e102 Abstracts / Journal of the American Society of Hypertension 8(4S) (2014) e99–e105

The ability of renin-angiotensin-aldosterone system (RAAS) suppression

to reduce albuminuria is clear. However, chronic suppression of RAAS

does not impede the development of cardiorenal damage in all cases. Mi-

croalbuminuria is one of the predictors. With high prevalence, patients un-

der chronic treatment show albuminuria or even develop de novo

microalbuminuria, but there are not available markers able to predict pa-

tients’ evolution.

The purpose of the study is to discover a molecular fingerprint in urine

associated to albuminuria progression in HBP patients chronically treated,

allowing the evaluation of patients’ response to the action of RAAS

inhibitors.

We have investigated changes in urine proteome and metabolome by using

complementary omics approaches. Urine was collected from hypertensive

patients under chronic suppression of RAAS, and healthy subjects. Patients

were classified as: normoalbuminuric who had remained stable (normo-

normo), normoalbuminuric who had progressed to microalbuminuria

(normo-micro) and microalbuminuric who had remained stable (micro-mi-

cro). By differential gel electrophoresis (DIGE), 27 protein spots were

found significantly altered (fold change >2, p value <0.05) corresponding

to 11 proteins which respond to albuminuria condition with different

trends: 2 proteins were altered in all patients versus controls, 3 proteins re-

sponded specifically to microalbuminuria and 6 proteins were altered

significantly in either normo-normo, normo-micro or micro-micro patients’

group. By nuclear magnetic resonance, 26 metabolite signals showed vari-

ation in response to albuminuria finding three different trends: responders

to albuminuria progression, responders to HBP condition itself, or re-

sponders at intermediate condition (normo-normo or normo-micro) which

do not differentiate among control and micro-micro individuals.

In conclusion, a specific protein and metabolite fingerprint in urine respond

to albuminuria condition and progression in HBP patients under chronic

suppression of RAAS.

Keywords: hypertension; albuminuria; proteomics; urine

P-178

Low presription of ACEI/ARB among hypertensive patients who

showed two consecutive albuminuria during national health

screening program in Korea

Eunmi Ahn,y,2 Dong Wook Shin,2 Hyung-kook Yang,1 Jae Moon Yun,2

Hyejin Lee,2 BeLong Cho.2 1National Cancer Center, Goyang-si, Korea,

Republic of; 2Seoul National University Hospital, Seoul, Korea, Republic

of

While routine screening of abuminuria is controversial, use of ACEI/ARB

is recommended for hypertensive patients with albuminuria. In Korea, a

biennial general health screening test including urine dipstick test is pro-

vided to all adult population. We aimed to determine and evaluate what

percentage of hypertensive patients with albuminuria from routine health

screening program in Korea are prescribed with ACEI/ARB after the

screening.

A 3% of the adult general population was sampled randomly as a retro-

spective cohort from National Health Insurance Corporation (NHIC) as

of Dec. 31st, 2002 and followed until 2010. National Health Screening

Data and National Health Insurance Claims Data were merged for this

study. We defined our target population to be patients with hypertension

who were not prescribed with ACEI/ARB before the second screening

test, and showed albuminuria (urine albumin >1+ by dipstick test) in

two consecutive screening tests (average interval of two years). We

described ACEI/ARB prescription rate within six months after the second

albuminuria.

Among 1,576 hypertensive patients with two consecutive albuminuria,

only 11.6% of them were prescribed with ACEI/ARB within six months

after the second albuminuria. For age, the ACEI/ARB prescription was

most common among patients between 40w59 years (14.7%), and the

rate was higher than those aged between 20w39 (6.5%) and >60 (9.9%)

(Both Ps<0.05). There was no significant difference by gender. For

screening year, the prescription showed an increasing trend; 10.5% for

those who were second screened in 2005-2006, to 14.6% for those who

were second screened in 2009-2010, however, the change was not statisti-

cally significant (P¼0.278).

Only a small proportion of hypertensive patients who were detected persis-

tent albuminuria during routine health screening subsequently received

adequate antihypertensive agents. A public health strategy is needed to

enhance the appropriate follow-up care and ACEI/ARB prescription for

patients with hypertensive chronic kidney disease.

Keywords: hypertensive chronic kidney disease; proteinuria; ACEI/ARB;

population-based screening

P-179

Office and ambulatory blood pressure changes 24 months after renal

denervation in patients with resistant hypertension

Thomas Lambert, Verena Gammer, Alexander Nahler, J€urgen Kammler,

Hermann Blessberger, Alexander Kypta, Simon H€onig, Karim Saleh,

Stefan Schwarz, Clemens Steinwender. Linz General Hospital, Linz,Austria

Introduction: Renal denervation (RDN) is a promising treatment option in

addition to medical antihypertensive treatment in patients suffering from

resistant hypertension. Despite the growing interest in RDN, only few

long-term data about blood pressure (BP) changes in ambulatory blood

pressure measurements (ABPM) after RDN are published so far.

Methods: We have systematically investigated the effects of RDN on

ABPM in a consecutive series of patients with resistant hypertension (of-

fice BP >160mmHg under treatment of at least three antihypertensive

drugs). Office BP measurement and ABPM was performed in all patients

at baseline and 3, 6, 12 and 24 months after RDN, respectively. Patients

with an average systolic office BP reduction of more than 10 mmHg 6

months after RDN were classified as responders.

Results: Between June 2010 and May 2011, we performed RDN in 32 pa-

tients with resistant hypertension. A 24-month follow-up could be obtained

in all patients, with 21 patients (65.6%) being classified as responders after

6 months. In these responders, mean office BP dropped from 175.3�15.9/

96�14.2 mmHg at baseline to 164.8�24.4/93.2� 0.4 mmHg (p¼0.040/

p¼0.323) after 24 months and the mean 24-hour BP in ABPM decreased

from 146.8 � 17.0/89.1 � 11 mmHg to 136.8 � 15.0/83.2 � 10.7 mmHg

(p¼0.034/p¼0.014).

Conclusions: Renal denervation provides sustained significant BP reduc-

tion in about two-thirds of patients with resistant hypertension 24 months

after the procedure. This reduction can be demonstrated not only by office

BP but also by ABPM.

Keywords: renal denervation; resistant hypertension; ambulatory blood

pressure measurement

P-180

P66 Shc regulates renal vascular tone in hypertension-induced

nephropathy

Andrey Sorokin, Bradley Miller, Oleg Palygin, Aron M. Geurts,

John D. Imig, Alexander Staruschenko. Medical College of Wisconsin,Milwaukee, WI, United States

Renal preglomerular arteriolies are maintaining strong vascular tone to

provide a large pressure gradient in a short distance. Their autoregulatory

responses are extremely important for the maintenance of renal microcir-

culation. The hypertension-induced nephropathy is accompanied by

impaired renal microvascular responses but molecular mechanisms causing

unresponsiveness remain elusive. The purpose of this study was to assess

the contribution of adaptor protein p66 Shc to regulation of renal vascular

tone and renal vascular dysfunction associated with hypertension-induced

nephropathy. p66 Shc, a longevity-associated product of Shc1 gene, is

implicated in the pathogenesis of age-related diseases and regulation of

sensitivity to oxidative stress. To address the role of p66 Shc in regulating