e64 Journal of Hypertension Vol 34, e-Supplement 1, September 2016
Conclusions: In the Italian population, a combination of validated short- and
long-term CVD risk scores allows selecting for preventive action initiation/in-
tensification individuals whose risk is currently not fully addressed, and reducing
un-necessary, costly overtreatment.
OS 06-08 THE IMPACT OF VISIT-TO-VISIT VARIABILITY
IN BLOOD PRESSURE ON THE DEVELOPMENT
OF METABOLIC SYNDROME IN THE HEALTHY
POPULATION: A POPULATION-BASED
PROSPECTIVE COHORT STUDY IN KOREA
Hyung Tak Lee1, Jinho Shin Shin2, Jin-Kyu Park2, Young-Hyo Lim2. 1Department
of Cardiology, Gumdan Top General Hospital, Korea, Republic of, 2Department of
Cardiology, Hanyang University College of Medicine, Korea, Republic of
Objective: The aim of this study is to evaluate the effect of visit-to-visit variability
(VVV) of blood pressure (BP) on development of metabolic syndrome (Mets) in general
population without cardiovascular disease, diabetes mellitus, MetS, and BP medication.
Design and method: We used data from the Korean Genome Epidemiology Study
(KoGES) conducted by the Korean Centers for Disease Control and Prevention
(KCDC). All cohorts who were followed first 3 periods without omission, formed
the basis of the study sample, which consisted of 7195 people. Of these samples,
3431 subjects who had cardiovascular disease, diabetes mellitus, or metabolic syn-
drome were excluded, and 312 subjects who were using antihypertensive medication
in first 3 periods were excluded. Our final study sample consisted of 3452 cohorts.
Results: The mean age was 53.5 (8.25) years. The proportion of male was 50.2%.
Average follow-up duration was 5.91 ( 0.17) years. In generalized estimating
equation (GEE), the development of MetS was associated with mean systolic
BP (SBP) (Odds ratio (OR) 1.042, 95% confidence interval (CI) 1.0351.048,
p < 0.001), mean diastolic BP (DBP) (OR 1.059, 95% CI 1.0491.069, p < 0.001),
standard deviation (SD) of SBP (OR 1.036, 95% CI 1.0171.055, p < 0.001), and
SD of DBP (OR 1.053, 95% CI 1.0271.080, p < 0.001) after adjusted for age,
sex, and MetS component. When mean SBP, mean DBP, SD of SBP, and SD of
DBP were entered all together in the analysis model, mean SBP (OR 1.033, 95%
CI 1.0201.045, p < 0.001) and SD of DBP (OR 1.033, 95% CI 1.0031.063,
p = 0.030) were significantly associated with the development of MetS.
Conclusions: In general population without cardiovascular disease, diabetes mel-
litus, MetS, and BP medication, mean SBP and VVV of DBP was associated with
the development of MetS.
Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved.
OS 06-09 THE SYNERGISTIC ASSOCIATION BETWEEN
VITAMIN D AND VITAMIN K WITH INCIDENT
HYPERTENSION
Adriana Van Ballegooijen, Natasja Van Schoor, Ingeborg Brouwer, Marjolein
Visser, Joline Beulens. Department of Health Sciences, VU University, Netherlands
Objective: Vitamin D plays an important role in calcium homeostasis. The role of
vitamin D in bone and cardiovascular health has mainly been studied in isolation
and the synergistic effect of vitamin D and vitamin K is largely unknown. We as-
sessed whether serum 25-hydroxyvitamin D [25(OH)D] levels and dephosphory-
lated, uncarboxylated matrix Gla protein (dp-unMGP) levels an established
marker of vitamin K status are associated with incident hypertension among
older adults in the Netherlands.
Design and method: We used data from the Longitudinal Aging Study Amster-
dam (LASA), a population-based, prospective cohort with baseline measurements
obtained between 2002 and 2003 and 3 follow-up exams. We studied 257 men and
women, aged 55 to 65 years free of prevalent cardiovascular disease, hypertension
and use of anti-hypertensive medication with follow-up data. We measured se-
rum 25(OH)D and dp-ucMGP from previously frozen baseline samples. We used
Cox-regression analyses to estimate hazard ratios and 95% confidence intervals
for 25(OH)D and dp-ucMGP categories with incident hypertension through 2012
(blood pressure 140/90 mmHg or initiation of blood pressure-lowering drugs).
Results: During a median follow-up of 6.1 years, 52% of the cohort (n = 133)
developed hypertension. Mean SD serum concentration of 25(OH)D was
58.9 22.3 nmol/L and median dp-ucMGP was 310 (IQR: 209425) nmol/L.
Compared with the category of 25(OH)D 50nmol/L and dp-ucMGP < 310
nmol/L, the category 25(OH)D < 50 nmol/L and dp-ucMGP 310 was associated
with a greater hazard ratio for incident hypertension: 1.72 (1.06, 2.81) adjusting
for age, sex, body mass index, and type 2 diabetes. This hazard ratio was larger
than for serum 25(OH)D < 50 nmol/L or dp-ucMGP310 nmol/L: HR 1.08 (0.67,
1.72) and 1.43 (0.85, 2.41), respectively.
Conclusions: Serum 25(OH)D and dp-ucMGP are synergistically associated with
a greater risk of developing hypertension. Randomized controlled trials should
investigate whether supplementation of both vitamin D and vitamin K can lower
blood pressure and hypertension risk.