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Introduction: Left ventricular hypertrophy (LVH) is a well-known strong predictor formorbidity and mortality of hypertensive patients. Studies have showed that LVH is greatlyaffected by blood pressure control, and it is best reflected by ambulatory blood pressuremonitoring (ABPM). However, ABPM and echocardiography as standard measurement aredifficult to be performed in rural areas in Indonesia due to the lack of health facilities.Although clinic blood pressure (CBP) and electrocardiography (ECG) are inferior to ABPMand echocardiography, but they can be used as good alternatives.Objectives: We sought to evaluate whether an individual CBP correlates with risk of LVH.Methods: Cross-sectional study was conducted in three primary hospitals in rural areas inIndonesia, from April to September 2013. Hypertensive patients admitted to emergencyroom or outpatient clinic were classified into controlled CBP and uncontrolled CBP.Diagnosis of LVH was based on ECG using combination of five voltage-based and pointscore criteria (Sokolow-Lyon, Cornell voltage, Lewis index, Minnesota code, and Romhilt-Estes point-score) to increase sensitivity. Bivariate analysis were performed to evaluatesignificance between CBP and electrocardiographic LVH, continued with multivariateanalysis to investigate CBP’s significance after adjusted with other relevant factors.Results: Of 145 hypertensive patients included (46.2% male; mean age 56 years), only 35patients (24.1%) had controlled CBP. Prevalence of electrocardiographic LVH was 40%.LVH was significantly higher in patients with uncontrolled CBP (48.2% vs 14.3% p¼0.001) than controlled CBP (Odds Ratio 5.5; 95%CI 2.016-15.440). Multivariate analysisshowed that CBP remained significant as predictor for electrocardiographic LVH (OR 3.9,95% CI 1.228-12.163) after adjusted to duration of known hypertension, smoking, dia-betes, dyslipidemia, and body-mass index.Conclusion: Individual CBP correlates with risk of LVH. Controlled CBP predicts lowerrisk of electrocardiographic LVH. This study showed that CBP can be used as an alternativewhen ABPM is difficult to be performed in rural areas.Disclosure of Interest: None Declared

PT243

Finding enablers and knowing barriers - facilitating primary health care nurses toimplement an absolute CVD risk approach in general practice

Tracey M. Bucki*1, Harry Patsamanis1, Bianca Crosling1, Jinty Wilson11National Heart Foundation of Australia, Melbourne, Australia

Introduction: Absolute cardiovascular disease (CVD) risk is the numerical probability of acardiovascular event occurring within a five-year period. Recognising primary health carenurses (PHCNs) integral role in the general practice team, the Heart Foundation Victoria inpartnership with the Australian Primary Health Care Nurses Association developed an onlinelearning module (OLM). The module is based on the National Vascular Disease PreventionAlliance’sGuidelines for the management of absolute CVD risk and is a mechanism to translate anew evidence based guideline into practice. The OLM is designed to improve PHCN con-fidence to systematically assess and manage patients at risk of CVD in general practice.Objectives: To evaluate outcomes of the OLM through a one year post evaluation amongPHCNs who have completed the module. In particular, to determine the enablers andbarriers to implementing an absolute CVD risk approach in general practice.Methods: Almost 700 PHCNs who had completed the module were approached by emailto participate in an online feedback survey. Participants were asked if they had imple-mented any improvements relating to the practice team, data systems or patient manage-ment since completing the module. Participants were also asked to report any challengesthey had experienced.Results: In total, 151 completed surveys were received (22% response rate).The most common improvements implemented by participants since completing the

OLM included:

- explaining absolute CVD risk to another staff member- downloading the web based risk calculator onto the practice desktop- routinely recording and updating risk factors- using electronic recall and reminder system to target eligible patients- providing lifestyle counselling/action plans to patients.

The most common barriers reported in relation to implementing absolute risk included‘lack of time’ and ‘getting the practice team on board’.Case studies detailing PHCNs experiences in implementing an absolute CVD risk

approach within their practice will also be presented.Conclusion: The evaluation has demonstrated that the OLM is a mechanism to translate anew evidence based guideline into practice. Insight into enablers and barriers in imple-menting absolute CVD risk has empowered the Heart Foundation to refine their multi-faceted strategy in engaging and influencing Australian general practice to adopt anabsolute CVD risk approach.Disclosure of Interest: None Declared

PT244

Assessment of musculoskeletal pain in participants of cardiac rehabilitation

Daiane P. Lima1, Daiana C. Bündchen1, Sabrina W. Sties1, Priscilla G. Wittkopf1,Ana I. Gonzáles1, Almir Schmitt Neto1, Pablo A. B. de Araujo1, Vitor G. Angarten1,Tales de Carvalho*11Cardiology and Exercise Medicine Center, Santa Catarina State University, Florianópolis, Brazil

Introduction: In patients with cardiovascular disease, musculoskeletal disorders may limittreatment and adherence to cardiac rehabilitation (CR), mainly due to the pain.Objectives: To verify the prevalence of musculoskeletal pain at rest and if it is influencedby physical activity.

GHEART Vol 9/1S/2014 j March, 2014 j POSTER/2014 WCC Posters

Methods: We prospectively studied 37 patients with cardiovascular diseases, 60.73 � 10.2years old, both gender, at entry in CR and after three months they underwent evaluation ofpain at rest and if it is worsened by physical activity, through an adaptation of themusculoskeletal system assessment inventory (MSSAI). The data were analyzed usingdescriptive statistics, and the Wilcoxon test was used to assess differences between pairedscores, with significance level of 5%.Results: Knee pain (24.1%) and low back pain (19.3%) were the problems most reported.At baseline, 57% of participants reported the presence of pain at rest, that after threemonths dropped to 52% (p¼0.223). The presence of pain aggravated by exercise wasreduced from 27% to 16% (p ¼ 0.038). There were no significant changes in the intensityof pain at rest and that worsened by physical activity.Conclusion: There was a decrease in the prevalence of musculoskeletal pain aggravated byphysical activity and no changes were verify in pain at rest, suggesting possible involvementof patients with musculoskeletal pain in cardiac rehabilitation.Disclosure of Interest: None Declared

PT245

The Impacts of Cardiac Rehabilitation Program on Functional Status and Quality ofLife of Coronary Artery Disease Patients With Left Ventricular Dysfunction

Masoumeh Sadeghi1, Mahboobeh Taghavi2, Mohammad Garakyaraghi2, Hamidreza Roohafza2,Nizal Sarrafzadegan*21Cardiac Rehabilitation Research Center, 2Isfahan Cardiovascular Research Center, IsfahanCardiovascular Research Institute, Isfahan University of MedicalScieces, Isfahan, Iran, IslamicRepublic Of

Introduction: Cardiac rehabilitation is defined as the “coordinated sum of interventionsrequired to ensure the best physical, psychological and social conditions so that patientswith chronic or post-acute cardiovascular disease may, by their own efforts, preserve orresume optimal functioning in society and, through improved health behaviors, slow orreverse progression of disease.Objectives: We determined the impacts of cardiac rehabilitation on functional status andquality of life in CAD patients.Methods: Coronary artery disease patients with mild to moderate left ventriculardysfunction participated in an exercise-based rehabilitation program for eight consecutiveweeks. Subjects underwent exercise test before and eight weeks after rehabilitation. Qualityof life was assessed with Short-Form Health Survey questionnaire.Results: Seventy patients (mean age ¼ 57.5 � 10.2 years, 77.1% male) were studied. Afterrehabilitation, peak exercise capacity measured in metabolic equivalents increased from8.00�2.56 to 10.08�3.00 (P < 0.001) and exercise duration increased from 14.17�5.27to 17.21�5.85 min (P < 0.001). Also, the patients’ quality of life improved in severalphysical and psychological dimensions (p < 0.05).Conclusion: Cardiac rehabilitation results in a significant improvement in health relatedquality of life, functional status, and exercise capacity of CAD patients with mild tomoderate left ventricular dysfunction.Disclosure of Interest: None Declared

PT246

Effect of Recommended Physical Activity Dose on Maternal Metabolic Outcomes inPregnant Latina Women

Robinson Ramírez-Vélez*1, Grupo de investigación en ciencias aplicadas al ejercicio físico, eldeporte y la salud (GICAEDS), Facultad de Cultura Física, Deporte y Recreación, UniversidadSanto Tomás, Bogotá, D.C., Colombia1Facultad de Cultura Física, Deporte y Recreacion, Universidad Santo Tomas, Bogota, Colombia

Introduction: Despite recommendations for pregnant women to be active, themajority of LatinAmerican women are not meeting guidelines. Physical activity may reduce risk of maternaldisorders of pregnancy, but few data exists on physical activity in pregnant Latina women.Objectives: To evaluate the influence of recommended physical activity dose on maternalmetabolic outcomes in in pregnant latina women.Methods: This is a secondary analysis of data from a controlled randomized trial designedto determine the influence of physical exercise on endothelial function in pregnant women.The study included Sixty-seven nulliparous in gestational week 16–20, attending forprenatal care at three tertiary hospitals in Colombia who were randomly assigned into oneof two groups: 1) The experimental group took part in aerobic exercise at an intensity of55–75% of their maximum heart rate for 60 min, three times a week for 12 weeks, 2) Thecontrol group undertook their usual physical activity. The primary outcomes were changesin immediately after the 12 weeks intervention on blood lipids, insulin sensitivity(HOMA-IR)and body composition.Results: At the end of the 12-week program, there was no difference in the change in bio-markers total cholesterol -6mg/dL (95%CI -21 to 33), low-density lipoprotein -8mg/dL (95%CI -3 to 29), glucose 0.3 mg/dL (95%CI -6 to 6), fasting insulin -2 mU/L (95%CI -2 to 4) orHOMA-IR -0.9 (-0.1 to 1.9). Triglycerides and very-low density lipoprotein were significantlylower in the experimental group by -28 mg/mL (95%CI 1 to 55) and -6 mg/dL (95%CI 1 to11), respectively. There were no significant differences between the groups regardingmaternal weight gain or fatness during pregnancy. The experimental group showed lowervalues fat-free mass, body fat and skinfold thicknesses (biceps, triceps, subscapular, andsuprailiac regions) than did the control group, but these differentials were non-significant.Conclusion: The potential public health benefits of exercise are too great and this studysupports existing guidelines indicating that latina women may begin or maintain an ex-ercise program during pregnancy.Disclosure of Interest: None Declared

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