SAT0622-HPR SAFETY IN PATIENTS WITH RHEUMATOID ARTHRITIS IN BIOLOGICAL TREATMENT OVER 65 YEARS OF AGE

Background:A bias has been described with the lowest prescription of biologic treatments (bDMARD) in patients with rheumatoid arthritis (RA) in the elderly, despite presenting activity rates comparable to young population and higher risk of functional disability. This could be due to concerns about co-morbidities and polypharmacy1.Objectives:1) To define the characteristics of patients with RA ≥65 years and bDMARD to follow up in the Day Hospital of University Assistance Complex of León during the last year. 2) To record the incidence rate (IT) and ratio of incidence rates (RDI) of infections, neoplasms and cardiovascular events (CD) during the course of your therapy.Methods:Observational, retrospective study of patients diagnosed with RA according to ACR 1987 and/or ACR 2010 criteria in intravenous biological treatment during 2019 with ≥65.Results:40 patients with an average age at diagnosis of 55.9±15.76 years were included, 67.5 % of them were women. The average duration of the disease was 17.65±13.15 years. 40% had a history of smoking, 35% hypertension, 20% dyslipemia and 20% diabetes mellitus. A 97.5% were positive FRRA, 57% positive ACPA, 37.5% nodular and 65% erosive. As for pre-treatment, 70% had been with conventional (cDMARD) ≥2DMARD (Methotrexate (MTX) (92.5%) and Leflunomide (60%)). The mean dose of prednisone was 8.79 ±10.14 mg/day. The incidence rate of infections was 1.5%, and neoplasms and CD were 0.75% per person-years. The age at the beginning of the first bDMARD was 67.45 ± 8 years, the second (n=20) 67.98±6.64 and the third (n=7) 71.79±7.49. The first biological was a 52.5% anti-TNF, 5% anti-CTLA4, 30% anti-CD20 and 12.5% antiIL6 (25% monotherapy and combined with MTX 57.5%). The second was 30% anti-TNF, 25% antiCTLA4, 15% antiIL6 and 30% antiCD20 (50% in monotherapy and 40% methotrexate); with the third anti-TNF 42.85%, antiCTLA4 14.29%, antiIL6 14.29% and antiCD20 28.57% (42.86% in monotherapy and 42.46 with methotrexate). The mean doses of prednisone were 6.08±6.82, 4.38±7.21 and 6.95±5.94 mg/day respectively. The IT of bDMARD infections were 8.81%, 19.81% and 7.4% person-years; of neoplasia 1.04%, 0 and 0; and EC 3.63%, 0 and 1.85 person-years. The RTIs with first, second and third biological infections were: 5.88, 13.25, 4.95; with neoplasms 1.38; with EC 1.38, 0 and 0.69. The mean total accumulated corticosteroid dose was 17.69±15.01 mg/day.Conclusion:1) Patients over 65 years old receiving bDMARD in our Day Hospital in 2019 were long-standing RA with aggression data, who had not responded to ≥2 cDMARD and required medium-high doses of prednisone.2) In our sample there is a link between incidence of infection and the introduction of biological therapy, which is maintained with the increasing age of our patients, and it is not so clear with neoplasms and CD. These data are consistent with the existing literature1,2,3.3) Larger, comparative studies with RA under 65 years are needed, but it is reasonable to conclude that if bDMARD is required, elderly patients could be a high-risk group for infections, requiring special monitoring and follow-up.References:[1]Alla Ishchenko, Rik J. Lories. Safety and Efficacy of Biological Disease-Modifying Antirheumatic Drugs in Olfer Rheumatoid Arthritis Patients: Staying the distance. Drugs Aging 2016;(33):387-398.[2]Atsuko Murota, Yuko Kaneko, Kunihiro Yamaoka y Tsutomu Takeuchi. Safety of Biologic Agents in Elderly Patients with Rheumatoid Arthritis. J Rheumatol 2016; (43): 1984-1988.[3]Kosuke Ebina, Motomu Hashimoto, Wataru Yamamoto, Toru Hirano, Ryota Hara, Masaki Katayama et al. Drug tolerability and reasons for discontinuation of seven biologics in elderly patients with rheumatoid arthritis. The ANSWER cohort study. PLoS ONE 14 (15):e0216624Disclosure of Interests:None declared

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Incidence of Tuberculosis in Inflammatory Rheumatic Diseases: Results from a Lithuanian Retrospective Cohort Study

Medicina ◽

10.3390/medicina56080392 ◽

2020 ◽

Vol 56 (8) ◽

pp. 392

Author(s):

Dalia Miltinienė ◽

Giedrė Deresevičienė ◽

Birutė Nakčerienė ◽

Valerija Edita Davidavičienė ◽

Edvardas Danila ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Cohort Study ◽

Incidence Rate ◽

Rheumatic Diseases ◽

Retrospective Cohort ◽

Significant Risk ◽

Inflammatory Rheumatic Diseases ◽

The Mean ◽

Rheumatic Patients

Background and objective: With an increase in survival rates among rheumatic patients, comorbidities and infections, in particular, have gained more importance, especially after the introduction of biologicals to the treatment algorithms. Tuberculosis (TB) infection has always been given a special attention in patients with rheumatic diseases (RD). Although Lithuanian population has one of the highest TB incidence rates among European countries, the incidence of TB in the rheumatic patients’ population is still unknown. The aim of this study was to assess the incidence rate of TB in an inflammatory RD retrospective cohort and to compare that rate with a rate in a general population. Material and Methods: Patients with the first-time diagnosis of inflammatory RD during the period between 1 January 2012 and 31 December 2017 were identified from the Lithuanian Compulsory Health Insurance Information System database SVEIDRA. All cases were cross-checked with Health Information center at the Institute of Hygiene, for the vital status of these patients and date of death if the fact of death was documented, and with Tuberculosis Register operated by Vilnius University Hospital Santaros Klinikos, for the confirmation of TB cases. Sex and age standardized incidence ratios (SIR) were calculated by dividing the observed numbers of TB among rheumatic patients by the expected number of cases, calculated using national rates from Lithuanian Department of Statistics Official Statistics website. Results: Overall, 8779 patients with newly diagnosed RD were identified during the 2013–2017 period, these included 458 patients who used biological disease modifying drugs (bDMARDs). The mean duration of the follow-up period was 2.71 years. The cohort consisted mainly of women (70%) and a half of the cohort were rheumatoid arthritis (RA) patients (53%). Mean age of patients at the time of RD diagnosis was 56 years (range = 18–97 years). There were 9 TB cases identified during 23,800 person years of follow-up: 2 cases among them were treated with bDMARDs. The mean calculated annual TB incidence in RD cohort was 37.81 per 100,000 person years, which is consistent with the incidence rate predicted by national estimates, with a resultant SIR of 0.90 (0.41–1.70). The unadjusted hazard ratio for bDMARD use versus no bDMARD use was 4.54 (0.94; 21.87) in a total cohort and very similar in rheumatoid arthritis cohort; in both cohorts, it was not a statistically significant risk. Conclusions: Here, we present the first nationwide cohort study to assess the incidence of TB in a broad spectrum of inflammatory RD. Although limited by short follow-up period, this study shows that TB incidence in RD cohort does not exceed TB incidence in the general Lithuanian population.

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Incidence of Crohn’s disease in Stockholm County 1955–1989

Gut ◽

10.1136/gut.41.4.480 ◽

1997 ◽

Vol 41 (4) ◽

pp. 480-486 ◽

Cited By ~ 97

Author(s):

A Lapidus ◽

O Bernell ◽

G Hellers ◽

P-G Persson ◽

R Löfberg

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Elderly Patients ◽

Incidence Rate ◽

Confidence Intervals ◽

Incidence Rates ◽

Entire Study Period ◽

Stockholm County ◽

Entire Study ◽

The Mean

Aim—To evaluate the incidence of Crohn’s disease in Stockholm County between 1955 and 1989.Methods—A cohort of 1936 patients with Crohn’s disease was retrospectively assembled. Incidence rates and changes in disease distribution were assessed.Results—The mean increase in incidence was 15% (95% confidence intervals 12% to 18%) per five year period with a mean annual incidence rate at 4.6/105during the last two decades. The mean incidence for the entire study period was similar for men and women. The mean age at diagnosis increased from 25 years in 1960–64 to 32 years in 1985–89, partly because of an increasing proportion of patients aged at least 60 years at diagnosis. The proportion of patients with colonic Crohn’s disease at the time of diagnosis increased from 15% to 32% (17% difference; 95% confidence intervals 12% to 23%) whereas the proportion of patients with ileocaecal disease decreased from 58% to 41% (17% difference; 95% confidence intervals 10% to 24%) during the study period. Elderly patients had a higher proportion of small bowel disease and a lower proportion of ileocolonic disease compared with the younger patients.Conclusion—The incidence rate of Crohn’s disease in Stockholm has stabilised at 4.6/105 and the proportion of elderly patients has increased during a 35 year period. Colonic Crohn’s disease has increased in frequency with a reciprocal decrease in ileocaecal disease.

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THU0517 THE ROLE OF ULTRASOUND-DEFINED SYNOVITIS GRADE I IN PATIENTS PRESENTING WITH INFLAMMATORY ARTHRALGIA, A RETROSPECTIVE STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4886 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 497.2-497

Author(s):

J. Arroyo Palomo ◽

M. Arce Benavente ◽

C. Pijoan Moratalla ◽

B. A. Blanco Cáceres ◽

A. Rodriguez

Keyword(s):

Rheumatoid Arthritis ◽

Inflammatory Arthritis ◽

Statistical Tests ◽

Median Number ◽

Painful Joint ◽

Significant Difference ◽

The Mean ◽

Specialized Unit

Background:Musculoeskeletal ultrasound (MSUS) is frequently used in several rheumatology units to detect subclinical inflammation in patients with joint symptoms suspected for progression to inflammatory arthritis (IA). Synovitis grade I (EULAR-OMERACT combined score) is known to be a casual finding in healthy individuals, but studies headed to unravel its possible role on rheumatic diseases are sparse.Objectives:To investigate the correlation between synovitis grade I, and the diagnosis of IA made after a year follow-up period since MSUS findings, in patients of an MSUS-specialized unit of a Rheumatology Department.Methods:We conducted a descriptive, retrospective and unicentric study. 30 patients were selected from the MSUS-specialized unit of our Rheumatology Department from July-18 to January-19. Patients presenting synovitis grade 0 (exclusively), 2 and/or 3 on combined score were excluded. Data collection at baseline included age, sex, immunological profile and previous physical examination to the MSUS findings, as well as the diagnosis made by the rheumatologist in 1-year visit follow-up: dividing the patient sample into two groups: those who were diagnosed with IA and those not. Non-parametric statistical tests for comparing means were used.Results:The mean age was 51,6 years and 70% were females. 6 (20%) patients were diagnosed with inflammatory arthritis after a year follow-up: 2 (4,8%) psoriatic arthritis, 1 (3,3%) undifferentiated arthritis, 1 (3,3%) rheumatoid arthritis, 1 (3,3%) Sjögren’s syndrome. Non-inflammatory arthropathies were also found 24 (80%), of which, 12 (40%) were non-specific arthralgias and 8 (19%) osteoarthritis.In the group of patients who did not developed an IA the mean C-reactive protein (CPR) value was 3,12 mg/L and erythrocyte sedimentation rate (ESR) was 8,2 mm; all of them were rheumatoid factor (RF) positive and ACPA-negative except one patient. 5 (31,3%) patients presented low antinuclear antibodies (ANAs) levels. In those who HLA B-27 and Cw6 were tested (4,25%); both were negative except for one that was HLA B-27 positive. The median number of swollen and painful joint count was 0, and the mean of joints with MSUS involvement was 3,5; the mean involved metacarpophalangeal (MCP) joints was 1,83; proximal interphalangeal (PIP) joints was 1,48 and distal interphalangeal (DIP) joints 0,21.Among the group of patients that developed an IA the mean of CPR and ESR was 9,27 mg/L and 14,17 mm respectively; 2 (33%) patients were RF- positive, and 1 ACPA-positive. ANAs were positive in 3 cases (50%). The median of swollen joint count was 2 and for painful joint count was 0, the median of joints with MSUS involvement was 4,5. The mean of MSUS involvement was for MCP, PIP and DIP joints: 1,67, 2 and 0. Comparing the means of CPR values in the two groups with Student’s t-test we obtained a statistically significant difference (p=0,023). No other significant differences were found.Conclusion:Despite the limitations and possible statistical bias, the presence of MSUS-defined synovitis grade I and elevated CRP levels could be related to further diagnoses of inflammatory arthropathy. Besides, the absence of synovitis in DIP joints might have a diagnostic role. Normal physical exploration and normal levels of CRP might suggest low MSUS value. However, further research is needed to clarify the role of MSUS-defined synovitis grade I.References:[1]D’Agostino MA et al. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 1: definition and development of a standardized, consensus-based scoring system. RMD Open. 2017;3(1):e000428.[2]Van den Berg R et al. What is the value of musculoskeletal ultrasound in patients presenting with arthralgia to predict inflammatory arthritis development? A systematic literature review. Arthritis Research & Therapy (2018) 20:228.Disclosure of Interests:None declared

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Diamond-Shaped Mini-Craniotomy: A New Concept in Neurosurgery

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0041-1730942 ◽

2021 ◽

Author(s):

Giuseppe Emmanuele Umana ◽

Gianluca Scalia ◽

Marco Fricia ◽

Giovanni Federico Nicoletti ◽

Domenico Gerardo Iacopino ◽

...

Keyword(s):

Elderly Patients ◽

Temporal Muscle ◽

Brain Computed Tomography ◽

Computed Tomography Scans ◽

The Mean ◽

Clinical Records ◽

Dural Opening ◽

Traditional Approaches ◽

Scalp Incision

Abstract Background We describe, step by step, a modified, less invasive, diamond-shaped mini-craniotomy that optimizes dural opening and can be performed in elderly patients affected by acute subdural or intracerebral hematomas, in therapy with antiplatelets or anticoagulants. Methods We retrospectively analyzed the clinical records of 67 patients (mean age of 78.5 years) treated in our institution, during a period of 10 years, with this novel diamond-shaped craniotomy. Seventeen patients were treated for intracerebral hemorrhage and 50 patients for acute subdural hematomas. All the patients were in therapy with antiplatelets or anticoagulants. Results Approach-related complications were not detected. Ten of 67 patients (14.9%) presented temporal muscle atrophy; there was no scar deformity, paresthesia, hyperalgesia, or ramus frontalis palsy around the scalp incision. Thirty-day mortality was 22%. The mean follow-up was 1.3 years. One-month postoperative brain computed tomography scans showed a satisfactory hematoma evacuation in 57 of 67 patients (85%). Conclusions The diamond-shaped mini-craniotomy for acute subdural and intracerebral hematomas is safe and effective, and it should be considered as an alternative to traditional approaches, particularly in elderly patients.

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LigaSure Haemorrhoidectomy versus Conventional Diathermy for IV-Degree Haemorrhoids: Is It the Treatment of Choice? A Randomized, Clinical Trial

ISRN Gastroenterology ◽

10.5402/2011/467258 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 15

Author(s):

Maurizio Gentile ◽

Michele De Rosa ◽

Gabriele Carbone ◽

Vincenzo Pilone ◽

Francesca Mosella ◽

...

Keyword(s):

Clinical Trial ◽

Postoperative Pain ◽

Operative Time ◽

Randomized Study ◽

Late Complications ◽

The Third ◽

Effective Instrument ◽

The Mean ◽

Complications Rate

Introduction. Milligan-Morgan haemorrhoidectomy performed with LigaSure system (LS) seems to be mainly effective where a large tissue demolition is required. This randomized study is designed to compare LigaSure haemorrohidectomy with conventional diathermy (CD) for treatment of IV-degree haemorrhoids. Methods. 52 patients with IV-degree haemorrhoids were randomized to two groups (conventional diathermy versus LigaSure haemorrhoidectomy). They were evaluated on the basis of the following main outcomes: mean operative time, postoperative pain, day of discharge, early and late complications. The time of recovery of work was also assessed. All patients had a minimum follow-up of twelve months (range 12–24). All data were statistically evaluated. Results. 27 patients were treated by conventional diathermy, 25 by LigaSure. The mean operative time was significantly shorter in LS, such as postoperative pain, mainly lower on the third and fourth postoperative day: moreover pain disappeared earlier in LS than CD. The time off-work was shorter in LS, while there was no difference in hospital stay and overall complications rate. Conclusions. LigaSure is an effective instrument when a large tissue demolition is required. This study supports its use as treatment of choice for IV degree haemorrhoids, even if the procedure is more expansive than conventional operation.

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P034 Macrophage activation syndrome in Juvenile Idiopathic Arthritis

Rheumatology ◽

10.1093/rheumatology/keab722.026 ◽

2021 ◽

Vol 60 (Supplement_5) ◽

Author(s):

Rahma Guedri ◽

Glaimeriem ◽

Zohra Fitouri ◽

Saayda Ben Becher ◽

Bechir Hamza

Keyword(s):

Biological Treatment ◽

Pediatric Rheumatology ◽

Macrophage Activation Syndrome ◽

Macrophage Activation ◽

Systemic Jia ◽

Rheumatology Unit ◽

The Mean ◽

And Biological Markers ◽

Activation Syndrome

Abstract Objectives To describe the epidemiological, clinical-biological, and therapeutic characteristics of children with systemic JIA complicated with a macrophage activation syndrome (MAS). Methods It was a retrospective study, including children with JIA followed at the pediatric rheumatology unit of the children's hospital in Tunis for 22 years (January 1999 to December 2020), and presented MAS during their follow-up. Results We included 40 patients with JIA. Nineteen children (47.5%) presented MAS during the disease. They are 11 boys and 8 girls, with a sex ratio of 1.3. The mean age was 5.31 years (range: 0.66–10.83 years). The circumstances of the occurrence were variable. MAS was inaugural in 10 patients. Three of our patients presented MAS twice. MAS was definitive with clinical and biological markers in 12 cases and only biological in 7 cases. Seventeen of our patients were treated with intravenous Corticosteroids. Seven Childs among them received, in combination, Immunoglobulins (IG). We prescribed a biological treatment in 3 patients. We have mourned only one death. Conclusion MAS is a severe complication of JIA and is the leading cause of death.

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Isoelastic Cementless Total Hip Replacement in Rheumatoid Arthritis. Long-Term Results

Hip International ◽

10.1177/112070009200200202 ◽

1992 ◽

Vol 2 (2) ◽

pp. 43-46

Author(s):

U. Fusco ◽

R. Capelli ◽

A. Avai ◽

M. Gerundini ◽

L. Colombini ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Hip Replacement ◽

The Other ◽

Long Term Results ◽

X Rays ◽

X Ray ◽

The Mean ◽

Cementless Total Hip Replacement

Between 1980 and 1987 we have implanted 46 isoelastic cementless THR in 40 patients affected with rheumatoid arthritis. We have reviewed 38 hips clinically and by X-ray. The mean follow-up was 8,5 years. Harris hip scores ranged from 30.6 preoperatively to 73,4 post-operatively when reviewed. While on the other hand Merle D'Aubigné hip scores ranged from 7,06 pre-operatively to 15,59 post-operatively. All patients have been satisfied, and X-rays showed an improvement for both Charnely and Gruen X-ray score.

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Endoscopic Mucosal Resection: Early Experience in British Columbia

Canadian Journal of Gastroenterology ◽

10.1155/2010/897473 ◽

2010 ◽

Vol 24 (4) ◽

pp. 239-244 ◽

Cited By ~ 6

Author(s):

Mayur Brahmania ◽

Eric Lam ◽

Jennifer Telford ◽

Robert Enns

Keyword(s):

British Columbia ◽

Barrett’S Esophagus ◽

Endoscopic Mucosal Resection ◽

Barrett's Esophagus ◽

Low Grade ◽

Complication Rates ◽

The Third ◽

Mucosal Resection ◽

The Mean

BACKGROUND: Endoscopic mucosal resection (EMR) has been proposed as a primary method of managing patients with dysplasia- or mucosal-based cancers of the esophagus.OBJECTIVES: To evaluate the use of EMR for the treatment of Barrett’s esophagus with dysplasia or early adenocarcinoma, assessing efficacy, complication rates and long-term outcomes.METHODS: All patients who underwent EMR at St Paul’s Hospital (Vancouver, British Columbia) were reviewed. Eligible patients were assessed with aggressive biopsy protocols. Detected cancers were staged with both endoscopic ultrasound imaging and computed tomography. Appropriate patients were offered EMR using a commercially available mucosectomy device. EMR was repeated at six- to eight-week intervals until complete. Patients with less than one year of follow-up or who were undergoing other ablative methods were excluded.RESULTS: Twenty-two patients (all men) with a mean (± SD) age of 67±10.6 years were identified. The mean duration of gastroesophageal reflux disease was 17 years (range four to 40 years) and all were receiving proton pump inhibitor therapy. The mean length of Barrett’s esophagus was 5.5±3.5 cm. One patient had no dysplasia (isolated nodule), three had low-grade dysplasia, 15 had high-grade dysplasia (HGD) and three had adenocarcinoma. A mean of 1.7±0.83 endoscopic sessions were performed, with a mean of 6±5.4 sections removed. Following EMR, three patients developed strictures; two of these patients had pre-existing strictures and the third required two dilations, which resolved his symptoms. There were no other complications. Three patients underwent esophagectomy. Two had adenocarcinoma or HGD in a pre-existing stricture. The third patient had an adenocarcinoma not amenable to EMR. One patient with a long segment of Barrett’s esophagus underwent radiofrequency ablation. At a median follow-up of two years (range one to three years), the remaining 18 patients (82%) had no evidence of HGD or cancer.CONCLUSION: Most patients with esophageal dysplasia can be managed with EMR. Individuals with pre-existing strictures require other endoscopic and/or surgical methods to manage their dysplasia or adenocarcinoma.

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P1339ARTERIOVENOUS FISTULA AND BASILIC VEIN TRANSPOSITION IN ELDERLY PATIENTS ON HEMODIALYSIS: AN OBSERVATIONAL STUDY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1339 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Vinant Bhargava ◽

Priti Meena ◽

Ambrish Satwik ◽

Apurv Srivastava ◽

A K Bhalla ◽

...

Keyword(s):

Elderly Patients ◽

Vascular Access ◽

Elderly Population ◽

The Elderly ◽

Primary Patency ◽

New Delhi ◽

Secondary Patency ◽

Basilic Vein ◽

The Mean

Abstract Background and Aims With the increase in the line expectancy of chronic kidney disease in the older population (>60 years), the numbers requiring haemodialysis is progressively rising. The elderly population may be different from the younger in terms of non-suitable vessels for access creation, non-maturation, and vascular calcifications, and this may alter the outcomes of use of arteriovenous fistula (AVF). This study was conducted to analyse the outcomes of AVF in elderly patients (>60 years). Method Retrospective study was conducted in the Department of Nephrology at Sir Ganga Ram Hospital, New Delhi. Patients of more than 60 years of age in whom AVF was created from 1st January 2012 to 31st December 2016 were included in the study. Follow-up data of 3.5 years was analysed. The primary endpoint was to assess primary and secondary patency rates. Results A total of 300 patients were included in the study. The mean age was 63.8 years. Radiocephalic AVF (RCAVF) was the most common site of [69.8% (n = 210)], followed by brachiocephalic (BCAVF) in 25.2% (n = 75) and basilic vein transposition (BVT) in 5% (n = 15). At 12 months, overall survival of the AVF was 66.8%. At 42 months, the primary patency rate of RCAVF, BCAVF, and BVT was 50.6%, 52.6%, and 50.4% respectively. The commonest cause of access failure was thrombosis (20.4%) followed by non-maturation (9%). Vascular access abandonment was found least in BCAVF. Conclusion AVF remains the preferred vascular access for haemodialysis in the elderly population. Brachiocephalic AVF has higher primary and secondary patency rates. Thrombosis and failure of maturation are major concerns in the elderly AVF.

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The association between carotid intima-media thickness and new-onset hypertension in a Chinese community-based population

BMC Cardiovascular Disorders ◽

10.1186/s12872-019-1266-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Long Zhang ◽

Fangfang Fan ◽

Litong Qi ◽

Jia Jia ◽

Ying Yang ◽

...

Keyword(s):

Blood Pressure ◽

Strong Association ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Incidence Rates ◽

Community Based ◽

Media Thickness ◽

The Mean ◽

New Onset

Abstract Background Hypertension and arterial vasculopathy may be mutual causes and effects. It is unknown whether carotid intima-media thickness (cIMT) is reliably predictive of the presence of newly developed hypertension in the Chinese population. This study evaluated the impacts of cIMT on new-onset hypertension in a community-based population without hypertension at baseline in China. Methods A total of 672 Chinese subjects who had complete data for demographics, baseline and follow-up blood pressure measurements, and cIMT measurements at baseline were included in our study. Baseline cIMT was obtained under standardized procedures using the GE Vivid 7 ultrasound system equipped with an 8-MHz linear array vascular probe (GE Medical Systems, Milwaukee, Wl, USA). The outcome was the incidence of hypertension at follow-up. Multivariate regression models were used to access the association between baseline cIMT and the risk of new-onset hypertension. Results Subjects were 51.5 ± 4.7 years old, and 32.0% were male. The mean baseline systolic blood pressure (SBP) was 122.5 ± 10.0 mmHg. The mean baseline diastolic blood pressure (DBP) was 72.4 ± 7.5 mmHg. The number of subjects with thickened cIMT (maximum ≥0.9 mm) at baseline was 198 (29.5%). After 2.3 years of follow-up, the rate of new-onset hypertension was 12.6%. The incidence rates of hypertension in the groups with thickened cIMT and normal cIMT were 19.2 and 9.9%, respectively. In the multivariable logistic regression analyses, both the average (OR = 1.69, 95% CI: 1.30–2.19, P = 0.0001) and maximum (OR = 1.55, 95% CI: 1.23–1.95, P = 0.0002) cIMT were significantly associated with new-onset hypertension after adjustment for various confounders. The group with thickened cIMT showed a higher risk for the incidence of hypertension, with an OR of 1.82 (95% CI: 1.07–3.10, P = 0.0270), compared to the normal group. Conclusion Thickened cIMT has a strong association with incident hypertension risk in a community-based population without hypertension at baseline in China.

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