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Conclusion: In healthy subjects was observed a predominance of 1V pattern, which re-flects both sympathetic and parasympathetic modulation. The parasympathetic relatedpattern of symbolic dynamics (2ULV) presented higher correlations with parasympatheticrelated indexes of time, frequency and nonlinear domains.Disclosure of Interest: None Declared

PW260

One Year Behavioral Intervention For Uncontrolled Hypertension: A Cross SectionalStudy In Bengkulu, Indonesia

Surya Marthias*1, Trevino A. Pakask2, Mazaya L. Palupi2, Amy C. Demeriyenes2,noviyanti yanti2, Anna Y. Putri21Public health, Faculty of Medicine Universitas Indonesia, 2Public Health, FMUI, Jakarta,Indonesia

Introduction: Hypertension has become a significant problem with prevalence of 31.7%among adult in Indonesia. Although effective drugs are available,management of hypertensionis still inadequate. In Bengkulu, hypertension accounted for higher of incidence rate andestimated 85 to 90% are uncontrolled with low compliance to anti hypertensive medication.Objectives: This study is carried out to identify factors contributing to uncontrolled hy-pertension and analized effect of intervention on drug consumed, systolic blood pressure(SBP) level, and 1-yearcoronary heart disease (CHD) risk.Methods: A cross sectional study was conducted on 2012 to 2013 with total 102 patientsage 50-80 with sustained uncontrolled hypertension in Primary Health Care, LebongDistrict, Bengkulu.Patient were recruited using consecutive sampling and given standard-ized questionnaire before and after one year behavioral intervention. Questionnaire hadbeen validated with alpha-cronbach 0,74. Guided discussion had done monthly in Centreof Geriatric as part of intervention for both groups,followed by evaluation of drugconsumed. We conduct analysis effect in SBP and 1-year CHD riskamong compliers and tocompare with an intention-to-treat analysisResults: Of 102 respondents, 55% were compliers who had significant increased inconsuming drug regularly (74% vs 26%), increased in knowledge score (54% vs 46%), andhad lower baseline SBP (133 vs 155 mmHg) compared with noncompliers. The effect ofintervention significant for SBPamong compliers (p¼0,04) with reduction of SBP at least1,2 mmHg in a mean, but not significantdifferent for 1-year CHD risk (p>0,05). Factorabsence of symptoms (70%) significantly contribute to uncontrolled hypertension(p¼0,02). However, family support in this regional was also played significant role thatinfluenced patient to consumed drug regularly.Conclusion: Patients with positive knowledge and attitude are more likely to comply withtreatment and could significantly reduce SBP in a year. Educational programs focusingonmodificating preventable risk factors and compliance towards antihypertensive drugsshould be carried out to reduce the mortality and morbidity associated with the disease.Disclosure of Interest: None Declared

PW261

Effects of the pulmonary hypertension manual (PulHMan) on awareness of exerciseamong patients with pulmonary hypertension

Abraham S. Babu*1, Ramachandran Padmakumar2, Arun G. Maiya1,31Physiotherapy, School of Allied Health Sciences, Manipal University, 2Cardiology, KasturbaMedical College, 3Dr. TMA Pai Endowment Chair in Exercise Science and Health Promotion,School of Allied Health Sciences, Manipal University, Manipal, India

Introduction: Pulmonary hypertension (PH) is a condition causing severe functionallimitations and poor quality of life. Exercise training is an important adjunct to manage-ment of patients with PH. However, exercise as an intervention is underutilized by bothhealth care professionals and patients. In order to improve awareness about PH andbenefits of exercise in its management, the ‘Pulmonary Hypertension Manual (PulHMan)’was developed through a structured methodology.

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

Objectives: To study the effects of the PulHMan on awareness of exercise among patientswith PH.Methods: A prospective pre-post study was conducted on 20 patients with PH attendingthe out-patient department of Cardiology at a tertiary level, University hospital in SouthIndia. A self-developed and validated questionnaire to assess awareness was used prior tothe intervention (i.e., providing education through the PulHMan) and after three months.Patients were contacted telephonically every month to determine if they had any queries.Institutional ethical clearance and written informed consent was obtained.Results: Tenmales and females each, with a mean age of 45.5�14.5 years diagnosedwith PH(WHO groups1-4; WHO-functional class I-IV, Right ventricular systolic pressure:89.2�21.1mm Hg; six minute walk distance: 315.5�119 meters) completed the study. Allpatients heard about PH from their physician andwere aware of onlymedical therapies for PH.None of the patientswere sure as to how tomonitor their symptoms, received a formal exerciseprogram or were aware of the benefits of exercise. After three months, 85%(17/20) knew theimportance of monitoring symptoms and 80%(16/20) were willing to exercise in order toperform their activities. 50% were aware of the benefits of exercise in terms of reducing dys-pnea, fatigue and improvement in daily activities and18/20 (90%)werewilling to participate inan exercise program with a greater preference for exercising at home (16/20;80%).Conclusion: The PulHMan improved awareness of PH and role of exercise in its man-agement among patients with PH. However, more studies are required to understand howthe PulHMan will alter exercise behavior among those with PH.Disclosure of Interest: A. Babu Grant/research support from: Tom Lantos Innvoation inCommunity Services award, Pulmonary Hypertension Association, R. Padmakumar: NoneDeclared, A. Maiya: None Declared

PW262

The positive effect of education on prevention and healing of patients with atrialfibrillation

Tünde Bettenbuch*1, Marianna Srej1, Piroska Szekeres1, Gábor Széplaki1, László Gellér1,Béla Merkely11Heart Center, Semmelweis University, Budapest, Budapest, Hungary

Introduction: Atrial fibrillation is the most common cardiac arrhythmia, which is rarelylife-threatening, but has a significant role in morbidity. The main goal in the treatment isthe prevention of stroke, since its risk is highly increased up to 17.6 fold.In 1977, WHO announced the program “ Health for All by 2000 ". In 1994 a long -term

National Health Program was initiated, which focused on the significance of coronary andcerebrovascular diseases and aimed mortality reduction. The WHO 2002 report points outthat a small number of preventable risk factors can greatly affect the appearance of a diseaseand early mortality. Thus it is of outmost important to clearly recognize their connectionswith disease prevalence.In May 2011, Semmelweis University Heart Center established a national patient orga-

nization for patients with cardiovascular disease. The Association currently has 700members. We offer patient education training courses once weekly for patients with cor-onary artery disease and once monthly for patients with atrial fibrillation.Objectives: The aim of the Association is patient education, to improve the knowledge aboutthe disease, the possible complications, treatment options, possible lifestyle changes, pre-vention, thus giving a greater chance of living with an increased quality of life. By education,we aimed to reduce the number of unnecessary hospital care and outpatient visits.Methods: We have done 1347 catheter ablations for atrial fibrillation in our Department inthe past 5 years, 695 of those in 2012-2013. 565 patients agreed to participate in theprogram; 380 came back once, 64 patients twice and 32 multiple times. A survey was doneto investigate the frequency of turning to medical care.Results: Based on our data, 92 of 380 patients participating in the program, while 186 of315 patients not requiring patient education showed up for unscheduled visits at ouroutpatient clinic (p<0.001). The most frequent causes were palpitations and need forrevising medications (anticoagulation, antiarrhythmics).Conclusion: According to our results, patients participating in the organized patient ed-ucation program had been able to live with a better quality in the first 6 months followingablation. They were more prepared to assess the severity of symptoms after treatment andunderstood the rationale of their medication better. Most of them did not require additionalvisits, hospitalization and information.Disclosure of Interest: None Declared

PW264

Two-year hospitalisation major causes and costs in patients with atherothromboticdisease

Emily Atkins*1, Elizabeth Geelhoed1, Tom Briffa11School of Population Health, University of Western Australia, Perth, Australia

Introduction: It is well understood that patients with established atherothrombotic disease(ATD) are at greater risk of further ATD events; however there is limited information on howcomorbidities and other admissions contribute to total hospitalisations and costs in the 24months following an ATD admission. This information is important in understanding howthose with ATD use health services, and the factors that may influence future ATD care.Objectives: Describe the total cost burden and causes of readmissions in the 24 monthsfollowing an ATD admission.Methods: The study sample is comprised of all WA residents aged 35-84 years admitted toa Western Australian tertiary public hospital in 2007 with a primary diagnosis of ATD.Linked hospital morbidity and mortality data provided a 15-year look-back for morbidityand 2 years of follow-up. Published costs were linked to the hospital discharge DiagnosticRelated Group codes and converted to 2013 Australian dollars using health index deflators.

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