The role of Lp-PLA2 as a significant biomarker of vascular inflammation was confirmed, and Lp-PLA2 seems to be closely correlated to cardiovascular events. It may be an important therapeutic target and may have an important role in prevention, risk stratification and personalised medicine.

Chronic venous disease (CVD) affects millions of people and negatively impacting the patient's quality of life (QoL) and most of the patients are diagnosed with CVD in advanced stages. The impact of newly diagnosed CVD on QoL has not been evaluated by other studies in Romania. The aim of this study was to assess the QoL for adult patients newly diagnosed with CVD addressing to the General Practitioner's (GP) office in Romania between June to August 2016. Patients included in the study were adult, signing the inform consent form, newly diagnosed with CVD or patients diagnosed with CVD, without CVD treatment the past 6 months. Data on demographic distribution, risk factors, clinical profiles, CVD symptomatology, QoL parameters, as well as pharmacological management practice were collected. The study included 1,893 patients (79.08% females) with 50.4% of patients in the age group 51-70 years. The most frequent CVD symptoms reported, were heavy leg sensation (85.74%), swelling of the feet (77.28%) and pain (73.11%). The most frequent CVD signs were telangiectasia and reticular veins (79.19%), varicose veins (65.77%) and edema (53.35%). The clinical, aetiological, anatomical and pathophysiological (CEAP) classification placed most of the patients in C3 class (31.85%), followed by C2 class (28.00%), C1 class (21.02%) and C4a (8.87%). Most of the patients reported 'low' or 'moderate' intensity of the CVD symptoms. QoL was affected for most of the patients at 'a mild' or 'moderate' degree, being noticed as a significant negative impact on physical, psychological, and social functioning components of QoL, correlated with CEAP class (P<0.001). Data regarding correlation of CEAP class, CVD symptoms and impact on QoL identified a significant correlation between all analyzed components (P<0.001). Study results prove that CVD diagnosis was established with relative delay and CVD is negatively affecting patients' QoL. Additional research will be needed to identify the long-term impact of CVD on QoL of the affected patients and their families.

Chronic venous disorder (CVD) is a complex disease, that affects millions of people worldwide, and due to the fact that in its early stages is often overlooked by healthcare providers and ignored by the patient, the assessment of incidence and prevalence of CVD is difficult to be made. The aim of this project was to assess the CVD prevalence, risk factors and clinical characteristics in the adult population in Romania. A cross-sectional survey was carried out in Romania from June 2015 to July 2015, including 185 general practitioners (GPs). Data regarding patient characteristics, risk factors, family medical history, CVD signs and symptoms, C-classification, and pharmacological management of CVD were collected. The study included 7,210 patients, predominantly female (71.0%), with the mean age of 58.2 years. Within the study population, 2,271 (31.5%) patients had already the CVD diagnosis established prior to the study visit, while for 2,664 (36.9%) patients, CVD was diagnosed during the visit, while for the rest of the patients, 2,275 (31.6%), CVD diagnosis was not established prior or during the study visit. Age, female, sex and previous pregnancies were major risk factors for developing CVD. The newly diagnosed CVD rate was 36.9% and the directly calculated CVD prevalence in June-July 2015 was 68.4%, while the indirectly calculated CVD prevalence was 80.7%. CVD is a very common disease, with a prevalence of CVD within the study population in June-July 2015 of 68.4%. The newly diagnosed CVD cases represent 36.9% of patients included in this study, nevertheless both parameters could be underestimated, as long as a significant percentage of patients presenting symptoms, but no CVD signs, were not considered by GPs as CVD cases.

Objective: To assess correlation between patient reported outcomes (PRO: socio-economic factors, depression level, and treatment adherence) and control of blood pressure (BP) and LDL-cholesterol (LDL-C). Design and method: This cross-sectional, observational, multicenter, epidemiological (SNAPSHOT-1) study included 2469 hypertensive patients with dyslipidemia, from outpatient clinics, recruited by cardiologists, diabetologists and general practitioners. Patients completed a three-part questionnaire including: (1) questions on socio-economic factors (education, marital status, working status, socio-professional category, incomes, and physical activity); (2) Patient Health Questionnaire (PHQ-9) (Depression scale); and (3) Hill-Bone Medication Adherence Scale (HBMAS) for hypertension and dyslipidemia (according to scoring guide, patients were considered as adherent if they answered “none of the time” or “some of the time” to specific questions). The correlations between PRO and control status and those between self-reported adherence and other PRO were assessed by logistic regression models (including variables with p-value<0.2 in univariate analyses on top of age, gender, and ethnicity). Results: Study population included 40.9% men, aged 65.0±10.0 years. Half of patients had depression symptoms (53.3%). The majority of patients self-reported being adherent to their hypertension (91.8%) and dyslipidemia (89.6%) treatments. Socio-economic factors are described in Table 1. Patients with higher socio-professional category (managerial), without depression symptoms, and good adherence to treatment were more likely to have their BP controlled. Patients with good adherence to treatment were more likely to have their LDL-C controlled (Table 2). Patients with higher socio-professional category, not married/not in relationship, physically active, and without depression symptoms were more likely to be adherent to antihypertensive treatment. Patients not married/not in relationship, physically active, and without depression symptoms were more likely to be adherent to lipid-lowering treatment. Higher education highly correlated with adherence to antihypertensive treatment (Table 3). Conclusions: Patient reported outcomes (PRO) correlate with BP and LDL-C control. Self-reported adherence to treatment also correlates with some socio-economic factors and with depression level. Thus, relevance of PRO assessment in routine clinical practice in patients with hypertension and dyslipidemia needs to be further evaluated.

Background Blood pressure (BP) and LDL-cholesterol control worldwide is still suboptimal. New European and American guidelines have introduced more strict recommendations regarding BP and LDL-cholesterol goals, but data of how difficult is to reach them in routine clinical practice is missing. Triple combination (preferably in a single pill) has been recommended as the 2nd step for the BP control, but data on its efficacy and treatment adherence is limited. Purpose To assess BP control at baseline, and after 6 months of optimized treatment with a single pill triple combination (of perindopril, amlodipine, and indapamide), and to assess associated risk factors control and treatment adherence. Methods In an observational, multicentric, prospective study, involving 209 investigators, we included 2077 patients (62±10 years; 49% men) with primary hypertension, in sinus rhythm, on current treatment with a single pill triple combination for at least one month prior to inclusion. General characteristics, cardiovascular risk factors, concomitant diseases, concomitant medications, fixed triple combination dosage, and adherence score were collected at baseline (V1), one month (V2), and 6 months (V3). Standardized office BP was measured with a single type sphygmomanometer, at each visit. Lipid profile was collected, if available. At V1 and V2, non-pharmacological and pharmacological treatment was optimized, according to the current guidelines. Results At baseline, BP control was suboptimal: only 37% of patients (38% of non-diabetic and 33% of diabetic patients) had optimal BP control as per ESC guidelines 2013, whereas only 10% of patients (11% of non-diabetic and 10% of diabetic patients) had optimal BP control as per ESC guidelines 2018. However, after 6 months of optimized treatment, 75% of patients (78% of non-diabetic and 67% of diabetic patients) had optimal BP control as per ESC guidelines 2013, while 33% of patients (33% of non-diabetic and 33% of diabetic patients) had optimal BP control as per ESC guidelines 2018. At baseline, despite that 52% of patients were on a statin, only 12% of patients at very high cardiovascular risk had an LDL-cholesterol<70 mg/dl, while only 25% of patients at high cardiovascular risk had a LDL-cholesterol<100 mg/dl; at 6 months, 13% of patients at very high cardiovascular risk had an LDL-cholesterol<70 mg/dl, while 30% of patients at high cardiovascular risk had a LDL-cholesterol<100 mg/dl. Single pill triple combination dose was increased at V1 in 29% of patients, and at V2 in 7% of patients. Adherence score increased from 7.0±1.6 at V1 to 7.4±1.1 at V3 (p<0.001). Conclusion BP control and LDL-cholesterol control, according to the new guidelines, is far from optimal. However, by optimizing non-pharmacological treatment and increasing dosing and adherence of a single pill triple combination, BP control can be markedly improved. Acknowledgement/Funding Servier Pharma