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sures like vaccination, chest X-rays, breast, PAP or, prostatic examination decreased the odds of uncontrolled BP (OR 0.78 95%CI 0.61-0.99). Age, smoking status, overweight-obesity, DM, and HC did not correlate with control. The most disturbing ndings in the present study were the lower prevalence of good BP control in our urban hypertensive population and that those who already suffered a target organ damage were likely to be poorly controlled. Key Words: Argentine Urban Population, Control, Hypertension

The study population consisted of 634 consecutive young and middleaged (31-65 years) men that visited our outpatient clinic. According to JNC VII classication 358 of them were hypertensive, while the remaining 276 were normotensive. Erectile dysfunction was evaluated using the International Index for Erectile Function questionnaire. As demonstrated in the Figure, erectile function score was related to

P-274 HIGH INCIDENCE OF MORBIDITY AND MORTALITY IN YOUNG, URBAN BLACK MEN WITH HYPERTENSION
Cheryl R. Dennison, Wendy Post, Roger S. Blumenthal, Lee R. Bone, David M. Levine, Martha N. Hill. School of Nursing, Johns Hopkins University, Baltimore, MD; Department of Medicine, Johns Hopkins University, Baltimore, MD; School of Public Health, Johns Hopkins University, Baltimore, MD. Black men with hypertension (HTN) in low SES populations have poor rates of HTN control and suffer early from its complications. In a 5-year randomized trial of urban black men ages 21-54 years with HTN (n309), we evaluated the effectiveness of a more intensive (MI) educational behavioral-pharmacological intervention by a nurse practitionercommunity health worker-MD team and a less intensive (LI) education and referral intervention. We previously demonstrated a decrease in BP and slowing of progression of renal insufciency and left ventricular hypertrophy at 36 months in the MI group. The objective of this analysis was to examine the incidence and predictors of morbidity and mortality over 60 months. At baseline, mean age was 41 ( 6) years and mean BP was 146 19/99 15 mm Hg. None of the men were receiving dialysis at baseline. Follow up (FU) rates were 85%, 82%, 75%, 70% and 65% at 12, 24, 36, 48 and 60 months. FU rates, accounting for men who were deceased, incarcerated, or moved, were 94% to 90% at 12 to 60 months. There was a high prevalence of unemployment, low income, alcohol and drug use. During the FU period 13 men developed ESRD requiring dialysis (8 in LI group, 5 in MI group) and 6 of those men died within 5 years of FU. Remarkably, a total of 51 men (17%) died during FU (28 in LI and 23 in MI group). The mean age at death was 43 years. Based on death certicates, the cause of death was cardiovascular disease related in 12 men, narcotic cocaine alcohol intoxication in 17, other causes in 13, and unable to obtain the death certicate in 9 men. In a logistic regression model of baseline BP care and control and sociodemographic variables, being unemployed (p0.02), dened as unemployed, retired, or disabled, was a signicant predictor of mortality. No signicant predictors were identied for ESRD/chronic renal insufciency. In conclusion, there is an extraordinarily high rate of ESRD and death due to both CVD related causes and drug and alcohol intoxication in young urban, low income, black men with HTN. There is an urgent need for appropriate social and medical support systems to assist this highly vulnerable population. Key Words: African-American, Health Disparities, Renal Failure

blood pressure levels both in hypertensive and normotensive subjects. Erectile dysfunction was found in 35.2% of patients with essential hypertension compared to 14.1% of normotensive subjects (x235.92, p0.001). The prevalence of erectile dysfunction is higher in patients with essential hypertension compared to normotensive subjects with similar demographic characteristics. Erectile dysfunction is related to blood pressure levels even in subjects with prehypertension, suggesting that this parameter may be taken in account for the management of individuals with prehypertension. Key Words: Erectile Dysfunction, Prehypertension, Systolic Blood Pressure

P-276 PREVALENCE, AWARENESS, TREATMENT AND CONTROL OF HYPERTENSION IN HELLAS (GREECE): THE HYPERTENSHELL NATIONAL STUDY (HYPERTENSION STUDY IN GENERAL PRACTICE IN HELLAS
Aris D. Efstratopoulos, Soa M. Voyaki, Athanasios A. Baltas, Filippos A. Vratsistas, Dimitrios-Eteoklis P. Kirlas, John T. Kontoyannis. Hypertension Center, General Hospital of Athens G. Gennimatas, Athens, Attica, Greece; Hypertension Center, General Hospital of Athens G. Gennimatas, Athens, Attica, Greece; Hypertension Unit, General Hospital of Athens G. Gennimatas, Athens, Attica, Greece; Health Center of Mouzaki, National Health System, Karditsa, Karditsa, Greece; Health Center of Thesprotiko, National Health System, Preveza, Preveza, Greece. The Hypertension Study in General practice in Hellas (Hypertenshell) is a cross-sectional survey tool much like NHANES to assess the prevalence, level of awareness, treatment and control of hypertension in Greece. It was conducted with the collaboration of physicians in 98 Health Centers, across Greece. The survey included an interview, blood pressure measurements on two clinical visits for verication of diagnosis and control of hypertension. Hypertension was dened as systolic BP140 mmHg and or diastolic BP90 mmHg, or current treatment with antihypertensive drugs, while the same threshold was taken for the assessment of control of hypertension. As a result 11950 inhabitants participated and 11540 were analyzed (% of the Greek population (11540/10.9 million-0.1%) (NHANES is 50

P-275 ERECTILE DYSFUNCTION IS RELATED TO SYSTOLIC BLOOD PRESSURE EVEN IN THE NORMAL BLOOD PRESSURE LEVELS
Michael Doumas, Alexandros Tsakiris, Stella Douma, Athina Hounta, Angelos Papadopoulos, Sotirios Tsiodras, Giorgia Paraskeuakou, Vicki Antoniou, Hellen Giamarellou. Hypertension Outpatient Clinic, 4th Dpt of Internal Medicine, University of Athens, Athens, Greece. The aim of our study was to evaluate the relationship between blood pressure levels and erectile dysfunction in young and middle-aged normotensive and hypertensive men.

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million / 290million-17%). The prevalence of hypertension was 31.1% (men 33.62%, women 28.4%), while in the elderly ( 65 years) the prevalence was higher (65.4%). A proportion of 39.8% of hypertensives they did not know that they suffer from hypertension (43% of men and 37% of women), giving an awareness of 60.2% (43% of men and 37% of women); 12.4% were aware but not treated (men 13.1%, women 11.8%), 18.4% were treated but not controlled (men 17.8%, women 18.8%), and 32.8% were treated and controlled ( men 33.3%, women 32.3%). We conclude that Hypertenshells study results show that hypertension is a common risk factor for cardiovascular disease in the Greek population, but awareness, treatment and control of hypertension are comparable to the best gures given for the problem, but there is a considerable potential for improvement in the control further. Key Words: Hypertension, prevalence, awareness, treatment, control, Hellas (Greece). Key Words: Epidemiology, Hellas (Greece), Hypertension

P-278 A CONSORTIUM FOR SOUTHEASTERN HYPERTENSION CONTROL (COSEHC) REGION SPECIFIC APPROACH FOR ASSESSING GLOBAL CARDIOVASCULAR RISK IN THE SOUTHEASTERN USA
Carlos M Ferrario, Mark Houston, Mariano Ferrario, William Besterman, Michael A Moore. Hypertension and Vascular Disease Center, Wake Forest University School of Medicine, Winston Salem, NC; The Hypertension Institute, St. Thomas Hospital, Nashville, TN; LowCountry Medical Group, Beaufort, SC. A new cardiovascular risk factor assessment tool derived from 47,080 subjects participating in 8 Europe and North America clinical trials has been modied to give a region-specic probability of cardiovascular death (CVD) in the Southeastern USA from data collected by 15 of 23 currently established COSEHC-designated Cardiovascular Centers of Excellence in GA, FL, MD, MS, NC, SC, OH, TN, and VA. The absolute predicted risk of dying from CVD within 5 years is based on a composite of 17 risk factors to allow greater precision in evaluation of the Metabolic Syndrome (MS) other than hypertension, dyslipidemia, and insulin resistance. Grading numerical scores included gender, height, age, systolic blood pressure, smoking, lipid proling, left ventricular hypertrophy, prior history of MI or stroke, serum creatinine levels, plasma homocysteine, fasting blood sugar, and a history of diabetes. Data were collected from electronic medical records or ICD codes abstracted into a proprietary web-based database developed by COSEHC. For the population as a whole systolic blood pressure was 137 7 mm Hg, LDL averaged 114 9 mg/dL, and fasting blood glucose was 118 12 mg/dL. On an average, 96,708 patients (50% males) proled from 15 Centers (mean age 61 yrs.) had an absolute grade score of 26 6 (SD), a value that indicates a 0.5% predicted risk of CVD every 5 years. The absolute predicted risk score was higher in males (32 4; range: 27 to 38) compared to females [21 5; range: 11 to 30 (p 0.05)] and all individuals fell into the moderate high risk for cardiovascular events. The data provides a substantive quantitative cross-sectional assessment of the absolute risk of death due to CVD as well as directly documenting the increased absolute risk of cardiovascular disease in the Southeastern USA. Prospective studies are underway to evaluate the predictive validity of this score assessment in the Southeastern USA. Moreover, the COSEHC Global Risk Factor Assessment Tool established a baseline to allow risk quantication, evaluation of treatment goals, and their efcacy for each of 17 identied risk factors. Key Words: Cardiovascular Risk Factors, Hypertension, Metabolic Syndrome

P-277 LEFT VENTRICULAR GEOMETRIC REMODELING AND CARDIOVASCULAR PROGNOSIS IN JAPANESE DIABETIC AND/OR HYPERTENSIVE PATIENTS
Kazuo Eguchi, Kazuomi Kario, Joji Ishikawa, Satoshi Hoshide, Shizukiyo Ishikawa, Kazuyuki Shimada. Cardiology Department, Jichi Medical School, Minamikawachi, Tochigi-ken, Japan; Cardiology Department, Shioya General Hospital, Yaita, Tochigi-ken, Japan. Objective: To investigate the impact of left ventricular geometry on cardiovascular prognosis in hypertensives and/or diabetic patients. Methods: We performed ambulatory BP monitoring and echocardiography in 425 patients consists of 157 diabetic hypertensives, 222 hypertensives and 46 diabetics (mean age: 67.3 years; men: 39.5%). They were classied with concentric hypertrophy (n124); eccentric hypertrophy (n117); concentric remodeling (n86); normal pattern (n98). Results: During follow up period, 26 cardiovascular events occurred (13 stroke, 6 ischemic heart disease, 6 heart failure and 1 sudden death). The incidences of cardiovascular events were 9.6% in concentric hypertrophy, 5.1% in eccentric hypertrophy, 8.1% in concentric remodeling, and 1.0% in normal pattern (Figure).

P-279 METABOLIC SYNDROME IN HIGH CARDIOVASCULAR RISK PATIENTS

Giovanni Gaudio, Alberto Schizzarotto, Pietro Margaroli, Piermario Bossi, Giuditta Riganti, Ivano Cosini, Adriano Daverio, Franco Rotolo, Luigina Guasti. Internal Medicine, Bellini Hospital, Somma Lombardo, Varese, Italy; Internal Medicine, Insubria University, Varese, Varese, Italy. The National Cholesterol Education Programs Adult Treatment III (ATP III) identied the metabolic syndrome as a multi risk factor for cardiovascular disease. The major components of metabolic Syndrome are: Abdominal Obesity as waist circumference M 102 W 88 Hypertension: BP 130/85 mmHg Dyslipidemia: TG 150 mg/dl; HDL M 40 ,W 50 mg/dl Fasting Glucose 110 mg/dl 100 in Diabetes (ADA) Proinammatory state Prothrombotic state

Conclusion: Cardiovascular events were most frequent in concentric hypertrophy and concentric remodeling than in eccentric hypertrophy. Increased relative wall thickness was associated with cardiovascular prognosis in Japanese hypertensives and/or diabetic patients. Key Words: Diabetes, Hypertension, Left Ventricular Geometric Remodeling