Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. Abstracts e259 Design and method: In this prospective cohort study with 54 patients suffering from resistent hypertension, 22 women and 32 men, 62 years old SEM ± 1.4, first diagnosed 13.8 years ago SEM ± 1.7, receiving 5.3 SEM ± 0.2 hypertension lowering agents, norepinephrine levels were measured at standardardised conditions before intervention and after 6 and 12 months. Two devices were used: Medtronic SimplicityTM (n = 45) and St. Jude Medical EnligHTNTM (n = 9) Patients hypertension was treated about 14 years with different combinations of medical therapy. Data analysis were performed with Graphpad Prism Software using the Student‘s t-test. A p-value < 0.05 indicates a statistically significant difference. Results: Please see images in the previous page. Conclusions: Norepinephrine levels, but not the duration of hypertension, could be a predictor for long time success in renal denervation. PP.23.18 ASSOCIATED FACTORS OF NOT ACHIEVING BLOOD PRESSURE GOALS IN TUNISIAN RESISTANT HYPERTENSION POPULATION: REAL WORLD PRACTICE H. Denguir, I . Yakdhane, C. Zrigue. Cardiology Departement, Gabes, TUNISIA Objective: Achieving blood pressure (BP) goals in resistant hypertension (RH) is important to prevent clinical complications such as stroke, aortic dissection, myocardial infarction, congestive heart failure, and renal failure. Scanty information is available on resistant hypertension in our country. This study allows us to assess the main risk factors of not achieving BP goals in a Tunisian RH population. Design and method: The study was carried out in 109 adults with RH living in the region of the southeast of Tunisia. According to BP goals achievement after 6 months, patients were divided into two groups: with (n = 68) and without BP goals achieving (n = 41). We aimed to determine the factors of non achieving BP goals. Results: Mean age of the patients was 70.3 ± 10.7 years and 62.4% were female. More than half of the subjects (53.2%) had diabetes mellitus, obese (33%), and (35.8%) with renal function impairment. Clinical BP values amounted to 146.4 ± 27.3/81.7 ± 13.6 mmHg despite the daily use of 3.7 ± 0.7 drugs and a medication adherence rate of 87.3%. BP goals were reached in 62.4% of the patients. In multivariate logistic regression analysis, not achieving BP goals in RH patients is more likely to be associated with cigarette smoking odds ratio (OR) 3.9, 95% confidence interval CI [0.94–16.09], obesity (OR) 2.65, 95% CI [1.04–6.78] and medication no-adherence (OR) 15.05, 95% CI [3.01–75.07]. Conclusions: In our RH patients, to achieve BP goals we should promote com- pliance to hypertension medications and reducing both cigarette smoking and obesity. PP.23.19 METABOLIC INDICATORS OF CARDIOVASCULAR DISEASES IN RESISTANT HYPERTENSION J. Walczewska, O. Siga, A. Dzieza-Grudnik, T. Grodzicki. Jagiellonian Univer- sity, Medical College, Department of Internal Medicine and Gerontology, Cra- cow, POLAND Objective: The aim of this study was to evaluate metabolic profile among patients with resistant hypertension (RHT) as well as to assess differences between subjects with newly diagnosed, well controlled and resistant hypertension (HT). Design and method: We examined 41 subjects with newly diagnosed HT without any treatment, 31 with controlled HT and 31 with RHT. We performed ABPM us- ing SpaceLabs 90207, 90217. Traditional metabolic risk factors of cardiovascular diseases (CVD) such a: age, sex, body mass index (BMI), waist-hip ratio (WHR) were assessed as well as plasma glucose level, total cholesterol, LDL, HDL, TAG, insulin, cortisol, high-sensitivity CRP (hsCRP) and glycated haemoglobin (HbA1c). One-way ANOVA and post-hoc Tukey tests were used to compare differences be- tween the groups. Results: The characteristics of three groups are summarized in table 1: Data in Table are presented as mean ± standard deviation(SD) or mediana[interquartile range] Statistically significant differences between groups are denoted: a–group 1 vs 2; b–group 1 vs3; c–group 2 vs 3 SBP–mean systolic blood pressure from 24 hours monitoring, DBP–mean diastolic blood pressure from 24 hours monitoring. Conclusions: Subjects with RHT were characterized by higher level of fasting glucose and HbA1c in spite of lack differences in BMI or WHR. Of note, no differ- ences in lipid profile or inflammation were observed between subjects with newly diagnosed hypertension, those with controlled HT or resistant hypertension. PP.23.20 PREVALENCE AND SEVERITY OF ERECTILE DYSFUNCTION IN PATIENTS WITH RESISTANT HYPERTENSION C. Boutari 1 , K.P. Imprialos 1 , K. Stavropoulos 1 , P. Kokkinos 2 , A. Pittaras 2 , C. Faselis 2 , K. Petidis 1 , P. Deligkaris 1 , N. Stavropoulos 1 , V. Athyros 1 , A. Karagiannis 1 , M Doumas 1 . 1 2nd Propedeutic Department of Internal Medi- cine, Aristotle University of Thessaloniki, Thessaloniki, GREECE, 2 Veteran Affairs Medical Center, Washington, DC, USA Objective: Erectile dysfunction is usually of vascular origin and is therefore com- mon in patients with essential hypertension. The prevalence of erectile dysfunc- tion in resistant hypertension has yet to be evaluated. The objective of our study was to estimate the prevalence and severity of erectile dysfunction in male pa- tients with resistant hypertension. Design and method: 124 consecutive male patients with resistant hypertension evaluated in our department’s hypertension outpatient clinic were included in our study. Resistant hypertension was defined according to the guidelines as blood pressure > 140/90 mmHg, despite the administration of at least three antihyper- tensive medications in maximum tolerated dose, including a diuretic. Erectile dys- function was estimated using the International Index of Erectile Function (IIEF) and a score below 26 was considered indicative of erectile dysfunction. Results: Only 5 patients had been asked whether they presented erectile problems and none of them had been requested to fill a relevant questionnaire. Erectile dysfunction was observed in 83 out of 124 patients of our study (66.9%). Erectile dysfunction was assessed as severe or moderate in the majority of our patients (61/83, 73.5%), whereas mild dysfunction was found in the remaining patients (22/63, 26.5%). Conclusions: Erectile dysfunction is particularly common among patients with resistant hypertension but unfortunately remains under-diagnosed in everyday clinical practice. Continuing medical education is essential for the timely diagno- sis and treatment of erectile dysfunction in order to improve the patients’ and their sexual partners’ quality of life. PP.23.21 THE HYPONATREMIC HYPERTENSIVE SYNDROME: WHEN SHOULD WE THINK ABOUT IT? R. Siliste, C. Homentcovschi, R. Ianula, D. Vasiliu, D. Spataru. Coltea Clinical Hospital, Internal Medicine and Cardiology Department, Bucharest, ROMANIA Objective: The hyponatremic hypertensive syndrome (HHS) was firstly described in pediatric patients. It is a rare, but serious complication of unilateral renal ste- nosis characterized by resistant hypertension and profound natriuresis. We report a patient with uncontrolled hypertension and severe hyponatremia, considered initially as being secondary to diuretic therapy.