The role of physical activity in the prevention and management of hypertension and obesity

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "The role of physical activity in the prevention and management of hypertension and obesity"

Transcription

1 The 1 st World Congress on Controversies in Obesity, Diabetes and Hypertension (CODHy) Berlin, October The role of physical activity in the prevention and management of hypertension and obesity R. Fagard, MD, PhD 2, Hypertension and Cardiovascular Rehabilitation Unit, University of Leuven K.U.Leuven, Belgium

2 Physical exercise and blood pressure - Epidemiological studies - Update on intervention studies: updated meta-analyses of randomized controlled trials - Recommendations

3 Epidemiological studies (1) Several large epidemiological studies which allowed for age and anthropometric characteristics have reported an inverse relationship between blood pressure and either habitual physical activity or physical fitness. The difference in blood pressure between the most and the least physically active or fit usually amounted to no more than 5 mmhg In addition, longitudinal observational studies found that physical activity and fitness are inversely related to the later development of hypertension

4 Epidemiological studies (2) However, it remains difficult to ascribe these findings to physical activity or fitness per se because of possibly interfering confounding factors Therefore, well-controlled intervention studies with random allocation to exercise or control are mandatory to further explore the relationship between exercise and blood pressure, and other cardiovascular risk factors

5 Physical exercise and blood pressue according to type of physical exercise Dynamic aerobic endurance training: training programs that involve large muscle groups in dynamic activities, designed specifically to increase aerobic endurance performance Resistance training: training programs that involve strength, weight, static and/or isometric training, designed specifically to increase muscular strength, power and/or endurance

6 Effects of endurance training on blood pressure, blood pressure regulating mechanisms and cardiovascular risk factors Cornelissen VA, Fagard RH Hypertension 2005; 46:

7 Our aim was to perform a comprehensive metaanalysis of the literature on the effects of dynamic aerobic endurance training on: - resting blood pressure, - ambulatory blood pressure, - hemodynamic and neurohumoral mechanisms, and - cardiovascular risk factors, including anthropometric characteristics, blood lipids and insulin sensitivity (Cornelissen & Fagard, Hypertension 2005)

8 Dynamic aerobic endurance training Selection of studies Randomized controlled trials, involving dynamic aerobic endurance exercise training of at least 4 weeks duration Parallel group and/or cross-over design Adult normotensive and/or hypertensive subjects Exclusion of cardiovascular (and other) diseases Reporting of (changes of) blood pressure Published in peer-reviewed journal

9 Dynamic aerobic endurance training Selected studies Number of studies: 72 Number of subjects: randomized: 3936 (median n per study: 32; range: 8-357) analysed: 3394 (overall: 88.7%; range : %) Number of study groups: 105 Demographic characteristics: Gender: ~ 57% men Age: median of group averages: 46.6 yr; range yr

10 Dynamic aerobic endurance training Characteristics of the training program Total duration (weeks) Frequency (n/week) Time/session* (min) Net intensity (%) Mode 16 (4-52) 3 (1-7) 40 (15-63) 65 (30-87) mainly walking, jogging, running, and/or cycling Values are median and range of study groups * Excluding warm-up and cool-down periods There are no significant differences among the three groups according to baseline blood pressure

11 Dynamic aerobic endurance training General characteristics Subgroups according to baseline BP All Optimal (High)Normal Hypertension P N of study groups N of trained subjects Age (yr) * 52.7* <0.001 Peak VO 2 (ml/min/kg) NS Heart rate (b/min) NS BMI (kg/m 2 ) * <0.05 Values are unweighted means Overall P-value for comparison of blood pressure subgroups * P 0.05 compared with optimal blood pressure group

12 Dynamic aerobic endurance training Overall results N Baseline Net change (95% CL) Peak VO 2 (ml/min/kg) (+3.5; +4.5) Heart rate (b/min) (-5.7; -3.9) Weight (kg) (-1.5; -0.9) Body fat (%) (-1.8; -1.0) Values are means, weighted for the number of trained participants Overall P < and among group P = NS for all variables Baseline body mass index: 26.5 kg/m 2

13 Dynamic aerobic endurance training Results: Anthropometric characteristics N Baseline Net change (95% CL) P Weight (kg)* (-1.5;-0.9) < Body fat (%) (-1.8;-1.0) < Waist circumference (cm) (-4.0;-1.7) < Waist-to-hip ratio (-0.018; ) < 0.05 Values are means, weighted for the number of trained participants * Baseline body mass index: 26.5 kg/m² Overall % change in 14 study groups: -2.3% (-3.3;-1.3); P < 0.001

14 Dynamic aerobic endurance training Overall results on blood pressure (mmhg) N Baseline Net change (95% CL) Resting blood pressure - systolic (-4.0; -2.0) - diastolic (-3.1; -1.7) Daytime ambulatory BP - systolic 11 - diastolic (-5.8; -0.9) -3.5 (-5.2; -1.9) Values are means, weighted for the number of trained participants Overall P < for resting BP, and < 0.01 for ambulatory BP 24 h BP in 2 trials which only reported 24 h BP

15 (Van Hoof et al, Am J Cardiol 1989; 63 : )

16 Overall results on haemodynamics

17 Dynamic aerobic endurance training Overall results on daytime and night-time blood pressure (mmhg) N Baseline Net change (95% CL) Daytime BP -systolic (-5.8;-0.9)** -diastolic (-5.2;-1.9)** Night-time BP -systolic (-2.8; +1.6) -diastolic (-2.5; +0.5) Values are means, weighted for the number of trained participants; ** P 0.01

18 Dynamic aerobic endurance training Results on blood pressure in BP subgroups (mm Hg) N Baseline Net change (95% CL) Optimal BP - systolic - diastolic (-4.2; -0.6)** -1.6 (-2.4; -0.7)* (High)Normal - systolic - diastolic (-3.1; -0.3)* -1.7 (-2.6; -0.7) + Hypertension - systolic - diastolic (-9.1; -4.6) (-6.5; -3.3) + Values are means, weighted for the number of trained participants *P 0.05; ** P 0.01; + P 0.001

19 DYNAMIC AEROBIC ENDURANCE TRAINING Results according to baseline body mass index (25 kg/m²) Mean weighted net changes (1) N Lean N Overweight Peak VO 2 (ml/min/kg) Heart rate (b/min) BMI (kg/m²) (+2.6; + 4.4) (-6.6; -3.2) (-0.33; ) (+3.2; +4.6) (-5.7; -3.2) (-0.60; -0.31) Values are weighted means (95% CL)

20 DYNAMIC AEROBIC ENDURANCE TRAINING Results according to baseline body mass index (25 kg/m²) Mean weighted net changes (2) Blood pressure (mm Hg) - systolic - diastolic N Lean N Overweight (-5.1; -1.6) (-3.5; -1.6) (-4.7; -1.9) (-3.7; -1.2) Values are weighted means (95% CL)

21 DYNAMIC AEROBIC ENDURANCE TRAINING AND BLOOD PRESSURE Mechanisms Haemodynamic and basic mechanisms of training-induced changes in blood pressure

22 Dynamic aerobic endurance training Mechanisms of the training-induced changes in blood pressure Change in weight/bmi? Sympathetic nervous system? Renin-angiotensin-aldosterone system? Insulin sensitivity? Endothelial function? Prostaglandins?

23 Net change in BP vs net change in BMI Systolic BP Diastolic BP Fagard, Med Sci Sports Exerc 1999; 31 : S624-S630

24 Dynamic aerobic endurance training Plasma norepinephrine (PNE) and renin activity (PRA) N Net % change P (95% CL) PNE (-40; -18) < PRA (-35; -4.7) < 0.05 Values are means, weighted for the number of trained participants

25 (Van Hoof et al, Am J Cardiol 1989; 63 : )

26 Dynamic aerobic endurance training Insulin sensitivity N Baseline Net change (95% CL) Glucose (mmol/l) (-0.20;-0.11) + (mg/dl) (-3.55;-1.92) + Insulin (IU/L) (-2.2;-0.53)** HOMA-index (-0.53;-0.094)** Values are means, weighted for the number of trained participants **P 0.01; + P HOMA-index: [(glucose(mmol/l)*insulin(iu/l))/22.5]

27 Dynamic aerobic endurance training Blood lipids N Baseline Net change (95% CL) P Cholesterol (mg/dl) - total (-5.03;+1.74) NS - HDL (+0.19;+2.28) < LDL (-11.6;+5.80) NS Triglycerides (mg/dl) (-21.3;+0.84) = 0.07 Values are means, weighted for the number of trained participants

28 Dynamic aerobic endurance training Conclusions Dynamic aerobic endurance training decreases blood pressure through a reduction of systemic vascular resistance, in which the sympathetic nervous system and the renin-angiotensin system appear to be involved, and favourably affects cardiovascular risk factors The training-induced blood pressure reduction is more pronounced in hypertensives than in non-hypertensives and is observed in lean and overweight subjects

29 Effect of resistance exercise on resting blood pressure A meta-analysis of randomized controlled trials Cornelissen VA, Fagard RH Journal of Hypertension 2005; 23:

30 Resistance training and blood pressure Selection of studies Randomized controlled trials, involving strength, weight, static and/or isometric training ( resistance training), designed specifically to increase muscular strength, power and/or endurance, and lasting at least 4 weeks Parallel group and/or cross-over design Adult normotensive and/or hypertensive subjects Exclusion of cardiovascular (and other) diseases Reporting (of changes) of blood pressure Published in peer-reviewed journal

31 Resistance training and blood pressure Selected studies Number of studies: 9 Number of subjects: randomized: 341 (median n per study: 26; range 20-84) analysed: 290 (overall: 85%; range: %) Number of study groups: 12 (normotension: 9; hypertension: 3) Demographic characteristics gender: 61% men age: range of group averages: yr

32 Resistance training and blood pressure Characteristics of the training programs Total duration (weeks) Frequency (n/week) Time/session (min) Intensity (% of 1 RM) Mode 14 (6-26) 3 (N=10); 2 (N=2)? 70 (30-90) conventional (N=8) circuit (N=3) static (N=1) Values are median and range of study groups, or number of study groups (N)

33 Resistance training and blood pressure Overall results N Baseline N Net change (95% CL) Age / / Peak VO 2 (ml/min/kg) (+0.3; +4.8)* Heart rate (b/min) (-1.7; +3.7) NS Weight (kg) (-2.7; +3.4) NS Body fat (%) (-1.6; -0.25)** N: number of study groups Values are means, weighted for the number of trained participants * P 0.05; ** P 0.01

34 Resistance training and blood pressure Overall results on blood pressure (mmhg) N Baseline Net change (95% CL) P Weighted for the number of trained participants Systolic (-7.1; +0.7) = 0.10 Diastolic (-6.1; -0.9) < 0.01 Weighted for the inverse of the variance of BP Systolic (-10.4; -1.6) < 0.01 Diastolic (-8.1; -1.4) < 0.01 N: number of study groups Values are means, weighted for the number of trained participants

35 Resistance training and blood pressure Conclusions Moderate intensity resistance training is able to decrease blood pressure, and could become part of the non-pharmacological intervention strategy to prevent and combat high blood pressure However, additional studies are needed, especially in the hypertensive population

36 Recommendations

37 RECOMMENDATIONS American College of Sports Medicine Position Stand: Exercise and Hypertension Pescatello, Franklin, Fagard, Farquhar, Kelley & Ray Medicine and Science in Sports and Exercise 2004; 36: Exercise is a cornerstone therapy for the primary prevention, treatment and control of hypertension Based upon the current evidence the following exercise prescription is recommended: frequency: on most, preferably all days of the week intensity: moderate intensity (40 - <60% of VO 2 reserve) time: 30 min of continuous or accumulated physical activity per day type: primarily endurance physical activity supplemented by resistance exercise

38 DYNAMIC AEROBIC ENDURANCE TRAINING AND BLOOD PRESSURE Influence of training intensity

39 Net change in BP vs training intensity Metaregression analysis Systolic BP Diastolic BP Fagard, Med Sci Sports Exerc 2001; 33 : S484-S492

40 Change in BP vs training intensity Studies comparing different training intensities Systolic BP Diastolic BP Fagard, Med Sci Sports Exerc 2001; 33; S484-S492

41 DYNAMIC AEROBIC ENDURANCE TRAINING VS DIET (CALORIC RESTRICTION) Fagard RH, Med Sci Sports Exerc 1999; 31: S624-S630

42 DYNAMIC TRAINING VS DIET Selection of studies Comparative trials of exercise vs diet, and/or exercise + diet vs diet alone Random group allocation Exclusion of cardiovascular (and other) diseases Reporting of (changes of) blood pressure at rest Published in peer-reviewed journal

43 DYNAMIC TRAINING VS DIET Selected studies Number of studies: 10 Number of comparisons: exercise vs diet: 11 exercise + diet vs diet: 11 Number of subjects: 1,087

44 DYNAMIC TRAINING VS DIET Baseline data N Exercise Diet Age (yr) (45.9; 53.9) Peak VO (ml/min/kg) (28.5; 34.8) BMI (kg/m²) (26.9; 29.6) SBP (mm Hg) (120.1; 131.1) DBP (mm Hg) (77.5; 86.1) Values are weighted means (95 % CL) 49.3 (45.2; 53.4) 31.4 (28.3; 34.5) 28.6 (27.1; 30.1) (118.8; 130.1) 80.9 (77.0; 84.8)

45 DYNAMIC TRAINING VS DIET Mean weighted changes Peak VO 2 (ml/min/kg) BMI (kg/m²) SBP (mm Hg) DBP (mm Hg) N Exercise Diet P < 0.01 (+2.3; +4.4) (-0.2; +2.1) < 0.01 (-0.67; -0.17) (-2.18; -0.97) < 0.01 (-5.2; -2.0) (-7.7; -4.1) < 0.05 (-3.8; -1.7) (-5.9; -2.4) Values are weighted means (95% CL)

46 DYNAMIC TRAINING VS DIET Baseline data N Exercise + diet Diet Age (yr) (45.4; 51.6) Peak VO (ml/min/kg) (25.2; 34.2) BMI (kg/m²) (27.1; 30.1) SBP (mm Hg) (120.1; 138.7) DBP (mm Hg) (77.0; 89.2) Values are weighted means (95% CL) 48.7 (45.6; 51.8) 29.1 (24.3; 33.8) 28.6 (27.0; 30.2) (120.1; 136.5) 82.1 (76.6; 87.6)

47 DYNAMIC TRAINING VS DIET Mean weighted changes N Exercise + diet Diet P Peak VO 2 (ml/min/kg) BMI (kg/m²) SBP (mm Hg) DBP (mm Hg) (+4.1; +6.6) (-2.73; -1.35) (-9.9; -4.4) (-7.5; -3.4) (-0.03; +1.7) (-2.37; -0.95) (-9.8; -3.9) (-6.0; -2.4) < < Values are weighted means (95% CL)

48 DYNAMIC TRAINING VS DIET Conclusions - Exercise appears to be less effective than diet in lowering body weight and blood pressure - The reduction of body weight was more pronounced when diet was combined with exercise than with diet alone, but there was no greater reduction in blood pressure with the combined intervention

49

50 EXERCISE AND HYPERTENSION Recommendations: pharmacological therapy When drug therapy is indicated in physically active people it should, ideally lower blood pressure not only at rest, but also during exertion not adversely affect exercise capacity decrease systemic vascular resistance Calcium channel blockers and ACE-inhibitors (or AT II receptor blockers) are currently the drugs of choice for the initiation of treatment in the exercising patient Diuretics and beta-blockers are not recommended; they may decrease exercise performance, cause electrolyte disturbances and/or may be on the doping list for some sports Calcium channel blockers and ACE-inhibitors (or AT II receptor blockers) can be combined for better blood pressure control If a third drug is required, a low-dose thiazide-like diuretic, possibly in combination with a potassium sparing agent, can be recommended

51 Recommendations ESC Study Group on Sports Cardiology - Recommendations for competitive sports participation in athletes with cardiovascular disease Pelliccia A, Fagard R, Björnstad HH et al. European Heart Journal 2005; 26: ESC Study Group on Sports Cardiology Recommendations for participation in leisure-time physical activities and competitive sports for patients with hypertension Fagard RH, Björnstad HH, Borjesson M et al. European Journal of Cardiovascular Prevention and Rehabilitation 2005; 12:

Depok-Indonesia STEPS Survey 2003

Depok-Indonesia STEPS Survey 2003 The STEPS survey of chronic disease risk factors in Indonesia/Depok was carried out from February 2003 to March 2003. Indonesia/Depok carried out Step 1, Step 2 and Step 3. Socio demographic and behavioural

More information

Know Your Number Aggregate Report Single Analysis Compared to National Averages

Know Your Number Aggregate Report Single Analysis Compared to National Averages Know Your Number Aggregate Report Single Analysis Compared to National s Client: Study Population: 2242 Population: 3,000 Date Range: 04/20/07-08/08/07 Version of Report: V6.2 Page 2 Study Population Demographics

More information

University of Padova, Padua, Italy, and HARVEST Study Group, Italy

University of Padova, Padua, Italy, and HARVEST Study Group, Italy University of Padova, Padua, Italy, and HARVEST Study Group, Italy ISOLATED SYSTOLIC HYPERTENSION IN THE YOUNG DOES NOT IMPLY AN INCREASED RISK OF FUTURE HYPERTENSION NEEDING TREATMENT Mos L, Saladini

More information

Treadmill Workstations: A Worksite Physical Activity Intervention

Treadmill Workstations: A Worksite Physical Activity Intervention Treadmill Workstations: A Worksite Physical Activity Intervention Dinesh John, Ph.D. 1,2 Dixie L. Thompson, Ph.D., FACSM 1 Hollie Raynor 1, Ph.D. 1 Kenneth M. Bielak. M.D. 1 David R. Bassett, Ph.D., FACSM

More information

High intensity exercise improves cardiac structure and function and reduces liver fat in adults with Type 2 diabetes

High intensity exercise improves cardiac structure and function and reduces liver fat in adults with Type 2 diabetes High intensity exercise improves cardiac structure and function and reduces liver fat in adults with Type 2 diabetes Sophie Cassidy, s.cassidy@ncl.ac.uk 1) Concentric remodelling 1.2 * Eccentricity ratio

More information

Jared Moore, MD, FACP

Jared Moore, MD, FACP Hypertension 101 Jared Moore, MD, FACP Assistant Program Director, Internal Medicine Residency Clinical Assistant Professor of Internal Medicine Division of General Medicine The Ohio State University Wexner

More information

Mesures non médicamenteuses pour prévenir et traiter une hypertension artérielle. JM Krzesinski Service de Néphrologie- Hypertension ULg-CHU Liège

Mesures non médicamenteuses pour prévenir et traiter une hypertension artérielle. JM Krzesinski Service de Néphrologie- Hypertension ULg-CHU Liège Mesures non médicamenteuses pour prévenir et traiter une hypertension artérielle JM Krzesinski Service de Néphrologie- Hypertension ULg-CHU Liège Disclosure No competing interest to declare about this

More information

Effects of Bariatric Surgery in Obese Patients with Hypertension The GATEWAY Randomized Trial

Effects of Bariatric Surgery in Obese Patients with Hypertension The GATEWAY Randomized Trial Effects of Bariatric Surgery in Obese Patients with Hypertension The GATEWAY Randomized Trial Carlos Aurelio Schiavon, MD, FACS On behalf of the GATEWAY Executive Committee and Investigators DISCLOSURE

More information

Socio-economic risk factors in the community-based PEP Family Heart Study

Socio-economic risk factors in the community-based PEP Family Heart Study Socio-economic risk factors in the community-based PEP Family Heart Study Gerda-Maria Haas 1. Evelyn Liepold 1. Peter Schwandt 1,2 1 Arteriosklerose-Praeventions-Institut. Muenchen - Nuernberg (Germany)

More information

Effects of Bariatric Surgery in Obese Patients with Hypertension The GATEWAY Randomized Trial

Effects of Bariatric Surgery in Obese Patients with Hypertension The GATEWAY Randomized Trial Effects of Bariatric Surgery in Obese Patients with Hypertension The GATEWAY Randomized Trial Carlos Aurelio Schiavon, MD, FACS On behalf of the GATEWAY Executive Committee and Investigators DISCLOSURE

More information

Cedars Sinai Diabetes. Michael A. Weber

Cedars Sinai Diabetes. Michael A. Weber Cedars Sinai Diabetes Michael A. Weber Speaker Disclosures I disclose that I am a Consultant for: Ablative Solutions, Boston Scientific, Boehringer Ingelheim, Eli Lilly, Forest, Medtronics, Novartis, ReCor

More information

Guidelines on cardiovascular risk assessment and management

Guidelines on cardiovascular risk assessment and management European Heart Journal Supplements (2005) 7 (Supplement L), L5 L10 doi:10.1093/eurheartj/sui079 Guidelines on cardiovascular risk assessment and management David A. Wood 1,2 * 1 Cardiovascular Medicine

More information

Results/ conclusion. Reference Duration Number subjects. Study description. Limitations of the data. Randomized controlled trial (RCT)

Results/ conclusion. Reference Duration Number subjects. Study description. Limitations of the data. Randomized controlled trial (RCT) (original) Appel, 1997 8 weeks 459 459 ; all received a control SAD for 3 weeks then randomized to (i) control (ii) a diet rich in fruits and veg (FV) or (iii) a combination diet (combo) rich in fruits,

More information

Research Article Comparison of Different Anthropometric Measurements and Inflammatory Biomarkers

Research Article Comparison of Different Anthropometric Measurements and Inflammatory Biomarkers International Inflammation Volume 2012, Article ID 124693, 5 pages doi:10.1155/2012/124693 Research Article Comparison of Different Anthropometric Measurements and Inflammatory Biomarkers Yaron Arbel,

More information

PFIZER INC. THERAPEUTIC AREA AND FDA APPROVED INDICATIONS: See USPI.

PFIZER INC. THERAPEUTIC AREA AND FDA APPROVED INDICATIONS: See USPI. PFIZER INC. These results are supplied for informational purposes only. Prescribing decisions should be made based on the approved package insert. For publications based on this study, see associated bibliography.

More information

Metabolic Consequences of Anti Hypertensives: Is It Clinically Important?

Metabolic Consequences of Anti Hypertensives: Is It Clinically Important? Metabolic Consequences of Anti Hypertensives: Is It Clinically Important?,FACA,FICA,MASH,FVBWG,MISCP CONSULTANT OF CARDIOLOGY DIRECTOR OF PORT-FOUAD HOSPITAL CCU Consideration of antihypertensive agents

More information

hypertension Head of prevention and control of CVD disease office Ministry of heath

hypertension Head of prevention and control of CVD disease office Ministry of heath hypertension t. Samavat MD,Cadiologist,MPH Head of prevention and control of CVD disease office Ministry of heath RECOMMENDATIONS FOR HYPERTENSION DIAGNOSIS, ASSESSMENT, AND TREATMENT Definition of hypertension

More information

SECONDARY HYPERTENSION

SECONDARY HYPERTENSION HYPERTENSION Hypertension is the clinical term used to describe a high blood pressure of 140/90 mmhg or higher (National Institute of Health 1997). It is such a health risk the World Health Organisation

More information

Epicardial adipose tissue in children is associated with an unfavorable cardiometabolic risk profile, but is not a stronger indicator than BMI

Epicardial adipose tissue in children is associated with an unfavorable cardiometabolic risk profile, but is not a stronger indicator than BMI Epicardial adipose tissue in children is associated with an unfavorable cardiometabolic risk profile, but is not a stronger indicator than BMI Schusterova I., Joppova E., Stromplova D., Fatulova N., Tohatyova

More information

ABSTRACT. Lance C. Dalleck 1, Devan E. Haney 1, Christina A. Buchanan 1, Ryan M. Weatherwax 1 ORIGINAL RESEARCH. Purpose:

ABSTRACT. Lance C. Dalleck 1, Devan E. Haney 1, Christina A. Buchanan 1, Ryan M. Weatherwax 1 ORIGINAL RESEARCH. Purpose: ORIGINAL RESEARCH Lance C. Dalleck 1, Devan E. Haney 1, Christina A. Buchanan 1, Ryan M. Weatherwax 1 ABSTRACT 1 Purpose: responses when exposed to regular exercise training. The purpose of this study

More information

Module 2. Global Cardiovascular Risk Assessment and Reduction in Women with Hypertension

Module 2. Global Cardiovascular Risk Assessment and Reduction in Women with Hypertension Module 2 Global Cardiovascular Risk Assessment and Reduction in Women with Hypertension 1 Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored,

More information

Hypertension Management Controversies in the Elderly Patient

Hypertension Management Controversies in the Elderly Patient Hypertension Management Controversies in the Elderly Patient Juan Bowen, MD Geriatric Update for the Primary Care Provider November 17, 2016 2016 MFMER slide-1 Disclosure No financial relationships No

More information

Secondary prevention and systems approaches: Lessons from EUROASPIRE and EUROACTION

Secondary prevention and systems approaches: Lessons from EUROASPIRE and EUROACTION Secondary prevention and systems approaches: Lessons from EUROASPIRE and EUROACTION Dr Kornelia Kotseva National Heart & Lung Insitute Imperial College London, UK on behalf of all investigators participating

More information

Metabolic Syndrome and Chronic Kidney Disease

Metabolic Syndrome and Chronic Kidney Disease Metabolic Syndrome and Chronic Kidney Disease Definition of Metabolic Syndrome National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III Abdominal obesity, defined as a waist circumference

More information

LONG-TERM EFFECTS OF SURGICAL MENAGEMENT OF PRIMARY ALDOSTERONISM ON THE CARDIOVASCULAR SISTEM

LONG-TERM EFFECTS OF SURGICAL MENAGEMENT OF PRIMARY ALDOSTERONISM ON THE CARDIOVASCULAR SISTEM LONG-TERM EFFECTS OF SURGICAL MENAGEMENT OF PRIMARY ALDOSTERONISM ON THE CARDIOVASCULAR SISTEM Riccardo Marsili, Pietro Iacconi, Massimo Chiarugi, Giampaolo Bernini*, Alessandra Bacca*, Paolo Miccoli Department

More information

Objectives. Describe results and implications of recent landmark hypertension trials

Objectives. Describe results and implications of recent landmark hypertension trials Hypertension Update Daniel Schwartz, MD Assistant Professor of Medicine Associate Medical Director of Heart Transplantation Temple University School of Medicine Disclosures I currently have no relationships

More information

Metoprolol Succinate SelokenZOC

Metoprolol Succinate SelokenZOC Metoprolol Succinate SelokenZOC Blood Pressure Control and Far Beyond Mohamed Abdel Ghany World Health Organization - Noncommunicable Diseases (NCD) Country Profiles, 2014. 1 Death Rates From Ischemic

More information

Val-MARC: Valsartan-Managing Blood Pressure Aggressively and Evaluating Reductions in hs-crp

Val-MARC: Valsartan-Managing Blood Pressure Aggressively and Evaluating Reductions in hs-crp Página 1 de 5 Return to Medscape coverage of: American Society of Hypertension 21st Annual Scientific Meeting and Exposition Val-MARC: Valsartan-Managing Blood Pressure Aggressively and Evaluating Reductions

More information

Supplementary Appendix

Supplementary Appendix Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Wanner C, Inzucchi SE, Lachin JM, et al. Empagliflozin and

More information

physiological changes that make a efficient and better able to deliver

physiological changes that make a efficient and better able to deliver Exercise Training Exercise training induces many physiological changes that make a conditioned individual more efficient and better able to deliver and use the oxigen and nutrients and resist fatigue.

More information

Hypertension, Hyperlipidemia and Obesity. Mi-CCSI

Hypertension, Hyperlipidemia and Obesity. Mi-CCSI Hypertension, Hyperlipidemia and Obesity Mi-CCSI Objectives Review the prevalence of hypertension, hyperlipidemia and obesity Correlation of the 3 conditions Discuss why it is important to treat these

More information

Management of Hypertension in special groups. DR-Mohammed Salah Assistant Lecturer of Cardiology Mansoura University

Management of Hypertension in special groups. DR-Mohammed Salah Assistant Lecturer of Cardiology Mansoura University Management of Hypertension in special groups BY DR-Mohammed Salah Assistant Lecturer of Cardiology Mansoura University AGENDA SPECIAL GROUPS SPECIFIC DRUDS FOR SPECIAL GROUPS TARGET BP FOR SPECIAL GROUPS:

More information

The combined effect of physical exercise and weight change on change in blood pressure: The HUNT study, Norway

The combined effect of physical exercise and weight change on change in blood pressure: The HUNT study, Norway Britha Kjellbotn The combined effect of physical exercise and weight change on change in blood pressure: The HUNT study, Norway BEV3901 Master Thesis Human Movement Science Programme Norwegian University

More information

Cardiovascular Health Practice Guideline Outpatient Management of Coronary Artery Disease 2003

Cardiovascular Health Practice Guideline Outpatient Management of Coronary Artery Disease 2003 Authorized By: Medical Management Guideline Committee Approval Date: 12/13/01 Revision Date: 12/11/03 Beta-Blockers Nitrates Calcium Channel Blockers MEDICATIONS Indicated in post-mi, unstable angina,

More information

Optimizing risk assessment of total cardiovascular risk What are the tools? Lars Rydén Professor Karolinska Institutet Stockholm, Sweden

Optimizing risk assessment of total cardiovascular risk What are the tools? Lars Rydén Professor Karolinska Institutet Stockholm, Sweden Optimizing risk assessment of total cardiovascular risk What are the tools? Lars Rydén Professor Karolinska Institutet Stockholm, Sweden Cardiovascular Disease Prevention (CVD) Three Strategies for CVD

More information

Total risk management of Cardiovascular diseases Nobuhiro Yamada

Total risk management of Cardiovascular diseases Nobuhiro Yamada Nobuhiro Yamada The worldwide burden of cardiovascular diseases (WHO) To prevent cardiovascular diseases Beyond LDL Multiple risk factors With common molecular basis The Current Burden of CVD CVD is responsible

More information

Clinical cases with Coversyl 10 mg

Clinical cases with Coversyl 10 mg Clinical cases Coversyl 10 mg For upgraded benefits in hypertension A Editorial This brochure, Clinical cases Coversyl 10 mg for upgraded benefits in hypertension, illustrates a variety of hypertensive

More information

Absolute cardiovascular disease risk management

Absolute cardiovascular disease risk management Quick reference guide for health professionals Absolute cardiovascular disease risk management This quick reference guide is for use by health professionals for primary prevention of cardiovascular disease

More information

Best Therapy for Resistant Hypertension: The PATHWAY-2 2 Study

Best Therapy for Resistant Hypertension: The PATHWAY-2 2 Study Best Therapy for Resistant Hypertension: The PATHWAY-2 2 Study Antonio Coca MD, PhD, FRCP, FESC Council on Hypertension. European Society of Cardiology Hypertension and Vascular Risk Unit. Department of

More information

2/11/2017. Weighing the Heavy Cardiovascular Burden of Obesity and the Obesity Paradox. Disclosures. Carl J. Lavie, MD, FACC, FACP, FCCP

2/11/2017. Weighing the Heavy Cardiovascular Burden of Obesity and the Obesity Paradox. Disclosures. Carl J. Lavie, MD, FACC, FACP, FCCP Weighing the Heavy Cardiovascular Burden of Obesity and the Obesity Paradox Carl J. Lavie, MD, FACC, FACP, FCCP Professor of Medicine Medical Director, Cardiac Rehabilitation and Preventive Cardiology

More information

Text-based Document. Predicting Factors of Body Fat of Metabolic Syndrome Persons. Downloaded 13-May :51:47.

Text-based Document. Predicting Factors of Body Fat of Metabolic Syndrome Persons. Downloaded 13-May :51:47. The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based

More information

The Evolution To Treatment Of Hypertension With Advanced Formulation

The Evolution To Treatment Of Hypertension With Advanced Formulation The Evolution To Treatment Of Hypertension With Advanced Formulation Dr. Donald Ang MBChB (UK) FRCP (Edin) MD (UK) CCST Cardiology (UK) FESC (Europe) Consultant Cardiologist Island Hospital Penang High

More information

By Prof. Khaled El-Rabat

By Prof. Khaled El-Rabat What is The Optimum? By Prof. Khaled El-Rabat Professor of Cardiology - Benha Faculty of Medicine HT. Introduction Despite major worldwide efforts over recent decades directed at diagnosing and treating

More information

Journal of the American College of Cardiology Vol. 48, No. 2, by the American College of Cardiology Foundation ISSN /06/$32.

Journal of the American College of Cardiology Vol. 48, No. 2, by the American College of Cardiology Foundation ISSN /06/$32. Journal of the American College of Cardiology Vol. 48, No. 2, 2006 2006 by the American College of Cardiology Foundation ISSN 0735-1097/06/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2006.03.043

More information

ANTI- HYPERTENSIVE AGENTS

ANTI- HYPERTENSIVE AGENTS CLINICAL ANTI- HYPERTENSIVE AGENTS Jacqueline van Schoor, MPharm, BSc (Hons) Amayeza Info Centre Hypertension represents a major public health concern. It affects about a billion people worldwide and is

More information

The New Hypertension Guidelines

The New Hypertension Guidelines The New Hypertension Guidelines Joseph Saseen, PharmD Professor and Vice Chair, Department of Clinical Pharmacy University of Colorado Anschutz Medical Campus Disclosure Joseph Saseen reports no conflicts

More information

THE EFFECT OF WEIGHT LOSS AND EXERCISE ON CARDIOVASCULAR STRUCTURE AND FUNCTION IN CLASS II AND III OBESE WOMEN. Steven David Verba

THE EFFECT OF WEIGHT LOSS AND EXERCISE ON CARDIOVASCULAR STRUCTURE AND FUNCTION IN CLASS II AND III OBESE WOMEN. Steven David Verba THE EFFECT OF WEIGHT LOSS AND EXERCISE ON CARDIOVASCULAR STRUCTURE AND FUNCTION IN CLASS II AND III OBESE WOMEN by Steven David Verba B.S., Slippery Rock University, 2007 M.S., University of Pittsburgh,

More information

Environmental. Vascular / Tissue. Metabolics

Environmental. Vascular / Tissue. Metabolics Global Risk Reduction--WINS Picking Mom and Dad-2016 Environmental Vascular / Tissue Metabolics Stop smoking-1b Physical activity-1b Weight control-1b Chelation therapy-3c Influenza vaccination-1b Blood

More information

Welcome! ACE Personal Trainer Virtual Exam Review: Module 5. Laura Abbott, MS, LMT. What We ll Cover This Module

Welcome! ACE Personal Trainer Virtual Exam Review: Module 5. Laura Abbott, MS, LMT. What We ll Cover This Module Welcome! ACE Personal Trainer Virtual Exam Review: Module 5 Laura Abbott, MS, LMT Master s Degree, Sports Medicine Licensed Massage Therapist Undergraduate degree in Exercise Science Instructor of Kinesiology,

More information

Hypertension Pharmacotherapy: A Practical Approach

Hypertension Pharmacotherapy: A Practical Approach Hypertension Pharmacotherapy: A Practical Approach Ronald Victor, MD Burns & Allen Chair in Cardiology Director, The Hypertension Center Associate Director, The Heart Institute Hypertension Center 1. 2.

More information

Case Study: Chris Arden. Peripheral Arterial Disease

Case Study: Chris Arden. Peripheral Arterial Disease Case Study: Chris Arden Peripheral Arterial Disease Patient Presentation Diane is a 65-year-old retired school teacher She complains of left calf pain when walking 50 metres; the pain goes away after she

More information

SITA 100 mg (n = 378)

SITA 100 mg (n = 378) Supplementary Table 1. Summary of Sulfonylurea Background Therapy at Baseline and During the Treatment Period. Sulfonylurea at baseline, n (%) SITA 100 mg (n = 378) CANA 300 mg (n = 377) Total (N = 755)

More information

Know Your Numbers Blood Pressure Cholesterol Blood Sugar

Know Your Numbers Blood Pressure Cholesterol Blood Sugar Know Your Numbers Blood Pressure Cholesterol Blood Sugar 2015 Wellness Warriors Sponsored by: Wayne State University Presented by: Debbie Cavender, RDN STRATEGIC WELLNESS, LLC The information in this presentation

More information

Mississippi Stroke Systems of Care

Mississippi Stroke Systems of Care Stroke Initiatives Mississippi State Department of Health Cassandra Dove, Chronic Disease Bureau 19 th Annual Stroke Belt Consortium March 1, 2014 Mississippi Stroke Systems of Care Heart Disease and Stroke

More information

Position Statement on Exercise and Hypertension

Position Statement on Exercise and Hypertension Australian Association for Exercise and Sports Science and Sports Medicine Australia Position Statement on Exercise and Hypertension James E. Sharmana,c,d,, Michael Stowasserb,c,d a School of Human Movement

More information

Obesity, metabolic dysfunction, and the risk of obesity-related cancer

Obesity, metabolic dysfunction, and the risk of obesity-related cancer Boston University OpenBU Theses & Dissertations http://open.bu.edu Boston University Theses & Dissertations 2016 Obesity, metabolic dysfunction, and the risk of obesity-related cancer Chadid, Susan https://hdl.handle.net/2144/16734

More information

Cardiovascular Risk Assessment and Management Making a Difference

Cardiovascular Risk Assessment and Management Making a Difference Cardiovascular Risk Assessment and Management Making a Difference Norman Sharpe March 2014 Numbers and age-standardised mortality rates from all causes, by sex, 1950 2010 Death rates halved Life expectancy

More information

Is there a mechanism of interaction between hypertension and dyslipidaemia?

Is there a mechanism of interaction between hypertension and dyslipidaemia? Is there a mechanism of interaction between hypertension and dyslipidaemia? Neil R Poulter International Centre for Circulatory Health NHLI, Imperial College London Daegu, Korea April 2005 Observational

More information

Μη φαρµακολογική θεραπεία της υπέρτασης Μαρία Μαρκέτου Επιµ. Α Καρδιολογική Κλινική ΠΑΓΝΗ

Μη φαρµακολογική θεραπεία της υπέρτασης Μαρία Μαρκέτου Επιµ. Α Καρδιολογική Κλινική ΠΑΓΝΗ Μη φαρµακολογική θεραπεία της υπέρτασης Μαρία Μαρκέτου Επιµ. Α Καρδιολογική Κλινική ΠΑΓΝΗ Δεν υπάρχει σύγκρουση οικονοµικών συµφερόντων Θεραπευτική προσέγγιση σύµφωνα µε τις κατευθηντήριες οδηγίες Θεραπευτική

More information

Structure and organization of blood vessels

Structure and organization of blood vessels The cardiovascular system Structure of the heart The cardiac cycle Structure and organization of blood vessels What is the cardiovascular system? The heart is a double pump heart arteries arterioles veins

More information

Conjugated Linoleic Acid Technical Document Feb Conjugated Linoleic Acid

Conjugated Linoleic Acid Technical Document Feb Conjugated Linoleic Acid Conjugated Linoleic Acid Technical Document Developed by INDI/SNIG for the Irish Sports Council 2014 Conjugated Linoleic Acid (CLA) Pubmed (Medline), SPORTDiscus and the Cochrane Library were searched

More information

Vascular Diseases. Overview: Selected Slides

Vascular Diseases. Overview: Selected Slides Vascular Diseases Overview: Selected Slides Total deaths and change in vascular death rates

More information

The State of Play of Diabetes Indicators

The State of Play of Diabetes Indicators The State of Play of Diabetes Indicators South Australian and National Information Catherine Chittleborough Janet Grant Anne Taylor April 2003 Diabetes Clearing House Population Research and Outcome Studies

More information

Effects of Combined Exercise Training on Body Composition and Metabolic Syndrome Factors

Effects of Combined Exercise Training on Body Composition and Metabolic Syndrome Factors Original Article Effects of Combined Exercise Training on Body Composition and Metabolic Syndrome Factors Introduction Chang-Ho Ha 1, *Wi-Young So 2 1. Dept. of Human Performance & Leisure Studies, North

More information

HYPERTENSION. Shelby Bublitz Winter Quarter 2015 Cory Ruth NTRS 415A-03 Shelly Truong Professor Owen

HYPERTENSION. Shelby Bublitz Winter Quarter 2015 Cory Ruth NTRS 415A-03 Shelly Truong Professor Owen HYPERTENSION Shelby Bublitz Winter Quarter 2015 Cory Ruth NTRS 415A-03 Shelly Truong Professor Owen What exactly is HYPERTENSION? Blood pressure is affected either by peripheral resistance or cardiac output.

More information

Deprivation Study. The Freiburg Study

Deprivation Study. The Freiburg Study The Freiburg Study Deprivation Study Free Radicals Inflammation (hs-crp) Blood Pressure (Systolic, Diastolic) Blood Lipids (Cholesterol, Triglycerides) Energy Utilization (Heart Rate) Sugar Metabolism

More information

Estrogens vs Testosterone for cardiovascular health and longevity

Estrogens vs Testosterone for cardiovascular health and longevity Estrogens vs Testosterone for cardiovascular health and longevity Panagiota Pietri, MD, PhD, FESC Director of Hypertension Unit Athens Medical Center Athens, Greece Women vs Men Is there a difference in

More information

Pediatric Obesity: A Multi-Disciplinary Approach to a Multi-Faceted Problem

Pediatric Obesity: A Multi-Disciplinary Approach to a Multi-Faceted Problem Pediatric Obesity: A Multi-Disciplinary Approach to a Multi-Faceted Problem Sharon A. Martino, PT, MS, PhD Associate Director Post Professional DPT Program Clinical Assistant Professor School of Heath,

More information

Carl J. Lavie, MD, FACC, FACP, FCCP

Carl J. Lavie, MD, FACC, FACP, FCCP Untangling the Heavy Cardiovascular Burden of Obesity and the Obesity Paradox Carl J. Lavie, MD, FACC, FACP, FCCP Professor of Medicine Medical Director, Cardiac Rehabilitation and Preventive Cardiology

More information

Lecture 7 Body Composition Lecture 7 1. What is Body Composition? 2. Healthy Body Weight 3. Body Fat Distribution 4. What Affects Weight Gain?

Lecture 7 Body Composition Lecture 7 1. What is Body Composition? 2. Healthy Body Weight 3. Body Fat Distribution 4. What Affects Weight Gain? Lecture 7 Body Composition 1 Lecture 7 1. What is Body Composition? 2. Healthy Body Weight 3. Body Fat Distribution 4. What Affects Weight Gain? 2 1 Body Composition Relative amounts of fat and fat-free

More information

Prognostic significance of blood pressure measured in the office, at home and during ambulatory monitoring in older patients in general practice

Prognostic significance of blood pressure measured in the office, at home and during ambulatory monitoring in older patients in general practice (2005) 19, 801 807 & 2005 Nature Publishing Group All rights reserved 0950-9240/05 $30.00 www.nature.com/jhh ORIGINAL ARTICLE Prognostic significance of blood pressure measured in the office, at home and

More information

Effect of a Modest Weight Loss in Normalizing Blood Pressure in Obese Subjects on Antihypertensive Drugs

Effect of a Modest Weight Loss in Normalizing Blood Pressure in Obese Subjects on Antihypertensive Drugs Received: November 4, 2015 Accepted: March 14, 2016 Published online: July 26, 2016 2016 The Author(s) Published by S. Karger GmbH, Freiburg This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives

More information

Establishment of Efficacy of Intervention in those with Metabolic Syndrome. Dr Wendy Russell - ILSI Europe Expert Group

Establishment of Efficacy of Intervention in those with Metabolic Syndrome. Dr Wendy Russell - ILSI Europe Expert Group Establishment of Efficacy of Intervention in those with Metabolic Syndrome Dr Wendy Russell - ILSI Europe Expert Group Conflict of interest regarding this presentation: I have no conflict of interest to

More information

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY VOL. 67, NO. 5, 2016 ª 2016 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN /$36.

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY VOL. 67, NO. 5, 2016 ª 2016 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN /$36. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY VOL. 67, NO. 5, 2016 ª 2016 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 0735-1097/$36.00 PUBLISHED BY ELSEVIER http://dx.doi.org/10.1016/j.jacc.2015.10.037

More information

The ACE Integrated Fitness

The ACE Integrated Fitness EXCLUSIVE ACE SPONSORED RESEARCH DOES THE ACE INTEGRATED FITNESS TRAINING MODEL ENHANCE TRAINING EFFICACY AND RESPONSIVENESS? By Lance C. Dalleck, Ph.D., Devan E. Haney, Christina A. Buchanan, Ph.D., and

More information

Internal and Emergency Medicine Official Journal of the Italian Society of Internal Medicine. ISSN Volume 8 Number 3

Internal and Emergency Medicine Official Journal of the Italian Society of Internal Medicine. ISSN Volume 8 Number 3 Hepatic Steatosis Index and Lipid Accumulation Product as middle-term predictors of incident metabolic syndrome in a large population sample: data from the Brisighella Heart Study Arrigo F. G. Cicero,

More information

Does the reduction in systolic blood pressure alone explain the regression of left ventricular hypertrophy?

Does the reduction in systolic blood pressure alone explain the regression of left ventricular hypertrophy? (24) 18, S23 S28 & 24 Nature Publishing Group All rights reserved 95-92/4 $3. www.nature.com/jhh ORIGINAL ARTICLE Does the reduction in systolic blood pressure alone explain the regression of left ventricular

More information

Objectives. Objectives. Alejandro J. de la Torre, MD Cook Children s Hospital May 30, 2015

Objectives. Objectives. Alejandro J. de la Torre, MD Cook Children s Hospital May 30, 2015 Alejandro J. de la Torre, MD Cook Children s Hospital May 30, 2015 Presentation downloaded from http://ce.unthsc.edu Objectives Understand that the obesity epidemic is also affecting children and adolescents

More information

PREVENTION. Pr Michel KOMAJDA ESC CONGRESS HIGHLIGHTS

PREVENTION. Pr Michel KOMAJDA ESC CONGRESS HIGHLIGHTS ESC CONGRESS HIGHLIGHTS PREVENTION Pr Michel KOMAJDA Dept of Cardiology University Pierre & Marie Curie Pitie Salpétrière Hospital PARIS France Thank you to B Williams and S Sharma michel.komajda@aphp.fr

More information

Why Do We Treat Obesity? Epidemiology

Why Do We Treat Obesity? Epidemiology Why Do We Treat Obesity? Epidemiology Epidemiology of Obesity U.S. Epidemic 2 More than Two Thirds of US Adults Are Overweight or Obese 87.5 NHANES Data US Adults Age 2 Years (Crude Estimate) Population

More information

Efficacy and safety of Olmesartan,Losartan, Valsartan, and Irbesartan in the Control of Essential Hypertension

Efficacy and safety of Olmesartan,Losartan, Valsartan, and Irbesartan in the Control of Essential Hypertension Efficacy and safety of Olmesartan,Losartan, Valsartan, and Irbesartan in the Control of Essential Hypertension Done by :Meznah zaid Al-mutairi Pharm.D Candidate Princess Nora Bint Abdul Rahman University

More information

Management of Hypertension. M Misra MD MRCP (UK) Division of Nephrology University of Missouri School of Medicine

Management of Hypertension. M Misra MD MRCP (UK) Division of Nephrology University of Missouri School of Medicine Management of Hypertension M Misra MD MRCP (UK) Division of Nephrology University of Missouri School of Medicine Disturbing Trends in Hypertension HTN awareness, treatment and control rates are decreasing

More information

Impact of Nicorandil on Renal Function in Patients With Acute Heart Failure and Pre-Existing Renal Dysfunction

Impact of Nicorandil on Renal Function in Patients With Acute Heart Failure and Pre-Existing Renal Dysfunction Impact of Nicorandil on Renal Function in Patients With Acute Heart Failure and Pre-Existing Renal Dysfunction Masahito Shigekiyo, Kenji Harada, Ayumi Okada, Naho Terada, Hiroyoshi Yoshikawa, Akira Hirono,

More information

LCZ696 A First-in-Class Angiotensin Receptor Neprilysin Inhibitor

LCZ696 A First-in-Class Angiotensin Receptor Neprilysin Inhibitor The Angiotensin Receptor Neprilysin Inhibitor LCZ696 in Heart Failure with Preserved Ejection Fraction The Prospective comparison of ARNI with ARB on Management Of heart failure with preserved ejection

More information

Faculty. Disclosures. Learning Objectives. Definitions. Definitions (cont) The Role of the Kidney in Cardiometabolic Disease

Faculty. Disclosures. Learning Objectives. Definitions. Definitions (cont) The Role of the Kidney in Cardiometabolic Disease Faculty The Role of the Kidney in Cardiometabolic Disease Christian W. Mende, MD, FACP, FACN, FASN, FASH Clinical Professor of Medicine University of California at San Diego San Diego, California Disclosures

More information

2017 Employee Wellness Health Assessment Report

2017 Employee Wellness Health Assessment Report Employee Wellness National Consortium for Building Healthy Academic Communities (BHAC) Healthier Tennessee Workplace 2017 Employee Wellness Health Assessment Report Blood Pressure 2017 (387 total) (National

More information

CATHETER-BASED RENAL DENERVATION INCREASES INSULIN SENSITIVITY AND IMPROVES GLUCOSE METABOLISM IN PATIENTS WITH RESISTANT HYPERTENSION

CATHETER-BASED RENAL DENERVATION INCREASES INSULIN SENSITIVITY AND IMPROVES GLUCOSE METABOLISM IN PATIENTS WITH RESISTANT HYPERTENSION CATHETER-BASED RENAL DENERVATION INCREASES INSULIN SENSITIVITY AND IMPROVES GLUCOSE METABOLISM IN PATIENTS WITH RESISTANT HYPERTENSION F. Mahfoud, Ch. Ukena, B. Cremers, I. Kindermann, M. Kindermann, P.

More information

Hypertension in Clinical Practice. Abeer Al Saweer, MBBS, Arab Board*

Hypertension in Clinical Practice. Abeer Al Saweer, MBBS, Arab Board* 1 Bahrain Medical Bulletin, Vol. 33, No. 1, March 2011 Education-Family Physician Corner Hypertension in Clinical Practice Abeer Al Saweer, MBBS, Arab Board* The global incidence of hypertension is growing.

More information

Yuqing Zhang, M.D., FESC Department of Cardiology, Fu Wai Hospital. CAMS & PUMC, Beijing, China

Yuqing Zhang, M.D., FESC Department of Cardiology, Fu Wai Hospital. CAMS & PUMC, Beijing, China What Can We Learn from the Observational Studies and Clinical Trials of Prehypertension? Yuqing Zhang, M.D., FESC Department of Cardiology, Fu Wai Hospital. CAMS & PUMC, Beijing, China At ARIC visit 4

More information

Dyslipidaemia. Is there any new information? Dr. A.R.M. Saifuddin Ekram

Dyslipidaemia. Is there any new information? Dr. A.R.M. Saifuddin Ekram Dyslipidaemia Is there any new information? Dr. A.R.M. Saifuddin Ekram PhD,FACP,FCPS(Medicine) Professor(c.c.) & Head Department of Medicine Rajshahi Medical College Rajshahi-6000 New features of ATP III

More information

Randomized Design of ALLHAT BP Trial

Randomized Design of ALLHAT BP Trial Outcomes in Hypertensive Black and Nonblack Patients Treated with Chlorthalidone, Amlodipine, and Lisinopril* *Wright JT, Dunn JK, Cutler JA et al. JAMA 2005:293:1595-1608. 42,418 High-risk hypertensive

More information

Physical Activity and Reduced Risk of Cardiovascular Disease. Chicago, IL. November 21, :30 PM 4:45 PM

Physical Activity and Reduced Risk of Cardiovascular Disease. Chicago, IL. November 21, :30 PM 4:45 PM Physical Activity and Reduced Risk of Cardiovascular Disease Chicago, IL November 21, 2008 3:30 PM 4:45 PM Session 7: Physical Activity and Reduced Risk of Cardiovascular Disease Learning Objectives Discuss

More information

Overview of the outcome trials in older patients with isolated systolic hypertension

Overview of the outcome trials in older patients with isolated systolic hypertension Journal of Human Hypertension (1999) 13, 859 863 1999 Stockton Press. All rights reserved 0950-9240/99 $15.00 http://www.stockton-press.co.uk/jhh Overview of the outcome trials in older patients with isolated

More information

A fixed-dose combination of bisoprolol and amlodipine in daily practice treatment of hypertension: Results of a noninvestigational

A fixed-dose combination of bisoprolol and amlodipine in daily practice treatment of hypertension: Results of a noninvestigational Hostalek U et al. Medical Research Archives, vol. 5, issue 11, November 2017 issue Page 1 of 11 RESEARCH ARTICLE A fixed-dose combination of bisoprolol and amlodipine in daily practice treatment of hypertension:

More information

Q&A. DEMO Version

Q&A. DEMO Version ACSM Exercise Specialist Exam Q&A DEMO Version Copyright (c) 2010 Chinatag LLC. All rights reserved. Important Note Please Read Carefully For demonstration purpose only, this free version Chinatag study

More information

Association of 24 h systolic blood pressure variability and cardiovascular disease in patients with obstructive sleep apnea

Association of 24 h systolic blood pressure variability and cardiovascular disease in patients with obstructive sleep apnea Ke et al. BMC Cardiovascular Disorders (2017) 17:287 DOI 10.1186/s12872-017-0723-y RESEARCH ARTICLE Open Access Association of 24 h systolic blood pressure variability and cardiovascular disease in patients

More information

Prescription Fitness. Robert M. Pepper, DO, FAAFP. ACOFP 55th Annual Convention & Scientific Seminars

Prescription Fitness. Robert M. Pepper, DO, FAAFP. ACOFP 55th Annual Convention & Scientific Seminars Prescription Fitness Robert M. Pepper, DO, FAAFP 8 ACOFP 55th Annual Convention & Scientific Seminars RX: FITNESS Robert M Pepper, DO, FAAFP Assistant Dean for Predoctoral Clinical Education West Virginia

More information

Objectives. JNC 7 Is Nice But What s Up With JNC 8? Why Do We Care? Hypertension Background: Prevalence

Objectives. JNC 7 Is Nice But What s Up With JNC 8? Why Do We Care? Hypertension Background: Prevalence JNC 7 Is Nice But What s Up With JNC 8? 37 th Annual CAPA Conference October 4 th 2013 Ignacio de Artola, Jr. M.D. Assistant Professor of Clinical Family Medicine Medical Director, Primary Care Physician

More information

Managing HTN in the Elderly: How Low to Go

Managing HTN in the Elderly: How Low to Go Managing HTN in the Elderly: How Low to Go Laxmi S. Mehta, MD, FACC The Ohio State University Medical Center Assistant Professor of Clinical Internal Medicine Clinical Director of the Women s Cardiovascular

More information

Hypertension Putting the Guidelines into Practice

Hypertension Putting the Guidelines into Practice Hypertension 2017 Putting the Guidelines into Practice Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored, or transmitted in any form or

More information