sitting in baseline study can be
treated as a predictor of CVD events in 6-years observation in PURE Poland study.
Methods:Poland is one of the 21 countries enrolled in global Prospective Urban and Rural
Epidemiology Study (PURE). Study population consists of 1401 participants aged between 30
and 85 years, who were examined with the use of International Questionnaire of Physical
Activity (IPAQ) long form. IPAQ includes physical activity questions related to different
types of physical activity and time spent sitting. Participants with history of cardiovascular
diseases in baseline were excluded from the analysis. Recorded CVD events included myo-
cardial infarction, stroke, heart failure and angina (symptomatic coronary disease). The
occurrence of CVD events was observed for 6 years after baseline. To assess the association
between time of sitting and CVD events Wilcoxon rank sum test was chosen.
Results:There was no statistically significant association between weekly total time of sitting
and total CVD events (p=0,079). Following the p-value given in Table 1, it can be seen that
the association between sitting and HF is nearly on the border of statistical significance
(p=0,059).
Conclusions:There is no obvious association between time of sitting and CVD events in 6-years
observation. In some of CVD events such as HF results are on the border of statistical
significance and further observation is required.
Table 1
Odds ratio Lower CI Highest CI p-value
MI 1.000 1.000 1.001 0,431
HF 1.001 1.000 1.001 0,059
Angina 1.001 1,000 1.001 0,22
stroke 1.000 0.999 1.001 0,908
CVD total 1.000 1.000 1.001 0.079
P456
An effective e-health behavioural change intervention in type 2 diabetes mellitus.
N Niall Colwell
1
, A Sheppard
2
, S Egan
2
1
South Tipperary General Hospital, Clonmel, Ireland,
2
Redicare, Cork, Ireland
Funding Acknowledgements: Diabetes Ireland
Topic: Diabetes and the Heart
The World Health Organization has nominated Obesity and type II Diabetes Mellitus (DM)
as priority health targets.
Purpose: to evaluate the efficacy of an 8 week e-Health intervention in DM subjects on clinical
Abstract Number: P450
Flowchart Study
T0: Intake Cardiac Rehabilitation T1 5: Days post Cardiac intake Start Cardiac Rehabilitation
Kinesiophobia (TSK-NL Heart)
Cardiac Anxiety (CAQ)
Kinesiophobia (TSK-NL Heart
Construct Validity
TSK-NL Heart and CAQ (r)
r= 0.57 ; p=<0.001
Test-retest reliability
ICC= 0.67; p=<0.001
Distribution kinesiophobia
(17-68 points)
median score: 39 points
Q1= 26-33, Q2= 33-39, Q=: 39-44, Q=: 44-56
Abstract Number: P450
Scatterplot
Abstracts S79

Abstract Number: P452
S80 EuroPrevent Congress Abstracts June 2019

outcomes of weight, blood pressure, total cholesterol (TC), triglycerides (TG), LDL-choles-
terol, HbA1c and medication requirements. From fifty self-selected patients, 39 completed the
programme. Dietary caloric intake was calculated at 500 kcal/day below basal-metabolic-rate
for overweight/obese subjects (n=37). Exercise targeted 10,000 steps/day. Wireless monitor-
ing of parameters (dietary App, weight, exercise) allowed for real-time diet and activity
monitoring; and tailored weekly subject review via phone or video-link. Medication require-
ments at baseline and on programme completion, were determined. Results showed that after
8 weeks participants lost on average 5.9% weight, had a reduction in both systolic and
diastolic BP of 8 and 7 % respectively; reduced TC and LDL cholesterol by 5% each and
TG by 18.5%; HbA1c was reduced 11.5%. Moreover, all parameter were significantly posi-
tively affected by the programme (P<0.05). These data recapitulate findings in overweight/
obese non-diabetics studied previously Table 1. Additionally, one third of DM patients
reduced their pill count or could come off diabetic medication.
Conclusions: These initial results indicate that a wireless-based e-Health programme was
effective in improving glycaemic control and weight loss, as well as other related cardiovas-
cular parameters in adults with DM. Aside from in-person enrollment and post-intervention
meetings, where clinical measurements were taken, the programme was delivered entirely
remotely using novel e-Health strategies, including an asynchronous video review. This has
considerable potential in Europe and indeed globally, given the urgent need to deliver effec-
tive, scalable and cost-effective methods to treat those with type II DM. Such e-health stra-
tegies could enhance the effectiveness of therapies used to treat DM also.
Three data sets who underwent e-Health p
Per Cent Reduction
DATA SET no. time
(wks)
Weight** Systolic* Diastolic* Total
Chol*
LDLc* TG* HbA1c*
LONDON 28 12 10.1 17.1 14.7 19.9
AMSTERDAM 232 16 10.6 13.7 14.2 17.2
EuroPrevent 39 8 5.9 8.3 6.9 4.9 5.9 18.5 11.5
In both overweight/obese subjects (London/Amsterdam) and DM subjects (EuroPrevent)
significant positive effects are achieved by the e-Health programme. (*P<0.05; **P<0.01)
P457
Noninvasive evaluation of intracranial pressure in type 2 diabetes mellitus
G Aguiar Mesquita Galdino
1
, S Cristina Garcia De Moura-Tonello
1
, S Nogueira
Linares
1
, J Cristina Milan-Mattos
1
, P Rehder Dos Santos
1
, M De Oliveira Gois
1
,
D Lineu Spavieri Junior
2
, S Mascarenhas
2
, T Beltrame
1
, A Maria Catai
1
1
Federal University of Sao Carlos, Physiotherapy, Sao Carlos, Brazil,
2
Braincare Health
Technology, Sao Carlos, Brazil
Funding Acknowledgements: CAPES, CNPq, FAPESP
Topic: Diabetes and the Heart
Introduction: Type 2 diabetes mellitus (T2DM) is one of the major global public health
problems. Beyond many other clinical signs, hyperglycemia is the main characteristics of
T2DM population that lead to micro and macrovascular impairments, decreasing tissues
blood flow. However, the influences of these vascular alterations at cerebral level (i.e., cere-
brovascular compliance) in T2DM patients are still under debate. To the best of our knowl-
edge there were no studies using noninvasive intracranial pressure in subjects with T2DM.
Purpose: Assess the relationship between noninvasive intracranial pressure (as an index of
cerebrovascular compliance) in T2DM patients and control group before and after active
postural challenge.
Methods: We evaluated 36 males aged between 40 and 64 years, non-smokers, without clini-
cally detected cardiovascular or cerebrovascular diseases. Participants were divided into two
groups: patients with diagnosed T2DM (n = 18) without cardiovascular autonomic neuro-
pathy and control participants composed by healthy subjects (CG, n = 18). Noninvasive
intracranial pressure was evaluated by a transducer (BCSs PICNI 2000) placed in patient’s
scalp on the left temporal region. The experimental protocol consisted of 15 minutes in supine
position, followed by active standing for 15 more minutes. The most reliable cerebral pressure
wave for each participant was selected for each posture (supine and standing) by a specific
algorithm. From the pressure wave morphology, two peaks were detected (P1 and P2) and the
ratio between them (P2/P1) were calculated as an index of cerebrovascular compliance. Two-
way mixed-design analysis of variance (ANOVA) was used to compare intracranial pressure
indices between groups (non-paired measures) and postures (repeated measures). The statis-
tical significance level (p) was set at 5%. Results: Subjects were matched (no statistical
significance differences were found, p>0.05) by weight (kg), height (m), age and body mass
index (kg/m2). No significant difference (p>0.05) in cerebrovascular compliance (i.e., P2/P1)
was found between groups within each posture. However, both groups presented statistically
(p<0.05) higher P2/P1 values during supine in comparison with standing (Figure 1).
Conclusion: There was no difference between groups, but cerebrovascular compliance was
higher during standing position in both groups. Therefore, T2DM presented preserved cere-
brovascular compliance adjustments during posture changes. This finding could be supported
by the fact that the participants selected for T2DM did not present clinical complications or
cardiovascular autonomic neuropathy.
Figure 1. Comparison of P2/P1
P458
Early cardiological changes associated with the use of iSGLT2 in real clinical
practice
M Herruzo Rojas
1
, MA Martin Toro
2
, M De Damas Medina
3
, MR Fernandez Olmo
2
,
A Moreno Carazo
3
, C Gutierrez Alcantara
3
, JC Fernandez Guerrero
2
1
Puerto Real Hospital, Cardiology, Puerto Real, Spain,
2
University Hospital of Jaen, Cardiology,
Jaen, Spain,
3
University Hospital of Jaen, Endocrinology, Jaen, Spain
Topic: Diabetes and the Heart
Introduction: As shown in previous studies, the use of inhibitors of sodium-glucose cotran-
sporter 2 (iSGLT2) seems to modify certain parameters of myocardial function, both systolic
and diastolic, becoming one of the possible theories that would explain its benefit on the
reduction of cardiovascular death.
Objetives: To analyze early cardiac structural changes and myocardial function associated
with the use of iSGLT2 in real clinical practice, measured by 2D echocardiography and
longitudinal global strain (LGS), as well as readmissions for heart failure.
Methods: Ongoing prospective study of consecutive cases. 41 patients with type 2 Diabetes
(DM2) who started treatment with iSGLT2 were included. 2D echocardiography and long-
itudinal global strain (SGL) were performed on all patients. We analyzed the differences
between the baseline visit and the second one, performed 3 months later.
Results: Average age: 60.15 9.2 years, 68.3% males. Average duration MD2: 12.17 8.5
years. HBP: 73.2%;
Dyslipidemia: 75.6%; Smokers 63.5%. The 26.8% has history of CVD: ischemic heart disease:
22%.12.2% previous admissions due to heart failure (IC). Baseline, 15% had left ventricle
systolic dysfunction (2.5% mild, 5% moderate, and 7.5% severe). After 3 months of follow-
up, cardiac structural changes were observed, with a significant decrease in left atrial volume
(50.5 17.2 vs 41.4 13.7ml, p <0.001). An improvement in left ventricular systolic function
assessed by Teicholz (58.6 11.8 vs 61.8 9.2%, p = 0.02) and by Simpson 4C (58.3 9.1 vs
60.6 7.5%) was observed. In patients with systolic dysfunction, an improvement was
observed, with global dysfunction of any degree in 10%, mild in 2.5%, 7.5% moderate,
Abstract Number: P456
E-Health Programme Picture 1
Abstracts S81

and 0% severe. No significant changes were seen in right atrial volume, parietal thickness, left
ventricular diameters, tissue Doppler parameters, TAPSE or LGS. Regarding the evolution of
diastolic function, dysfunction existed in any degree in 95.1% at baseline visit Vs 79.5% at 3
months, p = 0.07, not statistically significant but with a tendency to improve. Among the
patients with systolic dysfunction, only 1 readmission due to HF was recorded.
Conclusions: In our study, the use of iSGLT2 was associated with a reduction in left atrial size
that is possibly related to a decrease in left ventricular end-diastolic pressure. In addition, we
have observed changes in myocardial function, with an improvement in systolic function and a
tendency to improve diastolic dysfunction globally.
P459
Muscle power in upright row movement: predictor of all-cause mortality in indivi-
duals between 41 and 85 years of age - Preliminary results12/04/2019 08:30
CGS Araujo
1
, CL Castro
1
, JF Franca
1
, JA Laukkanen
2
, J Myers
3
, D Hamar
4
1
Exercise Medicine Clinic - CLINIMEX, Rio de Janeiro, Brazil,
2
University of Jyvaskyla,
Faculty of Sport and Health Sciences, Jyvaskyla, Finland,
3
Stanford University, VA Palo Alto
Health Care System, Palo Alto, United States of America,
4
Comenius University, Faculty of
Physical Education and Sport, Bratislava, Slovakia
Funding Acknowledgements: None
Topic: Risk Factors and Prevention Epidemiology
Background: muscle power is relevant to the performance of many daily and sporting actions
and tends to progressively decrease after 40 years of age.
Purpose: to investigate the relationship between muscle power and all-cause mortality in
subjects aged 41 to 85 years old.
Methods: a retrospective analysis of data from 3878 non-athlete adults aged 41 to 85 years old
(67.8% men) who underwent a maximal muscle power test in an upright row exercise between
February 2001 and December 2016. Mean age was 59 years, and 5% of the subjects were aged
over 80 years old. The highest value achieved after two or three attempts with increasing loads
was considered the maximal muscle power (MMP) and expressed in watts/kg of body weight.
MMP values were analyzed separately for sex and divided into quartiles for survival analysis.
Results: During a median follow-up of 6.5 years, 247 men (10.4%) and 75 women (6.4%) died.
Survival curves differed between quartiles of MMP for men and for women (p <.001). Men
and women with a MMP value above the median (Q3-Q4) had a death rate of 2.1% and 1.3%
per year, respectively, for Q3 and Q4, with a risk of dying 4 to 5x higher when compared to
Q2, and 10 to 13x higher when compared to those with results in the lower quartile.
Conclusion: MMP results in a daily movement can be used as a predictor of all-cause mortality
in men and women between 41 and 85 years of age. Interestingly, considering the value of
MMP, in order to have a low likelihood of premature death in the following six years, all you
need is to be above the median for your sex.
MMP &mortality
Sex Variable Q1 Q2 Q3 Q4
Men w/kg <1.9 1.9-2.5 2.51-3.0 >3
% deaths 23.5 9.4 2.5 1.8
Women w/kg <1 1-1.4 1.41-1.75 >1.75
% deaths 16.3 5.7 2.0 0.7
Table. Men and women MMP quartiles: range values and % of deaths
MMP men and women survival curves
P460
Time trends in incidence rates of total, ischemic and haemorrhagic stroke in Norway
2001-2014 using national administrative data from the CVDNOR project
I Ariansen
1
, J Igland
2
, H Ellekjaer
3
, G M Egeland
4
, G S Tell
2
, G Sulo
5
, R Selmer
1
1
Norwegian Institute of Public Health, Department of Chronic Diseases and Ageing, Oslo, Norway,
2
University of Bergen, Department of Global Public Health and Primary Care, Bergen, Norway,
3
St
Olavs Hospital, Stroke Unit, Department of Internal Medicine, Trondheim, Norway,
4
Norwegian
Institute of Public Health, Department of Health Registries, Bergen, Norway,
5
Norwegian Institute
of Public Health, Department of Health Promotion and Centre for Disease Burden, Bergen, Norway
Topic: Risk Factors and Prevention Epidemiology
Introduction: Diverging stroke incidence rates have been reported in Northern European
countries over the last decades. In Norway, national trends of stroke incidence are unknown.
Purpose: We estimated time trends in incidence (first time) of fatal and non-fatal ischemic
stroke, haemorrhagic stroke, subarachnoid bleeding and unspecified stroke in the period 2001-
2014, by sex and age group.
Methods: Nationwide hospital discharge diagnoses in the CVDNOR database and in the
National Patient Registry were linked to the National Cause of Death Registry. All hospita-
lizations with stroke as main or secondary diagnosis and out-of-hospital deaths with stroke as
underlying cause for individuals 25 years were obtained during 1994-2014. Incident stroke
was defined as hospitalization or out-of-hospital-death due to stroke with no prior hospita-
lization for stroke or stroke sequela during the previous seven years. Age adjusted incidence
rate ratios (IRR) per year were estimated by Poisson regression analyses. We used direct
standardization against the 2001 Norwegian population.
Results: During 44,633,176 person-years of follow up from 2001 to 2014, we identified 156,041
incident fatal or non-fatal total stroke cases, of which 71 % were ischemic, 12% haemorrha-
gic, 4% subarachnoid haemorrhages and 12% unspecified. From 2001 to 2014, age-standar-
dized incidence of total stroke declined from 476 to 341 cases per 100 000 person-years among
men and from 344 to 239 among women. Incidence rates of total and ischemic stroke declined
in individuals 45 years and older. Incidence rates of ischemic stroke increased by 2% per year
in men 25-44 years, IRR (95% CI) 1.02 (1.00, 1.02), p=0.001. Incidence rates of haemorrhagic
stroke decreased in the age group 45-84 years and increased by 2 % per year in men 85 years
and older, IRR 1.02 (1.00, 1.03), p=0.009.
Conclusion: Total stroke incidence rates declined from 2001 to 2014 in the Norwegian adult
population 45 years and older. Increased incidence rates of ischemic stroke in men below 45
years and of haemorrhagic stroke in men 85 years and older are worrying and need further
investigation.
P463
Association between cardiovascular health and sleep disturbances: results from two
population-based cohort studies, the paris prospective study 3 and the colaus study
NH Hausler
1
, QL Lisan
2
, TVS Van Slotten
3
, JHR Haba Rubio
1
, MCP Perier
2
,
FT Thomas
4
, ND Danchin
4
, CG Guibout
2
, PB Boutouyrie
5
, RH Heinzer
1
,
XJ Jouven
2
, PMV Marques-Vidal
1
, JP Jean-Philippe Empana
2
1
University Hospital Centre Vaudois (CHUV), Internal Medicine, Lausanne, Switzerland,
2
INSERM U970 Paris Cardiovascular Research Centre, Paris, France,
3
Maastricht University
Medical Centre (MUMC), Internal Medicine, Maastricht, Netherlands (The),
4
Centre
dƒ??Investigations Preventives et Cliniques, Paris, France,
5
HC¸ı
¨pital EuropC¸ °en Georges
Pompidou- UniversitC¸ °Paris Descartes, Paris, France
Funding Acknowledgements: This study was cofunded by the National Research
Agency (France) and the Swiss National Science Foundation (Switzerland).
Topic: Sleep Disorders
Background: Although cardiovascular risk factors usually cluster, their combined effect on
sleep disturbances remains unknown.
Purpose: We therefore aimed to investigate the association between cardiovascular health
(CVH), as defined by the American Heart Association, and several sleep disturbances.
Methods: Two community-based cohorts, the Paris Prospective Study 3 (PPS3, France,
n=6,441) and the CoLaus study (Switzerland, n=2,989) were analyzed. Using the 7 metrics
of the American Heart Association(nonsmoking; and ideal levels of body mass index, physical
activity, diet, blood pressure, fasting blood glucose and total cholesterol), participants with 0-
2, 3-4 and 5-7 ideal metrics were categorized as having low, moderate and high CVH. Sleep-
disordered breathing (SDB) was evaluated with the Berlin questionnaire (proxy SDB) and
SDB severity was measured by polysomnography; excessive daytime sleepiness (EDS) was
evaluated with the Epworth scale, whereas insomnia symptoms and short/long sleep duration
were extracted from the Pittsburg Sleep Quality index. Associations between each sleep dis-
turbance and global CVH (primary exposure) but also behavioral (nonsmoking; and ideal
levels of body mass index, physical activity, diet) and biological (ideal levels of blood pressure,
fasting blood glucose and total cholesterol) CVH (secondary exposure) were quantified in
multivariable logistic regression analyses and Odds ratio (OR)/relative risk ratio (RRR)
together with their 95% confidence intervals (CI) were estimated.
Results: When compared to poor CVH, subjects with intermediate and ideal global CVH had
lower odds of proxy for SDB in both cohorts (ORs up to 0.55; 95% CI 0.44-0.68 and 0.35;
95% CI 0.22-0.53, respectively) and had lower SDB severity as defined by the American
Academy of Sleep Medicine(RRR up to 0.07; 95% CI 0.02-0.20). Similar associations were
found for behavioral and biological CVH. Subjects with intermediate and ideal global CVH
had lower odds of EDS in PPS3 (ORs 0.82; 0.72-0.95 and 0.80; 0.82-1.02, respectively). A
similar association was found with behavioral CVH in both cohorts. No consistent associa-
tions were found between CVH and short/long sleep duration or insomnia symptoms.
Conclusion: Higher levels of CVH, especially behavioral CVH, are associated with lower odds
of presenting SDB and EDS.
P464
Prevalence and correlates of insomnia in coronary heart disease patients.
L Lars Froid
1
1
University of Oslo, Department of Behavioural Sciences in Medicine, Oslo, Norway
Topic: Sleep Disorders
Introduction: There is some evidence that insomnia may be highly prevalent in coronary heart
disease (CHD) patients. However, previous studies are few, mainly with limited sample size or
biased samples. Furthermore, the extent to which insomnia is associated with demographic,
clinical, psychological factors and inflammation is not known.
Purpose: To determine the prevalence of insomnia and its associations with demographic,
clinical, and psychological correlates in a large sample of unselected CHD patients.
Methods: The sample comprised 1082 patients aged 31-80 (mean 62) years (21% female
gender) who participated in the cross-sectional Norwegian Coronary Prevention (NOR-
S82 EuroPrevent Congress Abstracts June 2019

COR) Study. Consecutive patients hospitalized with myocardial infarction and/or a coronary
revascularization procedure in 2011-14 responded to a comprehensive self-report question-
naire and participated in a clinical examination with blood sample collections including
assessment of high sensitivity C-reactive protein (hs-CRP) 2-36 (median 16) months later.
Insomnia was assessed with Bergen insomnia scale (BIS) designed to measure insomnia
based on the diagnostic criteria for insomnia in DSM-IV as defined by the American
Psychiatric Association. Binary logistic regression analyses were used to investigate the asso-
ciation between insomnia and covariates.
Results: In total, 43% of the patients reported insomnia at follow-up, and 23.8% of them used
sleep medication. The independent determinants of insomnia are presented in the Table.
Anxiety was the strongest covariate, followed by obstructive sleep apnoea, type D personality,
female gender, low fish intake, diabetes, and CRP. No significant associations were found for
age, low socioeconomic status, somatic comorbidity, drug adherence, participation in cardiac
rehabilitation, smoking, LDL cholesterol, and hypertension. Interestingly we found a strong
association with anxiety, but not depression in the adjusted analyses.
Conclusion: Insomnia was prevalent after a CHD event and associated with psychological
factors, subclinical inflammation, and unfavorable lifestyle behavior. Our results emphasize
the importance of identifying patients with insomnia and ensuring appropriate treatment of
insomnia as a part of cardiac rehabilitation.
P466
Sensitivity and specificity of cardiovascular risk thresholds used to guide treatment
therapy
A Abderrahim Oulhaj
1
, A Suliman
1
1
United Arab Emirates University, Institute of Public Health, Al Ain, United Arab Emirates
Topic: Risk Factors and Prevention Cardiovascular Risk Assessment
Background: Cardiovascular disease (CVD) prevention guidelines strongly recommend risk
assessment and stratification to identify patients eligible for drug therapy such as Statins.
These patients are usually identified as those with a CVD risk exceeding a specific threshold.
The choice of the treatment threshold has been a point of controversy as it is not based on
strong scientific evidence. An ideal threshold should lead to treating all patients who, if not
treated, will subsequently develop a CVD event (high sensitivity) while avoiding unnecessary
treatment of patients who will not develop a CVD event (high speciEcity).
Objectives: To assess the performance measures (sensitivity, specificity) of the current treat-
ment threshold (7.5%) used by the 2013 American College of Cardiology/American Heart
Association (ACC/AHA) blood cholesterol guidelines. We also investigated if the perfor-
mance measures are improved when the threshold depends on sex and age.
Methods: We used the most updated version of the Framingham Offspring cohort study
containing 3,588 participants free of CVD at baseline. The performance measures are esti-
mated using the revised 10-year Pooled Cohort RISK Equation model. Time-dependent sen-
sitivity, specificity and area under the Roc curve (auc) were calculated. Performance measures
were also estimated for a range of age and sex specific-thresholds. A CVD event was defined as
nonfatal myocardial infarction, death from coronary heart disease, or fatal or nonfatal stroke.
RESULTS: Overall, 31% of subjects were eligible for statins therapy when using a threshold
of 7.5%. Only 16% of women were eligible for statin therapy compared to 49% men. Also,
the majority (70 %) of subjects over 65 years were recommended for statin therapy compared
to 36% in those aged between 56-64 and 10% in those aged between 40-55. The current
threshold has a specificity of 87% and a sensitivity of 39% meaning that it misses statin
recommendation in 61% of patients who will subsequently develop a CVD event. The sensi-
tivity was lower (26%) in younger subjects (40-55 years) compared to 56% in subjects aged 56-
65 and 87% in subjects aged 66+. The threshold has also low sensitivity (39%) in women
compared to (63%) in men.
Conclusions: We showed, using the newly revised 10-year Pooled Cohort Risk Equation, that
the 7.5% threshold for statin therapy used in the American guideline leads to over-treatment
of older subjects and men and under-treatment of younger subjects and women. A threshold
depending on age and sex would improve these performances.
P467
Assessment of the additional capacity of a genetic risk score in the prediction of
coronary artery disease and its discriminative power
M Neto
1
, MI Mendonca
1
, A Pereira
1
, JA Sousa
1
, J Monteiro
1
, R Rodrigues
1
,
AC Sousa
1
, M Rodrigues
1
, E Henriques
1
, S Borges
1
, AI Freitas
1
, I Ornelas
1
,
A Drumond
1
, R Palma Dos Reis
2
1
Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal,
2
New University of
Lisbon, Faculty of Medical Sciences, Lisbon, Portugal
Topic: Risk Factors and Prevention Cardiovascular Risk Assessment
Predicting future coronary artery disease (CAD) in healthy adults even using the new risk
factors beyond the traditional ones, seems sometimes disappointing.
Aims: Investigate the role of 33 genetic variants emerged from GWAS apart from phenotypic
and behaviour information, in prediction and discrimination of CAD.
Methods: A case-control study was performed with 3050 subjects (1619 coronary patients and
1431 controls) from GENEMACOR. Traditional and new risk factors (TRF) such as smok-
ing, dyslipidemia, diabetes, family history, hypertension, body mass index, physical inactivity,
heat rate, creatinine clearance, alcohol, pulse wave velocity, homocysteine, glucose, fibrino-
gen, lipoprotein (a), APO B lipoprotein, CRP (as) were investigated as well as the 33 genetic
variants (Fig 1) previously associated with CAD. Genotyping was performed by TaqMan
Real-Time PCR method. A multiplicative genetic risk score (mGRS) with these 33 variants
has been created. Multiple logistic regression models were used to estimate the ORs and 95%
CI, without and with GRS (5th quintile) adjusted for potential confounders. Area under the
ROC curve (AUC) of each one was compared using Delong test.
Results: In our population, the GRS mean was 0.640.75 (patients) and 0.460.51 (controls).
After multivariate model with all the studied risk factors, the following: alcohol, pulse wave
velocity, body mass index, lipoprotein APO B, PCR (as) did not remain in the equation and all
others showed independency and significance for CAD. When the last quintile of the score is
added to the model, CAD risk is 1.93 95% CI 1.56-2.40 (p<0.0001). In the first ROC curve
with all risk factors, the AUC was 0.80 and adding the last quintile of mGRS the AUC
increased slightly to 0.81 with statistical significance (p=0.002).
Conclusions: Although with statistical significance, the genetic information together with the
nongenetic did not add a strong evidence for CAD risk. Future knowledge about rare genetic
variants and other SNPs as well as their complex interactions both with genetic and environ-
mental factors will provide an improved clinical utility of the GRS.
P468
Impact of a cardiovascular disease screening result on prevention-seeking behavior
and compliance with preventive treatment in asymptomatic ROBINSCA participants
S J A M Sabine Denissen
1
, CM Van Der Aalst
1
, M Vonder
2
, M Oudkerk
2
,HJDe
Koning
1
1
Erasmus Medical Center, Public Health, Rotterdam, Netherlands (The),
2
University Medical
Center Groningen, Center for Medical Imaging North-East Netherlands, Groningen, Netherlands
(The)
Funding Acknowledgements: European Research Council - Advanced Research Grant
(#294604)
Topic: Risk Factors and Prevention Cardiovascular Risk Assessment
Introduction: A teachable moment for preventive behavioral change can occur when asympto-
matic individuals receive their cardiovascular disease (CVD) screening result. This study
investigated prevention-seeking behavior and compliance to preventive treatment of partici-
pants of the population-based Risk Or Benefit IN Screening for CArdiovascular disease
(ROBINSCA) trial after receiving a screening result.
Methods: Asymptomatic Dutch individuals (n=43,447) were randomized (1:1:1) to screening
for CVD by either traditional risk assessment (intervention arm A), or determining the
amount of coronary artery calcification (CAC) (intervention arm B), or to usual care (control
arm). A random sample (n=600) of ROBINSCA participants with a screening result (arms A
and B) received an online questionnaire (in 2017) to measure the impact of a CVD screening
result in low and increased (arm A; risk>10%, arm B; Agatston100) risk groups.
Results: Of all respondents (438/600; 73%), 63.5% was men and the mean age (Standard
Deviation) was 63.86.9 years. Individuals with an increased CAC-score consulted their
general practitioner (GP) more often compared to increased risk individuals from arm A;
140/149 (94%) and 86/137 (62.8%) respectively (p<0.001). Current use of blood pressure and
cholesterol lowering drugs was significantly higher in the increased CAC-score-group (108/140
(77.1%)), compared to the group with an increased traditional risk (35/80, 43.8%; p<0.001).
Self-reported compliance was high (98.1-100%).
Conclusions: Receiving the screening result might be a teachable moment that can enhance
CVD prevention-seeking behavior through consulting a GP and high compliance to preven-
tive treatment. The impact of the screening result was more profound in the increased CAC-
score-group.
P470
Subclinical abnormalities in left atrial - left ventriculoarterial coupling in middle -
aged hypertensive patients
N Neli Georgieva
1
, A Borizanova - Petkova
1
, E Kinova
1
, A Goudev
1
1
University Hospital Tsaritsa Yoanna, cardiology, Sofia, Bulgaria
Topic: Risk Factors and Prevention Cardiovascular Risk Assessment
Background: The concept of "ventriculoarterial coupling" could be a key determinant for the
prediction of cardiovascular events. The interaction between left atrium (LA) and ventricu-
loarterial coupling for evaluation of functional abnormalities remains unclear.
Purpose: The purpose of the present study was to assess the relationship between ventricu-
loarterial coupling and LA changes in middle aged hypertensive patients.
Methods: We studied 60 consecutively middle - aged patients (54 13 years), separated in two
groups: 45 with mild to moderate hypertension and duration up to 5 years and 15 healthy
controls. All parameters for arterial stiffness 24 - hour central systolic pressure (cSys24h),
central pulse pressure (cPP24h), augmentation index 24h (Aix24h) and 24 - hour pulse wave
velocity (PWV24h) were measured non invasively with oscillometric method by Mobil-O-
graph PWA. All patients underwent standard two - dimensional echocardiography with
Spackle racking analysis for LA and left ventricle (LV) global longitudinal strain (GLS).
Results: Statistically significant differences in parameters of vascular stiffness were found in
patients with hypertension in comparison with healthy controls: cSys24h (116.64 10.52 vs.
108.46.19 mm Hg, p<0.001), cPP24h (46.579.51 vs. 40.44.98 mm Hg, p<0.02), PWV24h
(8.481.51 vs. 6.290.91 m/s, p<0.0001). Patients with hypertension had higher LV filling
pressures: E/e? ratio (9.842.85 vs. 7.621.58, p<0.006), greater volume of LA (LAVI:
31.869.78 vs. 24.964.89 ml/m2,p<0.011) and reduced LA - GLS (29.143.90 vs.
41.334.37 %, p<0.0001) in comparison to control group. There were no statistically signifi-
cant differences in Aix24h and cardiac output between the two groups. There is moderate
positive correlation between cPP24h (r = 0.418, p<0.001) and LAVI. PWV24h correlated
moderately and positively with LAVI (r=0.442, p<0.0001), and negatively with LAGLS (r
= - 0.459, p<0.0001).
Conclusion: Early signs of abnormal LALV coupling are related to arterial stiffness in
Abstracts S83

middleaged hypertensive patents. LA remodeling could be used for the prediction of cardi-
ovascular events in this population. Further investigations are needed for prognostic and
therapeutic value of LA remodeling.
P471
Remote ischemic preconditioning and short-term effects on the autonomous ner-
vous function, arterial stiffness and grip strength
J Mueller
1
, M Taebling
1
, R Oberhoffer
1
1
Institute of Preventive Pediatrics, Technische Universita¨t Mu¨nchen, Munich, Germany
Topic: Risk Factors and Prevention Cardiovascular Risk Assessment
Objective: Remote ischemic preconditioning (RIPC) are short episodes of ischemia and reper-
fusion applied to remote tissue to trigger responses in a specific organ or cardiovascular bed.
This study investigates whether RIPC has a short-term effect on the autonomous nervous
function (ANS) arterial stiffness and blood pressure (BP) as well as grip strength.
Patients and
Methods: From March 2018 to October 2018, we included 47 healthy volunteers (27 female,
age 25.7 3.2 years) into this single-blinded randomized-controlled crossover trial.
Participants received measuring of the ANS based on 260 adjacent heartbeats. Then BP
and arterial stiffness were measured in supine position with an oscillometric device. Finally,
the grip strength of the dominant hand was determined with a Jamar dynamometer as the best
of three attempts. Afterwards participants were randomized into intervention or SHAM
group. The intervention group then underwent a RIPC protocol (3 cycles of 5min of 200
mmHg ischemia followed by 5min reperfusion) at the thigh. The SHAM group followed the
same protocol just on the upper arm with 40 mmHg pressure inflation. Directly after this 30-
minutes reassessments were conducted.
Results: When comparing the effect of RIPC to SHAM there was a significant improvement in
the root mean square of successive differences (RMSSD) a parasympathetic parameter of the
ANS (?rMSSD: 11.9 23.6 ms, p=.014). Also grip strength tended to improve (?grip: 0.04 
2.6 kg, p=.086). On the other hand there were no changes in systolic blood pressure (?BP: 1.1
6.7 mmHg, p=.892) and pulse wave velocity (PWV), a measure of arterial stiffness (?PWV:
0.01 0.26 m/s, p=.894).
Conclusions: RIPC improved the parasympathetic function of the ANS and suggests to
improve the grip strength. However it seems to have no effect on vessel hemodynamics in
the short term.
P472
Acute arterial responses of maximal exercise and rescue simulation in professional
firefighters
VS Vanessa Santos
1
, RN Rafaela Netas
1
, RP Rita Pinto
1
, VA Vitor Angarten
1
,
XM Xavier Melo
2
, BF Bo Fernhall
3
, HSC Helena Santa-Clara
1
1
University of Lisbon, Faculty of Human Kinetics, Lisbon, Portugal,
2
Gina
´sio Clube Portugueˆs,
GCP Lab, Lisbon, Portugal,
3
University of Illinois, College of Applied Health Sciences, Chicago,
United States of America
Topic: Risk Factors and Prevention Cardiovascular Risk Assessment
Introduction: Cardiovascular events are the leading cause of line-of-duty death among fire-
fighters. Intense physical exertion has independently been shown to trigger sudden cardiovas-
cular events, particularly in those who are sedentary. It is thought that the combination of
high levels of heat stress and physical exertion lead to sudden cardiac events in susceptible
firefighters. Cardiovascular risk factors have unfavorable impact on arterial function, includ-
ing decreased endothelial function, increased arterial stiffness and central blood pressure (BP),
all of which are predictive of cardiovascular mortality. However, more studies are needed to
understand acute arterial changes following firefighting activities.
Purpose: The purpose of this study was to compare the effects of maximal exercise and a
rescue simulation (RS) on arterial stiffness and blood pressure.
Methods: We evaluated thirty-eight professional firefighters aged 31.85.2, following a max-
imal cardiopulmonary exercise test (CPET), with an incremental individualized protocol
based on the maximal velocity reached on the shuttle run test. They also performed a RS
that consisted in the following: one rescue from the basement (a 30 kg manikin) and another
rescue from the 6th floor (an 80 kg manikin). Each floor had 3 flights of 10 stairs each (180 in
total). Arterial stiffness was measured by pulse wave velocity (PWV), pulse pressure (PP) and
both brachial and central mean arterial pressure (MAP) were obtained following 15 minutes
of supine rest and at 5 and 15 minutes after completion of maximal exercise or RS. We also
performed a dual energy radiological densitometry test to characterize the population.
Results: Significant differences were detected on carotid-femoral (c-f) PWV (p0.024) after
5min following CPET and after 15min following the RS, due to a decrease following both
tasks. On carotid-distal (c-d) PWV significant decreases were found after 5 and 15 min in
CPET (p=0.006 and p=0.028, respectively) and in RS (p=0.004 and p=0.001, respectively).
Controlling PWV for MAP, fat mass and lean mass did not alter the results. Significant
increases after 5min following CPET and RS were also found in brachial (p<0.001) and
central (CPET p=0.019 and RS p<0.001) PP and in MAP (p0.005).
Conclusions: In conclusion, we demonstrated that arterial stiffness decreased in these fire-
fighters following both maximal exercise and RS, and these effects were not dependent on
blood pressure. These findings improve our understanding of the cardiovascular response to
firefighting activities.
Abstract Number: P463
cardiovascular health and SDB
S84 EuroPrevent Congress Abstracts June 2019

P473
Investigation of the sensitivity of different individual electrocardiographic leads and
their groups to myocardial ischemia by the biophysical modeling
I Chaikovsky
1
, IO Syropjatov
1
, MM Budnyk
1
1
Glushkov Institute of cybernetics, Kiev, Ukraine
Topic: Risk Factors and Prevention Cardiovascular Risk Assessment
Background: The investigation of the information value of various ECG leads and their
combinations was one of the main topic in the first decades of clinical electrocardiography.
This question has not lost its value today, especially in the context of the increasingly wide-
spread miniature electrocardiographic devices with a limited number of leads. Only computer
simulations using adequate biophysical models of the genesis of an electrocardiogram, within
the framework of specially developed scenarios for a particular pathology, can reveal the
relationship of electrophysiological phenomena in the heart with the ECG changes observed
on the surface in different leads
Materials and methods: An investigation of the sensitivity of the electrocardiogram to changes
in the shape of the transmembrane action potential curve, reflecting the onset and develop-
ment of myocardial ischemia was made by means of the program for interactive simulation
ECGSIM. The principle of operation of the ECGSIM program is based on a physiological
model that interconnects local transmembrane potentials in different parts of the myocardium
with an surface ECG. Myocardial ischemia was modeled using a "combined" scenario in
which the values of 2 characteristics of the transmembrane action potential were changed:
change in the amplitude of the action potential and change in the duration of the horizontal
plateau phase with a constant slope in the repolarization phase. These scenario were per-
formed for 5 model nodes: a node on the anterior surface of the heart, on the left side surface,
on the back surface of the heart and two nodes on the apex of the heart. Also, in each of the
nodes, scenarios of simulation of ischemia were performed for 4 variants of the affected area.
The results of an assessment of the sensitivity to ischemia of each of the 12 electrocardiogram
leads, as well as leads from the limbs and chest leads separately were obtained. The results
were averaged over all nodes and affected area variants.The total sensitivity of all 12 leads is
taken as 100%.
Results: The sensitivity to simulated ischemia was significantly higher within the ST-T interval
than within the QRS complex, however, the sensitivity ratio of the individual leads and their
groups remained almost unchanged. The most sensitive were the chest leads V3 (15.7%), V4
(14.3%). The overall sensitivity of all 6 chest leads was 65.6%. As for limb leads, their
information content was significantly lower. The most informative of them turned out to be
the assignment of lead III (6.6%) and II (6.1%). The sensitivity of lead I, which is most often
used in miniature ECG devices, is even lower (5.3%). The overall sensitivity of all 6 leads from
the limbs was 34.4%.
Conclusion: In portable electrocardiographic devices, which are increasingly used in preventive
cardiology, it is advisable to use the maximum possible number of leads, at least all 6 limb
leads.
P475
Ischemic risk stratification by calculating the Duke treatmill score in women with
ischemic heart disease and associated thyroid pathology
D Gurzau
1
, B Caloian
1
, H Comsa
1
, A Sitar-Taut
1
, F Fringu
1
, B Dutu
1
, D Zdrenghea
1
,
D Pop
1
1
Clinical Rehabilitation Hospital, Cardiology, Cluj-Napoca, Romania
Topic: Risk Factors and Prevention Cardiovascular Risk Assessment
Introduction
In women, the number of deaths due to cardiovascular disease in Europe is higher than in
men, a high percentage due to ischemic heart disease.Women have many particularities,
including a more frequent impairment of the thyroid function.
Purpose
The purpose of the study is to stratify ischemic risk by calculating the Duke score in women
with ischemic heart disease and thyroid pathology.
Methods
150 patients with coronary artery disease, were included in this study and 27.3% were with
associated thyroid pathology. All patients underwent coronarography, stress testing, Duke
score calculation, and thyroid function (TSH) and cardiovascular risk factors were also eval-
uated. Duke Treadmill Score was calculated using the following formula: exercise time(5 x
ST deviation)(4 x angina score index). Depending on the value of the Duke Treadmill Score,
patients were classified as: low risk 5, moderate risk between -11 and +5 and increased risk
-11.
Abstract Number: P465
Multivariable Odds Ratios for insomnia
Abstracts S85

Results
The distribution of risk factors was as follows: smoking-27%, hyperglycemia-73%, tothal-
cholesterol-185.09 49.49 mg / dl, LDL cholesterol-104 39.63 mg / dl, HDL cholesterol-
43.57 10.31, triglyceride- 166.59 96.25 mg / dl. The mean value of the Duke Treadmill
Score was 5.5881 4.179. There were no significant differences in the mean age of patients
with thyroid impairment compared to those without this condition: 65.02 9.34 vs 62.57 
10.32, p = NS. At the same time, there were no significant differences between the Duke score
in patients with and without thyroid pathology 7.10 4.39 versus 5.12 4.05 (p-NS). From
the point of view of the ischemic risk appreciated by the Duke score, there were significant
differences between the two groups,but only for the high-risk category - 18% vs 5.55% (p =
0.048), and not for the moderate risk group- 81.81% vs. 94.44% (p-NS). The TSH value in
those with thyroid involvement and high Duke score was 4.21 3.73 vs. 1.95 1.12 (p
<0.05). In general, there were no statistically significant differences between the Duke score
and the TSH value. We mention that most patients with thyroid disease were undergoing
endocrine treatment during the assessment. There were no significant differences between the
exercise capacity assessed by the number of METs performed during the stress testing in this
two categories of patients: 5.49 1.72 vs 5.71 0.91 (p-NS). Regarding coronary vascular
disease in patients with thyroid pathology, most patients were with microvascular coronary
disease -63.41%.
Conclusion
In women with ischemic heart disease, thyroid function can help identify patients at high risk
of ischemia, especially in conditions of microvascular coronary involvement.
P476
Association between handgrip strength and all-cause mortality among Muscovites
aged 55 years and older.
A Imaeva
1
, S Shalnova
1
, Y Balanova
1
, A Kapustina
1
, G Muromtseva
1
, A Deev
1
,
V Shkolnikov
2
1
National Research Center for Preventive Medicine, Department of Epidemiology of Chronic Non-
Communicable Diseases, Moscow, Russian Federation,
2
Max Plank Institute for Demographic
Research, Rostock, Germany
Topic: Risk Factors and Prevention Cardiovascular Risk Assessment
Introduction: The handgrip strength, is an indicator for estimating the muscle strength, accord-
ing to several studies, can be also used as a predictor of the poor prognosis.
Aim: Association between handgrip strength and all-cause mortality among Muscovites 55
years and older.
Methods: This study was the part of the prospective cohort survey "Stress, aging and health."
1876 participants aged 55 years and older were included. All participants were divided into 5
groups according to the quintiles of handgrip strength (<20, 20-24, 25-30, 31-38, >38).
Handgrip strength was measured 3 times for both left and right hands with subjects in a
standing position using a dynamometer in units of kilograms. The maximum handgrip
strength among all measurements was used for the present analysis. The mean follow-up
was 8,5 years, 531 deaths occurred. Association between handgrip strength and all-cause
mortality was evaluated by Cox regression model.
Results: Mean age of the participants at the examination was 68,5 (7,3) years. The average
handgrip strength for both genders was 29,7 (10,4) kg. According to the mean handgrip
strength by age-specific categories, a gradual decrease was apparent, the decrease of handgrip
strength from 55-64 years to >74 years was 8 kg. The relative risk for all-cause mortality
(stratified for age and sex) for the 1st quintile of handgrip strength was 3,6 (95% confidence
interval [CI], 2,37-5,47) compared to the 5th quintile (reference group). The RR of all-cause
mortality stratified by sex for each 10 years increment of age was significantly low (RR 0,94,
95% CI, 0,53-0,96).
Conclusion: Handgrip strength is a significant predictor of all-cause mortality among
Muscovites aged 55 years and older.
P477
Undiagnosed risk factors of ischemic heart disease as a serious public health
problem.
N A Natalia Anna Drobek
1
, M Rydzewska
1
, P Sowa
1
, J Jamiolkowski
1
,
M Szpakowicz
1
, M Lapinska
1
, A Raczkowski
1
, I Kowalska
2
, A Adamska
3
,
M Ciolkiewicz
4
, R Motkowski
5
, K A Kaminski
1
1
Medical University of Bialystok, Department of Population Medicine and Civilization Diseases
Prevention, Bialystok, Poland,
2
Medical University of Bialystok, Department of Internal Medicine
and Metabolic Disorders, Bialystok, Poland,
3
Medical University of Bialystok, Department of
Endocrinology, Diabetology and Internal Medicine, Bialystok, Poland,
4
Medical University of
Bialystok, Department of Rehabilitation, Bialystok, Poland,
5
Medical University of Bialystok,
Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Bialystok,
Poland
Topic: Risk Factors and Prevention Cardiovascular Risk Assessment
Introduction: Ischemic heart disease, despite recent successes in secondary prevention and
invasive treatment, remains an important health problem in European countries and a major
cause of premature death. The most important risk factors include hypertension (HA) and
dyslipidaemia (DLP). Hypothyroidism (HT) also has profound effects on cardiac function
that can impact both blood pressure and lipids concentration.
Purpose: Objective of the study was to assess the prevalence of undiagnosed civilization
diseases such as HA, DLP, HT in the population in the setting of primary and secondary
prevention.
Methods: In total, 486 study participants (mean age 57,1314,54) were examined. The study
group consists of two subgroups: secondary prevention group - 248 patients with ischaemic
heart disease (IHD) aged 41-79 and primary prevention group: 238 subjects randomly
assigned from the local population (Population Group - PG) aged 20-79. Each participant
of the study had a three-time blood pressure (BP) measurement, from which the average was
calculated. Cardiovascular risk as well as diagnoses of HA and DLP have been established
according to the current ESC guidelines. Using the Friedewald formula including lipid profile,
the LDL-C fraction was computed unless TG were elevated >4.5 mmol/L. Systematic
Coronary Risk Evaluation (SCORE) was calculated. The diagnosis of HT was based on
concentrations of thyroid-stimulating hormone (TSH) and thyroid hormones: free thyroxine
Abstract Number: P467
Genetic variants and genetic risk score