CardioVascular Journal of Afr ica (off icial journal for PASCAR) www.cvja.co.za BIENNIAL CONGRESS SOUTHERN AFRICAN HYPERTENSION SOCIETY Hypertension Beyond Blood Pressure Management 16 – 18 SEPTEMBER 2022 33
Disclaimer The Abstracts for the Southern African Hypertension Society was reviewed by the SAHS Scientific Committee and not by the Editor-in-Chief, Regional Editors or reviewers of the Cardiovascular Journal of Africa. Only accepted abstracts are published.
CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 3 AFRICA Dear SAHS Members, Colleagues, and Industry Partners, Welcome to the SAHS Biennial Congress 2022. The scientific programme will provide opportunities for interdisciplinary learning, interaction, and networking with delegates, International Faculty and local Key Opinion Leaders involved in Hypertension Management. Sessions will include multiple lectures and debates on Hypertension Beyond Blood Pressure Management of current clinical interest as well as research oral- and poster presentations. On behalf of the Southern African Hypertension Society congress management committee, thank you and welcome to our international and local faculty, delegates, and industry sponsors. We are looking forward to hosting you at the SAHS biennial Congress, the next 2.5 days. Prof Nash Ranjith SAHS President WELCOME CONTENTS WELCOME 3 INTERNATIONAL FACULTY 4 LOCAL FACULTY 5 SPONSORS 6 SCIENTIFIC PROGRAMME 7-9 FLOOR PLAN 10 GENERAL INFO 11 LIST OF ABSTRACT 14 ORAL PRESENTATION ABSTRACTS 16-41 POSTER PRESENTATION ABSTRACTS 42-66
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 4 INTERNATIONAL FACULTY Professor Claudio Borghi Department of Medical and Surgical Sciences Head of division of Cardiovascular Medicine and Hypertension University of Bologna Via Massarenti, 9Bologna, Italy Biography Professor Claudio Borghi is Full Professor of Medicine and Head of the Department of Medicine and the ESH Excellence Center for Hypertension and Atherosclerosis at the University of Bologna. He is director of the post-graduate school on Emergency Medicine and chairman of the PhD program of Health and Technology of the University of Bologna His research activities have been mainly focused on clinical epidemiology and on the therapeutic approach to cardiovascular risk, with special interests in hypertension, dyslipidemia and related risk factors, including serum uric acid. Professor Borghi is Past President of the Italian Society of Hypertension. He is currently President of the Italian Foundation for Hypertension. He is chairman of the Research, Science and Educational Committee of the International Society of Hypertension and ex-officio member of the Council of the ESH. He is member of the Nucleus of the ESC Working Group on Pharmacotherapy and Pharmacology. Dr.Borghi has received the Talhal Zen Award from the European Society of Hypertension for his research on risk factors and cardiovascular disease and the 2022 WHL Peter Sleight Excellence Award in Hypertension Clinical Research from World Hypertension League. Professor Alta Schutte Professorial Fellow, The George Institute, Australia Principal Theme Lead: Cardiac, Vascular and Metabolic Medicine, UNSW Sydney Biography Alta (Aletta E.) Schutte is a UNSW SHARP Professor and Principal Theme Lead of Cardiac, Vascular and Metabolic Medicine in the Faculty of Medicine and Health at the University of New South Wales, Sydney, Australia; with a joint appointment as Professorial Fellow at the George Institute for Global Health. She has been the Principal Investigator of several multidisciplinary studies and has published over 300 papers on the topic of hypertension, and supervised over 85 postgraduate students. She is involved in numerous international consortia, and was one of 20 authors to join the Lancet Commission of Hypertension. She has received multiple awards including the Distinguished Woman Scientist in the Natural, Engineering and Life Sciences award, the NSTF South 32 TW Kambule Award; the British Association Medal; the Meiring Naude Medal; the AU-TWAS (African Union & The World Academy of Sciences) Award, and the 2019 African Union Kwame Nkrumah Regional Award for Scientific Excellence. She serves as Editor of the European Journal of Preventive Cardiology and on the Editorial Board of cardiovascular journals, such as Hypertension, the Journal of Hypertension, Journal of Clinical Hypertension, Journal of Human Hypertension, Current Hypertension Reports and BMC Medicine. She is a Fellow of the European Society of Cardiology and the Royal Society of South Africa; the Past President of the Southern African Hypertension Society (SAHS); and Immediate Past President of the International Society of Hypertension (ISH). Professor Neil Poulter Faculty of Medicine, School of Public Health Professor of Preventive Cardiovascular Medicine. Biography Professor Neil Poulter qualified at St Mary’s Hospital, London, in 1974, following which he trained in General Medicine. He then spent 5 years in Kenya co-ordinating a collaborative hypertension research programme at the Wellcome Trust Research Laboratories in Nairobi. He gained an MSc in Epidemiology with distinction at the London School of Hygiene and Tropical Medicine. He was Co-PI of the WHO Oral Contraceptive case-control Study at University College London Medical School. He is co-Director of the International Centre for Circulatory Health and Director of the Imperial Clinical Trials Unit. He is an Honorary Consultant Physician and Epidemiologist at the Peart-Rose (CVD Prevention) Clinic based at Hammersmith Hospital, London, where he is actively involved in the treatment of patients with hypertension and related problems. He was President of the British Hypertension Society from 2003-2005 and is the immediate Past-President of the International Society of Hypertension. In 2008, he was elected as one of the Inaugural Senior Investigators of the NIHR and also elected as a fellow of the Academy of Medical Sciences in 2009. He has contributed chapters to several major textbooks and published over 500 papers in peer-reviewed medical journals, including co-authoring several sets of national and international guidelines. Professor Poulter was identified as being among the top 1% most cited academics in clinical medicine in 2014 (Thomson Reuters Highly Cited Researcher report) and among the top 0.1% most cited researcher between 2008-2018 (Web of Science Group Highly Cited Researcher 2019 report). He has played a senior management role in several international trials including the ASCOT, ADVANCE, EXSCEL, DEVOTE, LEADER and CREOLE trials; other research activities include the optimal investigation and management of essential hypertension and dyslipidaemia; the association between birth weight and various cardiovascular risk factors; the cardiovascular effects of exogenous oestrogen and progesterone; the prevention and aetiology of type 2 diabetes and abdominal aortic aneurism; and ethnic differences in cardiovascular disease. He is the Chief Investigator of the May Measurement Month, an annual global blood pressure screening campaign initiated by the International Society of Hypertension. SOUTHERN AFRICAN HYPERTENSION SOCIETY
CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 5 AFRICA LOCAL FACULTY Dr Rajendra Bhimma Dr Tony Dalby Dr Riaz Dawood Dr Meagan Dudley Prof Lebo Gafane-Matemane Prof Erika Jones Prof Ruan Kruger Dr Karishma Lowton Prof Carina Mels Prof Girish Modi Dr Rajen Moodley Dr Martin Mpe Ms Nonhlanhla Mthembu Ms Nonkululeko Navise Prof Gavin Norton Dr Vernice Peterson Prof Nash Ranjith Prof Brian Rayner Prof Nqoba Tzabedze Dr Bridget Vermeulen Dr Lisa Ware Prof Angela Woodiwiss SOUTHERN AFRICAN HYPERTENSION SOCIETY
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 6 SAHS Congress 2022 Key Partners PLATINUM GOLD SILVER BRONZE
CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 7 AFRICA Time Topic Speakers | Chair Venue 08:00 - 09:20 Arrival & Registration 09:20 - 11:00 Plenary Session 1: Guidelines and Controversial Issues Chairs: Prof Nash Ranjith | Dr Martin Mpe Pandora 09:20 - 09:30 Opening & Welcome Prof Nash Ranjith 09:30 - 10:00 Recent diabetic trials on SGLT2 inhibitor effects related to cardiovascular risk and heart failure and renal protection Prof Nash Ranjith 10:00 - 10:30 How to measure blood pressure in the light of new technologies [OMRON] Prof Alta Schutte 10:30 - 11:00 Non-adherence as a cardiovascular risk factor and how to detect and improve adherence [SANDOZ] Prof Brian Rayner 11:00 - 11:30 TEA & COFFEE BREAK Aurora-Exhibition Hall | Conference Foyer 11:00 - 11:30 Poster Presentations SAHS Adjudicators: Prof Ruan Kruger | Dr Vernice Peterson | Prof Lebo Gafane - Matemane | Sr Adele Burger Comet 11:00 - 11:05 A comparison of retinal vessel functional responses between people living with HIV and HIV-free South Africans: Findings from the EndoAfrica-NWU study Dr Catharina Elizabeth Myburgh-Jacobsz 11:05 - 11:10 Selenium and cardiovascular protection in young adults: The African-PREDICT study Dr Yolandi Breet 11:10 - 11:15 Posterior inferior cerebellar artery impingement on the medulla oblongata: a case report Poobalan Naidoo 11:15 - 11:20 Kidney dysfunction: prevalence and associated risk factors in a community-based study from the North West Province of South Africa Nonkululeko Navise 11:20 - 11:25 Emotional and social contributors to higher blood pressure in children with a low quality of life: The ExAMIN Youth SA study Chanelle Volschenk 11:25 - 11:30 Association between central blood pressure and arterial stiffness and low cognitive scores in South African adults Dr Feziwe Mpondo 11:30 - 13:00 Plenary Session 2: Innovative Approaches to improve Treatment and Control Chairs: Prof Claudio Borghi | Prof Erika Jones Pandora 11:30 - 12:00 What’s new in the hypertension guidelines [PHARMA DYNAMICS] Prof Neil Poulter 12:00 - 12:15 May Measurement Month South Africa Prof Angela Woodiwiss 12:15 - 12:35 Population based approaches to reduce BP [OMRON] Prof Alta Schutte 12:35 - 13:00 Managing Hypertension: Importance of lifestyle changes in conjunction with medication [PHARMA DYNAMICS] Prof Neil Poulter 13:00 - 14:00 LUNCH AND MEET THE EXPERTS Prof Claudio Borghi |Prof Alta Schutte Aurora-Exhibition Hall | Conference Foyer 14:00 - 15:30 Plenary Session 3: Hypertension and co-morbidities Chairs: Dr Rajen Moodley | Dr Meagan Dudley Pandora 14:00 - 14:20 Facing the challenge of lowering blood pressure and cholesterol in the same patient [SERVIER] Prof Claudio Borghi 14:20 - 14:40 Patient with hypertension and heart failure [BAYER] Prof Nqoba Tsabedze 14:40 - 15:00 Chronic kidney disease: Hypertension management and treatment targets Prof Erika Jones 15:00 - 15:30 Gaps between evidence and guideline recommendations for hypertension diagnosis and targets [SERVIER] Prof Claudio Borghi 15:30 - 16:00 TEA & COFFEE BREAK Aurora-Exhibition Hall | Conference Foyer 15:30 - 16:00 Poster Presentations SAHS Adjudicators: Prof Ruan Kruger | Dr Vernice Peterson | Dr Meagan Dudley | Sr Adele Burger Comet 15:30 - 15:35 Deprescribing to Improve Polypharmacy Miss Precious Ncayiyana 15:35 - 15:40 The Value of Admission HbA1c in patients with Acute Myocardial Infarction Dr Dhayanee Sigamoney-Mudaly 15:40 - 15:45 Determinants of functional capacity in patients with chronic heart failure: Role of filling pressure and systolic and diastolic function El Mousaid Meriem 15:45 - 15:50 Hemoglobinopathies and dilated cardiomyopathy at the CHU Ibn RochdCasablanca El Mousaid Meriem 16:00 - 17:00 Plenary Session 4: Hypertension and Infectious Diseases Chairs: Prof Brian Rayner | Dr Lebo Gafane-Matemane Pandora 16:00 - 16:20 HIV and cardiovascular risk in South Africans Prof Carina Mels 16:20 - 16:40 Drug treatment of hypertension and adverse effects in the hypertensive HIV patient Dr Martin Mpe 16:40 - 17:00 Hypertension and COVID Prof Nqoba Tzabedze 17:00 - 18:00 Plenary Session 5: Gender and Special Populations Chairs: Prof Neil Poulter | Prof Ruan Kruger Pandora 17:00 - 17:20 Gender related issues in hypertension Dr Vernice Peterson 17:20 - 17:40 Hypertension in pregnancy - How to implement the guidelines Prof Erika Jones 17:40 - 18:00 Hypertension- oncology A new clinical problem Dr Rajen Moodley 19:00 FACULTY DINNER The Capital on Park Restaurant Scientific Programme Southern African Hypertension Society Biennial Congress - Hypertension Beyond Blood Pressure Management 16 - 18 September 2022, Sandton (Gauteng) 14 Clinical & 2 Ethics CEU’s International Faculty: Prof Neil Poulter (UK), Prof Claudio Borghi (Italy), Prof Alta Schutte (Australia) & Local Key Opinion Leaders Friday, 16 September 2022
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 8 Scientific Programme Southern African Hypertension Society Biennial Congress - Hypertension Beyond Blood Pressure Management 16 - 18 September 2022, Sandton (Gauteng) 14 Clinical & 2 Ethics CEU’s International Faculty: Prof Neil Poulter (UK), Prof Claudio Borghi (Italy), Prof Alta Schutte (Australia) & Local Key Opinion Leaders Time Topic Speakers | Chair Venue 07:30 - 08:30 Breakfast 08:30 - 10:15 Plenary Session 6: Hands-on Hypertension Chairs: Prof Ranjith | Prof Brian Rayner Pandora 08:30 - 09:05 Debate: Heart rate an independent risk factor in heart disease [MERCK] Prof Claudio Borghi | Dr Martin Mpe 09:05 - 10:15 Oral Presentations: (Basic, Clinical and Population) SAHS Adjudicators: Prof Ruan Kruger | Prof Angela Woodiwiss | Prof Carina Mels | Prof Brian Rayner 09:05 - 09:12 Cardiovascular risk and kidney function profiling using conventional and novel biomarkers in young adults: The African-PREDICT study Anja Degenaar 09:12 - 09:19 Perfusion and pulsatile pressure and the relationship with target organ damage: The African-PREDICT study Donavan Rooi 09:19 - 09:26 Carotid arterial stiffness associates with endothelial activation in young adults: The African-PREDICT study Prof Shani Le Roux 09:26 - 09:33 Risk factor profile of female patients presenting with acute myocardial infarction:a South African perspective Prof Naresh Ranjith 09:33 - 09:40 Comparison of cardiovascular health profiles across population surveys from five high- to low-income countries Dr Bridget Vermeulen 09:40 - 09:47 Independent Relationship Between Volume Overload and Aortic Stiffness in a Community with Prevalent Volume-Dependent Primary Hypertension Grace Tade 09:47 - 09:54 Relative Impact of Volume-Dependent Variations in Aortic Reservoir Function Versus Pressure Wave Effects on Pulse Pressure and Cardiac Mass at a Community Level Gavin R Norton 09:54 - 10:01 Impact of Thiazide-Like Diuretic Based Therapy on Increases in Systemic Blood Flow in Volume-Dependent Hypertension in Africa Vernice R Peterson 10:01 - 10:08 Proximal Aortic Stiffness Modifies the Relationship between Heart Rate and Backward Wave and hence Central Arterial Pulse Pressure Nonhlanhla Mthembu 10:08 - 10:15 Marked Increases in Proximal Aortic Characteristic Impedance and hence Forward Wave Pressures Beyond Brachial Blood Pressure in Patients with Angiographic Proven Coronary Artery Disease Danelle Els 08:30 - 10:15 Nurses | Doctors Parallel Session 1 Chair: Prof Erika Jones Pandora 1 08:30 - 09:00 How to diagnose hypertension - Current criteria, tips and tricks Dr Rajen Moodley 09:00 - 09:25 Lifestyle Interventions & Patient councelling [OMRON] Prof Ruan Kruger 09:25 - 09:45 The nutrition source - salt and sodium Dr Lisa Ware 09:45 - 10:15 Devices validation and calibration [OMRON] Prof Alta Schutte 10:15 - 10:45 TEA & COFFEE BREAK Aurora-Exhibition Hall | Conference Foyer 10:15 - 10:45 Poster Presentations SAHS Adjudicators: Dr Vernice Peterson | Prof Erika Jones | Prof Lebo Gafane - Matemane | Dr Meagan Dudley Comet 10:15 - 10:20 Results for the May Measurement Month global campaign from a university campus Ane’ Orchard 10:20 - 10:25 L-homoarginine, cardiovascular function and mortality risk in Black South Africans Maserame Cleopatra Mokhaneli 10:25 - 10:30 Influence of different grades of CKD and HD on cardiac function using myocardial strain: Longitudinal Global Strain El Mousaid Meriem 10:30 - 10:35 Obesity paradox in patients with stable angina El Mousaid Meriem 10:45 - 12:00 Plenary Session 7 Chairs: Dr Martin Mpe | Prof Angela Woodiwiss Pandora 10:45 - 11:10 How to stratify CV risk |Resistant HPT [SERVIER] Prof Claudio Borghi 11:10 - 11:35 Mechanisms of how intense BP lowering is beneficial in high risk populations Prof Gavin Norton 11:35 - 12:00 Systolic vs Diastolic BP as predictors of CV risk [PHARMA DYNAMICS] Prof Neil Poulter 10:45 - 12:00 Nurses | Doctors Parallel Session 2 Chair: Prof Carina Mels Pandora 1 10:45 - 11:00 Side effects of commonly used anti-hypertensive drugs. What to look for? Dr Meagan Dudley 11:00 - 11:15 The importance of BP control (basic) & HPT definitions - When to refer? [OMRON] Prof Alta Schutte 11:15 - 12:00 Ethics: Mental health for the cardiovascular patient and medical personnel Dr Karishma Lowton 12:00 - 13:00 LUNCH Aurora-Exhibition Hall | Conference Foyer 13:00 - 14:30 Plenary Session 8: Device Therapy for Hypertension Chairs: Prof Brian Rayner | Prof Nqoba Tsabedze Pandora 13:00 - 13:30 Renal denervation - Review of the latest data [MEDTRONIC] Dr Riaz Dawood 13:30 - 14:00 Device therapy for acute stroke management Prof Girish Modi 14:00 - 14:30 Hypertension and acute coronory syndrome focus on cardiac intervention Dr Tony Dalby 14:30 - 15:00 TEA & COFFEE BREAK Aurora-Exhibition Hall | Conference Foyer Saturday, 17 September 2022
CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 9 AFRICA 14:30 - 15:00 Poster Presentations SAHS Adjudicators: Prof Erika Jones | Prof Carina Mels | Prof Gavin Norton | Sr Adele Burger Comet 14:30 - 14:35 Eradication of Helicobacter spp. in spontaneously hypertensive rats reduces blood pressure to that of ancestral Wistar Kyoto rats Sarhana Dinat 14:35 - 14:40 Understanding the inter-relationships between socio-economic, sociodemographic, behavioural, and environmental factors for multimorbidity: a structural equation modelling approach Glory Chidumwa 14:40 - 14:45 Assessment of left ventricular systolic and diastolic function in patients with asymptomatic Type 2 diabetes Mahoungou Mackonia Noel Maschell 14:45 - 14:50 Intracardiac stenosing mass of the mitral valve: a case report. Mahoungou Mackonia Noel Maschell 14:50 - 14:55 Longitudinal global strain as a prognostic element in moderately reduced ejection fraction heart failure Mahoungou Mackonia Noel Maschell 14:55 - 15:00 Cognitive disorders: Atherosclerosis of the carotid artery in elderly non-stroke patients Mahoungou Mackonia Noel Maschell 15:00 - 16:50 Plenary Session 9: Hypertension in Special Populations Chairs: Prof Gavin Norton | Dr Vernice Peterson Pandora 15:00 - 15:20 Early vascular aging in the young Prof Ruan Kruger 15:20 - 15:45 Practical approach to a young hypertensive Prof Neil Poulter 15:45 - 16:10 Pathogenesis of hypertension in Africa Prof Angela Woodiwiss 16:10 - 17:20 Oral Presentations: (Basic, Clinical and Population) SAHS Adjudicators: Prof Erika Jones | Prof Ruan Kruger| Dr Vernice Peterson | Prof Brian Rayner Pandora 16:10 - 16:17 Independent Relationship between Circulating Atrial Natriuretic Peptide Concentrations and Endothelial Function in a Population with Age-Related Systemic Volume Overload. Nico Malan 16:17 - 16:24 Associations between kidney function and the soluble (pro)renin receptor in young adults: The African-PREDICT study Lebo F Gafane-Matemane 16:24 - 16:31 Contribution of Increases in Late Systolic Ejection Volume to the Impact of Heart Rate on Central Arterial Pulse Pressure in a Community Sample Angela J Woodiwiss 16:31 - 16:38 Hypertension perspectives and health behaviours among African youth: the impact of health education and employment. Mimi Mhlaba 16:38 - 16:45 Attenuated Relationships Between Indexes of Volume Overload and Atrial Natriuretic Peptide in Uncontrolled, Sustained Volume-Dependent Primary Hypertension. Suraj M. Yusuf 16:45 - 16:52 Influence of Diabetes Mellitus on Early and Late Outcome After Percutaneous Transluminal Coronary Angioplasty El Mousaid Meriem 16:52 - 16:59 Causes of Hypertension at a Children’s Hospital in Cape Town, South Africa Bonisiwe Chauke-Mkamba 17:20 - 17:50 SAHS AGM 2022 SAHS members Pandora 19:00 CONGRESS DINNER Prof Ranjith Welcome & Open Awards: Dr Mpe | Prof Brian Rayner - Vote of thanks Pandora 1 Time Topic Speakers | Chair Venue 07:00 - 08:40 Breakfast The Capital on Park Restaurant 08:45 - 10:00 Plenary Sesssion 10 Chairs: Angela Woodiwiss | Prof Ruan Kruger Pandora 08:45 - 09:05 A practical approach to syncope Prof Girish Modi 09:05 - 09:25 The heart and hypertension Prof Gavin Norton 09:25 - 09:30 Introduction to the SAHS NextGen Prof Ruan Kruger 09:30 - 09:40 Left ventricular remodelling and growth differentiating factor-15 in overweight and obesity: The African-PREDICT study. Dr Bridget Vermeulen 09:40 - 09:50 The association of von Willebrand factor and its cleaving protease (ADAMTS13) with health behaviours in young black and white adults: The African-PREDICT study Ms Nonkululeko Navise 09:50 - 10:00 Mechanisms of Heart Rate Effects on Central Arterial Pressure: Overinflation of the Role of Flow in an African Community Ms Nonhlanhla Mthembu 10:00 - 10:30 TEA AND COFFEE BREAK Aurora-Exhibition Hall / Conference Foyer 10:30 - 12:05 Plenary Session 11: Hypertension and Relevant Clinical Problems Chairs: Prof Nash Ranjith | Prof Alta Schutte Pandora 10:30 - 10:50 Should white coat hypertension be left untreated? Prof Brian Rayner 10:50 - 11:10 Hypertension in the very elderly [epidemiological aspects and treatment] Prof Nqoba Tsabedze 11:10 - 11:55 Ethics: Informed consent in clinical studies Dr Rajendra Bhimma 11:55 - 12:05 CLOSING ADDRESS AND DEPART Prof Nash Ranjith Pandora Sunday, 18 September 2022 Saturday, 17 September 2022 Time Topic Speakers | Chair Venue
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 10 SAHS Biennial Congress 2022 EXHIBITION HALL LAYOUT Exhib Platin 1 O 2 S 3 P Gold: 4 S 5 M Silver 7 C 8 N 9 11 12 10 A Bronz 6 M 11 B 12 A T Basement Parking Available P R Reception Restaurant Comet Pandora Pandora 1 3 10 8 7 6 SAHS Biennial Congress 2022: Exhibition Hall Layout 1 1 1 Aurora Exhibiton Area Enterance Corridor /Foyer 4 Conference Venue 5 2 Exhibition Room: Aurora Platinum: 1 Omron 2 Servier 3 PharmaDynamics Gold: 4 Sandoz 5 Merck Silver 7 Cipla 8 Novartis 9 Bayer 10 Aspen Bronze: eption Comet 3 Exhibition Room: Aurora Platinum: 1 Omron 2 Servier 3 PharmaDynamics Gold: 4 Sandoz 5 Merck Silver 7 Cipla 8 Novartis 9 Bayer 11 12 10 Aspen Bronze: 6 Medtronic 11 Boehringer-Ingelheim 12 Astra Zeneca Tea/Coffee & Lunch Stations Pillars Meet Expert Reception Restaurant Comet Pandora Pandora 1 Plenary Parallel Reception Comet Pandora 3 10 6 al Congress 2022: Exhibition Hall Layout 1 1 1 urora Exhibiton Area Enterance Corridor /Foyer Conference Venue 5 Exhibition Room: Aurora Platinum: 1 Omron 2 Servier 3 PharmaDynamics Gold: 4 Sandoz 5 Merck Silver 7 Cipla 8 Novartis 9 Bayer 10 Aspen Bronze: 6 Medtronic 11 Boehringer-Ingelheim 12 Astra Zeneca Tea/Coffee & Lunch Stations Pillars Meet Expert Reception Reception Comet andora 3 10 6 on Hall Layout ance 5 SOUTHERN AFRICAN HYPERTENSION SOCIETY
CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 11 AFRICA GENERAL INFORMATION Situated in the exhibition foyer of The Capital on the Park and is open from 08h00 daily. REGISTRATION Delegates are required to display their Congress badge at all times during the meeting. Only participants wearing a Congress badge will be admitted. No exceptions to this rule will be made due to security reasons. Your co-operation is appreciated. NAME BADGES Name Badges of Delegates attending the congress dinner have a unique identifier. Delegates are required to display their Congress badge when attending the Congress Dinner. CONGRESS DINNER We will require all Delegates, Faculty & Trade that wish to receive CPD points to complete the electronic Confirmation of Attendance Affidavit. A Scan with Smartphone Camera option is available at the Congress and an email will be sent to all delegates at the end of the Congress. CPD ACCREDITATION Congress Sessions - Smart Casual. DRESS CODE The Exhibition will take place in the Aurora Venue. Companies will exhibit their products and will be available to answer questions. We encourage delegates to meet and interact with the companies daily. EXHIBITION We encourage delegates to meet and interact with our international speakers during lunch, please join them. An area is set-up in Venue Foyer. MEET THE EXPERTS Refreshments and lunches will be served in the Aurora Venue and Foyer throughout the Congress. TEA & LUNCHES Each session room has limited capacity, and we are unable to reserve seats, therefore, once the room is full, for security reasons we will be unable to permit further access. VENUE CAPACITY DISCLAIMER The Organising Committee and the Congress Organiser accept no liability for any damages, injuries, and/or losses of whatever nature incurred by the participants and/or accompanying persons. For assistance or emergencies, contact the Congress Organising Team or visit the reception for assistance. Precious Kgomo: +27 074 693 3553 Congress Venue Address The Capital on the Park Sandton, 101 Katherine St, Sandton I Tel: 010 443 0000
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AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 14 ORAL PRESENTATION Entry Id Page no Name: 1344 16 Anja Degenaar 1345 18 Donavan Rooi 1346 19 Prof Shani Le Roux 1361 20 Prof Naresh Ranjith 1362 21 Angela J Woodiwiss 1363 23 Gavin R Norton 1364 25 Suraj M. Yusuf 1365 27 Vernice R Peterson 1368 29 Nonhlanhla Mthembu 1369 30 Bonisiwe Chauke-Mkamba 1371 31 Danelle Els 1372 33 Mimi Mhlaba 1374 34 Nico Malan 1375 36 Grace Tade 1386 38 Lebo F Gafane-Matemane 1391 39 EL Mousaid Meriem 1397 40 Dr Bridget Vermeulen POSTER PRESENTATION Entry Id Page no Name: 1356 42 Mahoungou Mackonia Noel Maschell 1340 43 Miss Precious Ncayiyana 1341 44 Nonkululeko Navise 1342 45 Dr Dhayanee Sigamoney-Mudaly 1343 46 Dr Catharina Elizabeth Myburgh-Jacobsz 1348 48 Dr Yolandi Breet 1349 50 Dr Feziwe Mpondo 1353 52 EL Mousaid Meriem 1357 53 Mahoungou Mackonia Noel Maschell 1359 54 Mahoungou Mackonia Noel Maschell 1366 55 EL Mousaid Meriem 1367 56 EL Mousaid Meriem 1370 57 Poobalan Naidoo 1377 58 Chanelle Volschenk 1380 59 Mahoungou Mackonia Noel Maschell 1381 60 Glory Chidumwa 1382 61 Ane’ Orchard 1383 62 Sarhana Dinat 1384 63 Alexander G. Arutyunov 1385 65 Maserame Cleopatra Mokhaneli 1388 66 EL Mousaid Meriem Know your blood pressure by SOUTHERN AFRICAN HYPERTENSION SOCIETY
CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 15 AFRICA SAHS Congress 2022 Key Partners PLATINUM GOLD SILVER BRONZE
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 16 Submission ID: 1344 Introduction Low- and middle-income countries experience an increasing burden of chronic kidney disease. Cardiovascular risk factors, including advancing age, may contribute to this phenomenon. We i) profiled cardiovascular risk factors (age, adiposity, blood pressure, glucose, lipid profiles and lifestyle factors) and biomarkers of kidney function (in young adults aged 20-30 years); and ii) investigated whether these biomarkers differed across age groups. Methods Biomarkers of kidney function, including estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio, alpha-1 microglobulin, neutrophil gelatinase-associated lipocalin (NGAL), uromodulin and the CKD273 urinary proteomics classifier, were used to divide the total population into quartiles to compare extremes (25th percentiles) on the normal kidney function continuum. The lower 25th percentiles of eGFR and uromodulin and the upper 25th percentiles of urinary albumin-to-creatinine ratio, alpha-1 microglobulin, NGAL, and the CKD273 classifier represented the more unfavourable kidney function groups. Results In the more unfavourable kidney function groups, adiposity markers and blood pressure were higher and adverse lipid profiles (all p<0.05) were present. Age was only higher in the more unfavourable eGFR and CKD273 classifier groups (all p<0.001). In the total group, eGFR declined while the CKD273 classifier score increased with increasing age (both p-trend <0.05). Lower eGFR (p<0.001) and NGAL (p<0.05) levels increased the odds of being in the upper CKD273 classifier percentile. Conclusion Even in a young and healthy cohort a more unfavourable kidney function profile was associated with cardiovascular risk factors. Name: Presenting Author Information Article Category Abstract Title Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa degenaaranja@gmail.com English Abstract Basic Sciences Cardiovascular risk and kidney function profiling using conventional and novel biomarkers in young adults: The African-PREDICT study Author Affiliation: Email: Anja Degenaar Upload your slides or pictures illustrating the case ORAL PRESENTATION
CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 17 AFRICA Authors Name & Surname Title Expertise Affiliation Email Country Carina Mels Prof Oxidative stress, Metabolomics, Proteomics Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit: Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa carina.mels@nwu.ac.za South Africa Anja Degenaar Miss Cardiovascular physiology Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa degenaaranja@gmail.com South Africa Adriaan Jacobs Dr Metabolism, cardiovascular physiology Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit: Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa adriaan.Jacobs@nwu.ac.za South Africa Ruan Kruger Prof Pediatric hypertension and premature cardiovascular disease development Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit: Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa 20035632@g.nwu.ac.za South Africa Christian Delles Prof Biomarkers of cardiovascular disease and cardiovascular risk Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom christian.Delles@glasgow.ac.uk Scotland Harald Mischak Prof Proteomic biomarkers Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom; Mosaiques Diagnostics GmbH, Hannover, Germany mischak@mosaiques.de Germany ORAL PRESENTATION Submission ID: 1344 continued
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 18 Submission ID: 1345 Authors Name & Surname Title Expertise Affiliation Email Country Donavan Rooi Mr Cardiovascular Physiology NWU HART rooi860@gmail.com South Africa Prof Shani BothaLe Roux Prof Cardiovascular Physiology NWU HART and MRC Research Unit for Hypertension and Cardiovascular Disease, NWU, North-West Province, South Africa shani.botha@nwu.ac.za South Africa Yolandi Breet Dr Cardiovascular Physiology NWU HART and MRC Research Unit for Hypertension and Cardiovascular Disease, NWU, North-West Province, South Africa 21195706@nwu.ac.za South Africa Introduction Hypertension and increased blood pressure can cause pathophysiological changes that result in subclinical target-organ damage (TOD). Pulsatile pressure (pulse pressure (PP)) has been associated with cardiovascular disease (CVD) but research is incongruent regarding the association of perfusion pressure (mean arterial pressure (MAP)) with CVD. Furthermore, limited literature exists on the strength of associations between different pressure measures with subclinical TOD, especially in young populations. Thus, the researchers aimed to compare the strength of associations of subclinical TOD markers with perfusion and pulsatile pressure in young South African adults. Methods This study included 1 187 young (aged 20-30 years), normotensive black and white participants from the African-PREDICT study. Twentyfour-hour MAP and 24-hour PP measurements were obtained, as well as measures of subclinical TOD: echocardiography, to determine left ventricular mass index (LVMi), carotid intima-media thickness (cIMT) with ultrasound, carotid-femoral pulse wave velocity (cfPWV) using a femoral cuff and applanation tonometry, central retinal arteriolar equivalent (CRAE) from fundus images and albumin to creatinine ratio (ACR) determined from spot urine samples. Results Stronger correlations were found between cIMT, cfPWV, and CRAE with perfusion pressure (all p<0.001) when compared to pulsatile pressure. Stronger independent associations were found with cfPWV (adjusted R2=0.26) and CRAE (adjusted R2=0.12) with perfusion pressure (all p≤0.001) when compared to pulsatile pressure. Conclusion In young, healthy adults, perfusion pressure correlated stronger with subclinical TOD markers when compared to pulsatile pressure. Name: Presenting Author Information Article Category Abstract Title North-West University HART rooi860@gmail.com English Abstract Basic Sciences Perfusion and pulsatile pressure and the relationship with target organ damage: The African-PREDICT study Author Affiliation: Email: Donavan Rooi Upload your slides or pictures illustrating the case ORAL PRESENTATION
CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 19 AFRICA Submission ID: 1346 Authors Name & Surname Title Expertise Affiliation Email Country Shani Botha-Le Roux Prof cardiovascular physiology, inflammation, risk factors, biomarkers, vascular disease Medical Research Council: Unit for Hypertension and Cardiovascular Disease, Hypertension in Africa Research Team (HART), North-West University, South Africa shani.botha@nwu.ac.za South Africa Edrich van Zyl Mr cardiovascular physiology Hypertension in Africa Research Team (HART), North-West University, South Africa lycanunity@gmail.com South Africa Ruan Kruger Prof pediatric hypertension, premature cardiovascular disease development Medical Research Council: Unit for Hypertension and Cardiovascular Disease, Hypertension in Africa Research Team (HART), North-West University, South Africa ruan.kruger@nwu.ac.za South Africa Lebo F GafaneMatemane Prof cardiovascular disease, renin-angiotensinaldosterone system, kidney physiology Medical Research Council: Unit for Hypertension and Cardiovascular Disease, Hypertension in Africa Research Team (HART), North-West University, South Africa lebo.gafane@nwu.ac.za South Africa Introduction The role of endothelial activation in atherosclerosis is known, but limited studies exist on endothelial activation in asymptomatic individuals. We investigated the relationship between carotid arterial stiffness and markers of endothelial activation in young healthy adults. Methods We included 1197 individuals with a median age of 24 years (25th & 75th percentiles: 22 27). Carotid strain, distensibility, compliance, beta-stiffness index (BSI), Peterson’s elastic modulus (PEM), Young’s elastic modulus (YEM) and carotid intima-media thickness (cIMT) were determined from B-mode ultrasonography. Intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), P-selectin and monocyte chemoattractant protein 1 (MCP-1) were analysed. Results VCAM-1 was highest and P-selectin lowest in the lowest tertile of strain, distensibility and compliance, and in the highest tertile of BSI, PEM and YEM (all p≤0.028), but not cIMT. In multivariable-adjusted and binomial logistic regression analyses, stiffness measures associated with higher VCAM-1 [strain (β=-0.14, OR=0.73); distensibility (β=-0.12, OR=0.72); compliance (β=-0.11, OR=0.76); BSI (β=0.10, OR=1.32); PEM (β=0.10, OR=1.30) YEM (β=0.10, OR=1.25); all p≤0.001] and higher ICAM-1 [compliance (β=-0.06), strain (OR=0.88); all p≤0.045], but lower P selectin [strain (β=0.10, OR=1.17); distensibility (β=0.08, OR=1.18); compliance (β=0.09); BSI (β= 0.11, OR=0.82); PEM (β=-0.09, OR=0.82); YEM (β= 0.09, OR=0.85); all p≤0.016] as well as lower MCP-1 [strain (β=0.07); distensibility (β=0.06, OR=1.17); compliance (β=0.08, OR=1.23); BSI (β= 0.07, OR=0.85); YEM (β=-0.06, OR=0.86); all p≤0.043]. Conclusion We found adverse relationships between measures of carotid arterial stiffness and markers of endothelial activation in healthy adults, suggesting that the development of arterial stiffness may be mediated by early onset endothelial activation. Name: Presenting Author Information Article Category Abstract Title Medical Research Council: Unit for Hypertension and Cardiovascular Disease, Hypertension in Africa Research Team (HART), North-West University, South Africa shani.botha@nwu.ac.za English Abstract Basic Sciences Carotid arterial stiffness associates with endothelial activation in young adults: The African-PREDICT study Author Affiliation: Email: Prof Shani Le Roux ORAL PRESENTATION
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 20 Submission ID: 1361 Authors Name & Surname Title Expertise Affiliation Email Country Jaqueline Cindy Govender Dr Medicine UKZN ranjith@lantic.co.za South Africa Naresh Ranjith Prof Cardiology UKZN ranjith@lantic.co.za South Africa Introduction Coronary artery disease [CAD] is a major cause of morbidity and mortality,and although previously reported to be more common in men, is now identified as a leading cause of death and disability in women. Significant differences occur between men and women with respect to the epidemiology, diagnosis, treatment, and prognosis of CAD. In the past, women were often under-represented in many CAD studies, leading to misdiagnosis and inappropriate treatment. There is a paucity of data on the prevalence and mortality outcome of CAD in women from developing countries like South Africa. This study investigated the incidence of acute myocardial infarction [AMI] in women in a regional hospital in Durban, South Africa, with respect to risk profiles and major adverse cardiac events [MACE]. Methods This was a single-center retrospective study conducted at the Coronary Care Unit at RK Khan Hospital, between 2003 to 2016 in female patients with acute myocardial infarction [AMI]. Demographic and clinical data stored in an electronic database were obtained from all patients. Patients with ST elevation MI (STEMI) who were eligible for thrombolysis received Metalyse as a reperfusion therapy. Only patients who consented for both coronary angiography and revascularization were referred to a tertiary hospital due to limited resources. The occurrence of MACE was recorded during hospital admission and 6 months post-discharge. Routine biochemistry was performed on admission using standardized techniques. Results A total of 1311 females were screened of whom 1160 patients were eligible for analyses. The mean age of the study population was 61.6 ± 10.7 years and they were stratified into 2 age groups; < than 65 years [n= 666 (57.4%)] and ≥ 65 years [n= 494 (42.6%)]. The commonest risk factors included dyslipidaemia [97.4%], hypertension [77%], diabetes [75.6%], and a family history of premature atherosclerosis [59%]. When adjusted for age, a significantly greater number of patients < 65 years had dyslipidaemia [P=0.038], obesity [P=<0.001], smoking [P=<0.001], and family history of premature atherosclerosis [ P=<0.001]. In contrast, patients ≥ 65 years were significantly more likely to present with hypertension [ P=<0.001], a previous history of AMI [P=0.004] and angina [P= 0.03]. MACE were observed in 40.2% [n=466] with older patients having a significantly higher prevalence compared to their younger counterparts[46.8% vs 35.3%, P< 0.001 ]. Cardiac failure [54.4%] and death [28.1%] were the most common adverse events seen. Most patients presented with ST elevation MI [74%] with 28% receiving pharmacological reperfusion. Only 337 patients [29%] were subjected to angiographic studies with the majority having triple vessel disease [48.7%], double vessel disease [22.6 %], single vessel disease [22.6%] and normal coronary epicardial vessels [6.2%]. Following multivariable logistic regression analysis, hyperglycaemia [p=0.006], hyperuricaemia [p= 0.001] and hypertriglyceridaemia [p= 0.014] were significantly associated with MACE. Conclusion Our study showed that women presented at a younger age and have multiple risk factors for AMI. A high proportion of patients experienced MACE particularly cardiac failure and death. This highlights the importance of vigilant screening and earlier intervention in women with risk factors that predispose them to CAD. Name: Presenting Author Information Article Category Abstract Title Dr Jaqueline Cindy Govender ranjith@lantic.co.za English Abstract Clinical Risk factor profile of female patients presenting with Acute Myocardial Infarction: A South African perspective Author Affiliation: Email: Prof Naresh Ranjith ORAL PRESENTATION
CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 21 AFRICA Submission ID: 1362 Authors Name & Surname Title Expertise Affiliation Email Country Angela J Woodiwiss Prof Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg Angela.Woodiwiss@wits.ac.za South Africa Nonhlanhla Mthembu Ms Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg nonhlanhla.mthembu@yahoo.com South Africa Vernice R Peterson Dr Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg vernice.peterson@wits.ac.za South Africa Ravi Naran Dr Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg naran.ravi1@gmail.com South Africa Introduction Heart rate (HR) lowering agents such β-adrenoreceptor blockers used for the management of hypertension in patients with cardiac conditions, increase central arterial (PPc), but not brachial pulse pressure (PP). However, the mechanisms of this effect are uncertain. A lower heart rate (HR) increases left ventricular (LV) ejection volume and hence systemic flow. Whether this contributes to the adverse effects of HR on central pulse pressure (PPc) through reservoir volume effects, is unknown. Methods Using non-invasive central pressure, aortic velocity and diameter measurements in the outflow tract (echocardiography), we assessed the role of LV ejection volume as a determinant of HR relations with PPc in 824 community participants. Results A lower HR was independently associated with both stroke volume (SV) (p<0.001) and a shift in ejection volume from early (until the first systolic shoulder) to late (from first systolic shoulder to peak PP) systole (p<0.05 to p<0.005). Adjustments for LV end diastolic volume (EDV) markedly diminished HR relations with SV and indexes of the shift in ejection volume to late systole. A lower HR was also independently associated with increases in both forward travelling pressure waves (Pf) and PPc (p<0.0001). However, adjustments for neither SV, nor indexes of a shift in ejection volume to late systole modified HR-Pf or PPc relations. This was despite relationships between indexes of a shift in left ventricular ejection volume to late systole and both Pf and PPc (p<0.0001). In contrast, adjustments for the increases in re-reflected and backward travelling wave pressures with a lower HR, eliminated HR-Pf and PPc relations. Conclusion In contrast to current thought, a lower HR is not associated with increases in PPc through an impact of increases in late systolic ejection volume on aortic reservoir volume, but rather through increases in backward wave pressures. These data suggest that increases in systemic flow, which may have beneficial effects in cardiac disease, are not responsible for increases in PPc with HR reduction. In contrast, increases in impedance to flow, which have deleterious effects in cardiac disease, are responsible for HR-associated increases in PPc. Name: Presenting Author Information Article Category Abstract Title Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa angela.woodiwiss@wits.ac.za English Abstract Population Sciences Contribution of Increases in Late Systolic Ejection Volume to the Impact of Heart Rate on Central Arterial Pulse Pressure in a Community Sample Author Affiliation: Email: Angela J Woodiwiss ORAL PRESENTATION
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 22 Suraj M Yusuf Mr Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg yusufmsuraj@kasu.ed.ng South Africa Grace Tade Dr Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg Oluwatosin.Tade@wits.ac.za South Africa Hamza Bello Dr Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg hamza.zuru@fubk.edu.ng South Africa Adamu Bamaiyi Dr Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg adamu.bamaiyi@udusok.edu.ng South Africa Carlos D Libhaber Prof Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg carlosnuclear1@gmail.com South Africa Patrick Dessein Prof Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg patrick.dessein22@gmail.com South Africa Ferande Peters Prof Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg ferande.peters@gmail.com South Africa Pinhas Sareli Prof Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg pinkysareli@gmail.com South Africa Gavin R Norton Prof Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg gavin.norton@wits.ac.za South Africa Authors Name & Surname Title Expertise Affiliation Email Country Submission ID: 1362 continued ORAL PRESENTATION
CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 23 AFRICA Submission ID: 1363 Introduction Although renal mechanisms are well-recognised as contributing to primary hypertension, this has until recently, never been demonstrated to translate into sustained volume-dependent hypertension. However, recent studies indicate that in Africa, renal-related sustained volumedependent primary hypertension is the dominant form of hypertension. The exact mechanisms through which a volume load determines increases in BP is nevertheless uncertain. We therefore aimed to identify the relative contribution of volume-dependent increases in aortic reservoir function, assessed from late systolic ejection volume, versus pressure wave (forward and backward) effects to variations in pulse pressure (PP) and LV mass index (LVMI) in a community with volume-dependent primary hypertension. Methods From central pressure, aortic velocity and diameter measurements (outflow tract) and echocardiography, we determined LV ejection dynamics, arterial wave morphology and LVM in an African community (n=734). Results LV end diastolic volume and circulating atrial natriuretic peptide concentrations were independently associated with both peak aortic flow (Q) and a shift in ejection volume from early (up to the first systolic shoulder, P1) (V1) to late (between P1 and peak PP) (V2) systole (p<0.0001). Independent of the component of forward wave pressures generated by the product of Q and characteristic impedance (Zc) to flow (PQxZc) and backward wave pressures (Pb), through V2 effects, V2/V1 was independently associated with peak central arterial PP (PPc)(p<0.0001). Relationships between V2/V1 and PPc were independent of stroke volume (SV). The impact of V2/V1 on PPc was second (standardized β-coefficient=0.166±0.017) to max PQxZc (0.417±0.030, p<0.001) and similar to Pb (0.244±0.034, p<0.0001). Independent of PQxZc, Pb and SV, through V2 effects, V2/V1 was also independently associated with LVMI and mean wall thickness (MWT) (p<0.0001), and in the same regression models, PQxZc (p<0.01), but not Pb showed significant relationships with LVMI. Conclusion In a community with prevalent and sustained volume-dependent primary hypertension, volume-dependent increases in reservoir function (late systolic ejection volume) contribute less than pressure waves to PP, but reservoir function is a primary determinant of LV structure. Targeting volume overload is essential in the management of volume-dependent hypertension. Name: Presenting Author Information Article Category Abstract Title Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. gavin.norton@wits.ac.za English Abstract Population Sciences Relative Impact of Volume-Dependent Variations in Aortic Reservoir Function Versus Pressure Wave Effects on Pulse Pressure and Cardiac Mass at a Community Level. Author Affiliation: Email: Gavin R Norton Authors Name & Surname Title Expertise Affiliation Email Country Gavin R Norton Prof Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg gavin.norton@wits.ac.za South Africa Suraj M. Yusuf Mr Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg yusufmsuraj@kasu.edu.ng South Africa Vernice R Peterson Dr Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg vernice.peterson@wits.ac.za South Africa ORAL PRESENTATION
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