8:30 a.m. Abstract 3151 – "Masked" hypertension hides higher risk of organ damage. "Masked" hypertension – the opposite of white coat hypertension – is blood pressure that's actually lower in the doctor's office than the 24-hour average. A new study finds it's also riskier. Three hundred thirty-three patients taking anti-hypertensive drugs for at least a year were divided into four groups: controlled hypertension (low office, low 24-hour BP); white coat hypertension (high office, low 24-hour BP); masked hypertension (low office, high 24-hour BP), and sustained hypertension (high office, high 24-hour BP). Target-organ damage – left ventricular mass index, carotid wall thickness and urinary albumin – was most increased in those with masked hypertension. Researchers concluded that masked hypertension is a "significant predictor" of target organ damage, independent of other variables. Average day and night BP was higher in those with sustained hypertension, but short-term BP variations were higher in those with masked hypertension. This variability may account for the greater impact of masked hypertension, which poses "an independent risk for target organ damage."
9 a.m. Abstract 3078 – What causes heart patients to delay seeking medical help? People with heart attack symptoms often delay seeking treatment, putting them at risk of a more damaging, and possibly fatal outcome. One key determinant in the timeliness of getting help is whether the patient perceives his or her symptoms as serious. Researchers sought to identify factors that influence symptom appraisal in a study of 193 patients, 49 percent female. Patients were asked to rate the seriousness of their symptoms from 1 (not at all) to 5 (extremely). In a statistical analysis the scientists found that demographic and clinical variables – age, gender, income, education and even pain intensity – "failed to predict symptom appraisal." But emotion-cognitive variables – anxiety, knowledge of heart attack symptoms, recognition of heart attack symptoms and perceived control – accounted for "a significant proportion" of symptom appraisal variance. Thus, the study shows that emotional values have a major impact on how patients appraise the seriousness of their symptoms, and may help point the way to interventions that reduce treatment delays.
9:15 a.m. Abstract 3099 – Tall stature heightens risk of atrial fibrillation in some patients. The size of heart chambers increases proportionally with height. Researchers found a "strong, direct correlation" between height and atrial fibrillation (AF), a rapid rhythm in the heart's upper chambers, among patients with impaired left ventricular function (LVD). In a study of 16,730 patients, stature predicted AF independent of body mass index, age, gender, heart ejection fraction or severity of heart failure. Males and females were divided into separate quartiles of height and grouped according to: no AF history; paroxysmal (intermittent) AF, or permanent AF. Prevalence of AF increased with each height quartile, and those in the tallest quartile (over 5'11" for men, 5'5" for women) were 1.6 times more likely to have AF than those in the shortest (below 5'7" for men, 5'1" for women). Odds ratio for AF in the tallest quartile was 1.51. Results for the two forms of AF were similar. Tall stature is a "potent predictor" of AF in patients with LVD, and may contribute to higher prevalence of AF in men, researchers said.
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