Comparative review of NICE, JNC8, SAHS and ISHIB. Brian Rayner, Division of Hypertension, University of Cape Town
|
|
- Dorothy Armstrong
- 5 years ago
- Views:
Transcription
1 Comparative review of NICE, JNC8, SAHS and ISHIB Brian Rayner, Division of Hypertension, University of Cape Town
2 Scope of Problem Deaths attributable to high blood pressure in males, South Africa Stroke Hypertensive disease Ischaemic heart disease other cardiovascular Prevalence of Hypertension in SA men Bradshaw et al MRC and CDiA 2011 Norman et al BOD at the MRC
3 Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1 25 million people Eleni Rapsomaniki, PhD, Adam Timmis, FRCP, Julie George, PhD, Mar Pujades-Rodriguez, PhD, Anoop D Shah, MRCP, Spiros Denaxas, PhD, Ian R White, PhD, Mark J Caulfield, MD, John E Deanfield, FRCP, Liam Smeeth, FRCGP, Bryan Williams, FRCP, Aroon Hingorani, FRCP and Harry Hemingway, FRCP The Lancet Volume 383, Issue 9932, Pages (May 2014) DOI: /S (14) Copyright 2014 Rapsomaniki et al. Open Access article distributed under the terms of CC BY Terms and Conditions
4 Figure 5 Source: The Lancet 2014; 383: (DOI: /S (14) ) Terms and Conditions
5 Figure 6 Source: The Lancet 2014; 383: (DOI: /S (14) ) Terms and Conditions
6 Principles Go et al, Effective approach to HT management, Hypertension 2014
7 Algorithm Development Go et al, Effective approach to HT management, Hypertension 2014
8 Awareness, Treatment and Control of USA Canada UK Germany Greece Spain China Japan Taiwan Mexico Hypertension Aware* Treated Controlled # Proportion of patients (%) *Prior diagnosis by health professional Use of BP medication # On BP medication, with SBP/DBP<140/90mmHg Whelton. J Clin Hypertens 2004;6:636 42
9 Kaiser Permanente Model Between number of patients with HT increased from 349,937 to Target BP from 44% to 80% In 2011 > 87% reached target Go et al, Effective approach to HT management, Hypertension 2014
10 PURE STUDY The PURE study enrolled 155,245 subjects between 35 and 70 years old, from both rural and urban areas in 17 countries to assess the influence of cardiovascular risk factors on cardiovascular disease and mortality. Overall, CV risk factors high-> middle-> lowincome countries Treatment and preventive measures also followed this pattern (p<0.0001). Yusuf, S, ESC 2013
11 Fatal CV Events Yusuf, S, ESC 2013
12 Wendy Hoy
13 Key Issues Thresholds for diagnosis and intervention First line therapy How to initiate? Treatment resistance
14 Non-controversial Life style modification Treat all CV risk factors as appropriate Compelling indications and contra-indications BP measurement Assessment of TOD
15 > 80 years > 160/90, target < 150/90 NICE -DIAGNOSIS
16 ISHIB - Risk stratification and treatment algorithm for blacks with hypertension. Risk Stratification No TOD or CVD BP > 135/85 Initiate treatment TOD or CVD BP > 130/80 Initiate treatment Target < 135/85 Target < 130/80 Adapted - Flack J et al. Hypertension 2010;56: Copyright American Heart Association
17 Death rates for diseases of the heart and stroke by race/ethnicity and sex, United States, 1980 to Mensah G A et al. Circulation 2005;111: Copyright American Heart Association
18 * # SAHS, NICE > 80 years, >160/90 Goal < 150/90 # Level E evidence
19 JNC-8 Minority View increasing the target will probably reduce the intensity of antihypertensive treatment in a large population at high risk for cardiovascular disease the evidence supporting increasing the SBP target from 140 to 150 mm Hg in persons aged 60 years or older was insufficient the higher SBP goal in individuals aged 60 years or older may reverse the decades-long decline in CVD, especially stroke mortality Wright JT Jr, Fine LJ, Lackland DT, Ogedegbe G, Dennison Himmelfarb CR. Ann Intern Med 2014; 160(7):
20 Indications for antihypertensive medication by age. Murthy V L et al. Hypertension. 2014;64: Copyright American Heart Association, Inc. All rights reserved.
21 Blood pressure treatment status by age. Murthy V L et al. Hypertension. 2014;64: Copyright American Heart Association, Inc. All rights reserved.
22 NICE/SA/JNC/ISHIB GUIDELINES Diuretics ACEi ARB CCB Diuretic/CCB preferred in black patients
23 Figure 1. Risk stratification and treatment algorithm for blacks with hypertension. Copyright American Heart Association Flack J et al. Hypertension 2010;56:
24 Aged under 55 years A Aged over 55 years or black person of African or Caribbean family origin of any age C* Step 1 Summary of antihypertensive drug treatment A + C* A + C + D Resistant hypertension A + C + D + consider further diureticor alpha- or beta-blocker Consider seeking expert advice Step 2 Step 3 Step 4 Key A ACE inhibitor or low-cost angiotensinii receptor blocker (ARB) 1 C Calcium-channel blocker (CCB) *D Thiazide-like diuretic See slide notes for details of footnotes 1-5
25 JNC-8 SAHS 2014
26 2014 Hypertension Guideline JNC-8 Dosing Strategies 1. Start low dose monotherapy and titrate to maximum dose before considering 2 nd drug 2. Start low dose monotherapy and add second drug at low dose 3. Start 2 drugs especially if BP > 160/100 mmhg or 20/10 mmhg above goal
27 Aged under 55 years A Aged over 55 years or black person of African or Caribbean family origin of any age C* Step 1 Summary of antihypertensive drug treatment A + C* A + C + D Resistant hypertension A + C + D + consider further diureticor alpha- or beta-blocker Consider seeking expert advice Step 2 Step 3 Step 4 Key A ACE inhibitor or low-cost angiotensinii receptor blocker (ARB) 1 C Calcium-channel blocker (CCB) *D Thiazide-like diuretic See slide notes for details of footnotes 1-5
28 Figure 1. Risk stratification and treatment algorithm for blacks with hypertension. Copyright American Heart Association Flack J et al. Hypertension 2010;56:
29 SAHS Practice Guidelines, CVJA, in press
30 Stepped care BP > 160/100 Start low dose diuretic, dose Not at target FDC with RAS inhibitor + CCB or diuretic Add ACE inhibitor/arb 6-12 months Not at target Add CCB, β blocker 4-8 weeks Not at target Optimise dose of FDC or combine RAS, CCB, diuretic
31 VALUE: Outcome and SBP Differences at Specific Time Periods: Primary Endpoint Time Interval (months) SBP mmhg Overall study end 1.7 PRIMARY ENDPOINT Odds Ratios and 95% CIs Favours valsartan Favours amlodipine Julius S et al. Lancet. June 2004;363:
32 NICE RESISTANT HT Beta blocker, alpha blocker
33 JNC -8
34 Figure 2. Guide to multidrug antihypertensive therapy in blacks with hypertension. Flack J et al. Hypertension 2010;56: Copyright American Heart Association
35 SAHS Beta blocker Aldosterone antagonist Vasodilator e.g. minoxidil Centrally acting Furosemide twice daily if egfr < 45mls/min
36 CONCLUSIONS Hypertension is major world wide epidemic There are substantial differences in awareness, prevalence and control rates, and CV outcomes Broad consensus for BP thresholds for intervention Consensus on BP targets/goals less aggressive than before Much closer agreement on optimal drug treatment (ACE or ARB, CCB, diuretic or all 3) Recognition for the wider use of drug combinations for optimal BP control, and earlier initial use of combinations in high risk e.g. > 160/100
37 Aldosterone and PRA in normotensive populations in SA/USA Black White 1 0 PRA Aldosterone Rayner et al, S Afr Med J 2002 Tu W et al. Hypertension. 2014;63:
38 Changes from baseline parameters in response to 2 week of treatment with 9-α fludrocortisone (ENaC) Tu W et al. Hypertension. 2014;63: Copyright American Heart Association, Inc. All rights reserved.
39 24,000 mmol Na Gordon s syndrome Gitelman s syndrome Na-Cl, WINK Thiazide GRK4 ENaC pseudohypoaldosteronism Liddle s syndrome SCNN1B, SCNN1G Na- K or H Amiloride mols Barter s syndrome KCNJ1 CASR Uromodulin ROMK Na-K-2Cl Furosemide Loss or gain of function leads to either hypotension or hypertension
Evolving Concepts on Hypertension: Implications of Three Guidelines (JNC 8 Panel, ESH/ESC, NICE/BSH)
Evolving Concepts on Hypertension: Implications of Three Guidelines (JNC 8 Panel, ESH/ESC, NICE/BSH) Sidney C. Smith, Jr. MD, FACC, FAHA, FESC Professor of Medicine/Cardiology University of North Carolina
More informationNICE BHS Hypertension guidelines 2011 update
NICE BHS Hypertension guidelines 2011 update Review for clinicians Sept 2011 Mark Thomas West Midlands Hypertension Centre Heart of England NHS Trust www.wmhc.co.uk mark.thomas@heartofengland.nhs.uk Full
More informationBy 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 informationOutcomes and Perspectives of Single-Pill Combination Therapy for the modern management of hypertension
Outcomes and Perspectives of Single-Pill Combination Therapy for the modern management of hypertension Prof. Massimo Volpe, MD, FAHA, FESC, Chair of Cardiology, Department of Clinical and Molecular Medicine
More informationSTANDARD treatment algorithm mmHg
STANDARD treatment algorithm 130-140mmHg (i) At BASELINE, If AVERAGE SBP 1 > 140mmHg If on no antihypertensive drugs: Start 1 drug: If >55 years old / Afro-Caribbean: Calcium channel blocker (CCB) 2 If
More informationCombination Therapy for Hypertension
Combination Therapy for Hypertension Se-Joong Rim, MD Cardiology Division, Yonsei University College of Medicine, Seoul, Korea Goals of Therapy Reduce CVD and renal morbidity and mortality. Treat to BP
More informationArticles. Funding Medical Research Council, National Institute for Health Research, and Wellcome Trust.
Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1 5 million people Eleni Rapsomaniki, Adam Timmis, Julie George,
More informationWhat s In the New Hypertension Guidelines?
American College of Physicians Ohio/Air Force Chapters 2018 Scientific Meeting Columbus, OH October 5, 2018 What s In the New Hypertension Guidelines? Max C. Reif, MD, FACP Objectives: At the end of the
More informationNew Recommendations for the Treatment of Hypertension: From Population Salt Reduction to Personalized Treatment Targets
New Recommendations for the Treatment of Hypertension: From Population Salt Reduction to Personalized Treatment Targets Sidney C. Smith, Jr. MD, FACC, FAHA Professor of Medicine/Cardiology University of
More informationHypertension Guidelines: International; African,?Kenyan
Hypertension Guidelines: International; African,?Kenyan Elijah N. Ogola University of Nairobi Kenya Cardiac Society Symposium 24 th 25 th February 2017 Eldoret Outline Background Overview of international
More informationDISCLOSURE PHARMACIST OBJECTIVES 9/30/2014 JNC 8: A REVIEW OF THE LONG-AWAITED/MUCH-ANTICIPATED HYPERTENSION GUIDELINES. I have nothing to disclose.
JNC 8: A REVIEW OF THE LONG-AWAITED/MUCH-ANTICIPATED HYPERTENSION GUIDELINES Tiffany Dickey, PharmD Assistant Professor, UAMS COP Clinical Pharmacy Specialist, Mercy Hospital Northwest AR DISCLOSURE I
More informationDEPARTMENT OF GENERAL MEDICINE WELCOMES
DEPARTMENT OF GENERAL MEDICINE WELCOMES 1 Dr.Mohamed Omar Shariff, 2 nd Year Post Graduate, Department of General Medicine. DR.B.R.Ambedkar Medical College & Hospital. 2 INTRODUCTION Leading cause of global
More informationManagement 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 informationHypertension Guidelines: Are We Pressured to Change? Oregon Cardiovascular Symposium Portland, Oregon June 6, Financial Disclosures
Hypertension Guidelines: Are We Pressured to Change? Oregon Cardiovascular Symposium Portland, Oregon June 6, 2015 William C. Cushman, MD Professor, Preventive Medicine, Medicine, and Physiology University
More informationPre-ALLHAT Drug Use. Diuretics. ß-Blockers. ACE Inhibitors. CCBs. Year. % of Treated Patients on Medication. CCBs. Beta Blockers.
Pre- Drug Use % of Treated Patients on Medication 60 50 40 30 20 10 0 1978 Diuretics ß-Blockers ACE Inhibitors Year CCBs CCBs Beta Blockers Diuretics ACE Inhibitors 1980 1982 1984 1986 1988 1990 1992 IMS
More informationADVANCES IN MANAGEMENT OF HYPERTENSION
Advances in Management of Robert B. Baron MD Professor of Medicine Associate Dean for GME and CME Declaration of full disclosure: No conflict of interest Current Status of Prevalence 29%; Blacks 33.5%
More informationHypertension Update Clinical Controversies Regarding Age and Race
Hypertension Update Clinical Controversies Regarding Age and Race Allison Helmer, PharmD, BCACP Assistant Clinical Professor Auburn University Harrison School of Pharmacy July 22, 2017 DISCLOSURE/CONFLICT
More informationJNC 8 -Controversies. Sagren Naidoo Nephrologist CMJAH
JNC 8 -Controversies Sagren Naidoo Nephrologist CMJAH Joint National Committee (JNC) Panel appointed by the National Heart, Lung, and Blood Institute (NHLBI) First guidelines (JNC-1) published in 1977
More informationHypertension Update Warwick Jaffe Interventional Cardiologist Ascot Hospital
Hypertension Update 2008 Warwick Jaffe Interventional Cardiologist Ascot Hospital Definition of Hypertension Continuous variable At some point the risk becomes high enough to justify treatment Treatment
More informationJNC Evidence-Based Guidelines for the Management of High Blood Pressure in Adults
JNC 8 2014 Evidence-Based Guidelines for the Management of High Blood Pressure in Adults Table of Contents Why Do We Treat Hypertension? Blood Pressure Treatment Goals Initial Therapy Strength of Recommendation
More informationNone. Disclosure: Relationships with Industry Conflicts of Interests. Learning Objectives: Participants will be able to:
2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report from the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) James W. Shaw, MD Memorial Lecture
More informationInsights into hypertension in children and adolescents in (South) Africa: the role of salt sensitivity
Insights into hypertension in children and adolescents in (South) Africa: the role of salt sensitivity Brian Rayner, Division of Nephrology and Hypertension, University of Cape Town Satellite View of Cape
More informationHYPERTENSION GUIDELINES WHERE ARE WE IN 2014
HYPERTENSION GUIDELINES WHERE ARE WE IN 2014 Donald J. DiPette MD FACP Special Assistant to the Provost for Health Affairs Distinguished Health Sciences Professor University of South Carolina University
More informationHypertension Guidelines: Lessons for Primary Care. Paul A James MD Professor and Chair Department of Family Medicine University of Washington
Hypertension Guidelines: Lessons for Primary Care Paul A James MD Professor and Chair Department of Family Medicine University of Washington Disclaimer and Financial Disclosure I have no financial interests
More informationClinical Updates in the Treatment of Hypertension JNC 7 vs. JNC 8. Lauren Thomas, PharmD PGY1 Pharmacy Practice Resident South Pointe Hospital
Clinical Updates in the Treatment of Hypertension JNC 7 vs. JNC 8 Lauren Thomas, PharmD PGY1 Pharmacy Practice Resident South Pointe Hospital Objectives Review the Eighth Joint National Committee (JNC
More informationHypertension (JNC-8)
Hypertension (JNC-8) Southern California University of Health Sciences Physician Assistant Program Management and Treatment of Hypertension April 17, 2018, presented by Ezra Levy, Pharm.D.! The 8 th Joint
More informationManagement of Hypertension. Ahmed El Hawary MD Suez Canal University
Management of Hypertension Ahmed El Hawary MD Suez Canal University Minimal vs. Optimal Care Resources more than science affect type of care and level of management. what is possible (minimal care) and
More informationDiversity and HTN: Approaches to optimal BP control in AfricanAmericans
Diversity and HTN: Approaches to optimal BP control in AfricanAmericans Quinn Capers, IV, MD, FACC, FSCAI Assistant Professor of Medicine Associate Dean for Admissions Do Racial Differences Really Exist
More informationLayered Approaches to Studying Drug Responses
Layered Approaches to Studying Drug Responses Brian B Hoffman, MD Chief of Medicine VA Boston Health Care System Professor of Medicine Harvard Medical School Conflict of Interest: US Federal Grant Funding
More informationADVANCES IN MANAGEMENT OF HYPERTENSION
Prevalence 29%; Blacks 33.5% About 72.5% treated; 53.5% uncontrolled (>140/90) Risk for poor control: Latinos, Blacks, age 18-44 and 80,
More informationManaging Hypertension in 2016
Managing Hypertension in 2016: Where Do We Draw the Line? Disclosure No relevant financial relationships Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine baron@medicine.ucsf.edu
More informationHypertension 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 informationHypertension and the 2017 Guidelines Meeting the Targets in Small Groups. Lisa Ivy APRN
Hypertension and the 2017 Guidelines Meeting the Targets in Small Groups Lisa Ivy APRN The 2017 Guideline is an Update to JNC7 New information regarding BP related risk of CVD Ambulatory BP monitoring
More informationUpdate on Current Trends in Hypertension Management
Friday General Session Update on Current Trends in Hypertension Management Shawna Nesbitt, MD Associate Dean, Minority Student Affairs Associate Professor, Department of Internal Medicine Office of Student
More information2. Measurement Specifications 3. Patient Messaging 4. Provider Messaging Other Recent Guidelines
Measure Up/Pressure Down Response to the Release of 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report from the Panel Members Appointed to the Eighth Joint National
More informationPrevention of Heart Failure: What s New with Hypertension
Prevention of Heart Failure: What s New with Hypertension Ali AlMasood Prince Sultan Cardiac Center Riyadh 3ed Saudi Heart Failure conference, Jeddah, 13 December 2014 Background 20-30% of Saudi adults
More informationEgyptian Hypertension Guidelines
Egyptian Hypertension Guidelines 2014 Egyptian Hypertension Guidelines Dalia R. ElRemissy, MD Lecturer of Cardiovascular Medicine Cairo University Why Egyptian Guidelines? Guidelines developed for rich
More informationMODERN MANAGEMENT OF HYPERTENSION Where Do We Draw the Line? Disclosure. No relevant financial relationships. Blood Pressure and Risk
MODERN MANAGEMENT OF HYPERTENSION Where Do We Draw the Line? Disclosure No relevant financial relationships Robert B. Baron, MD MS Professor and Associate Dean UCSF School of Medicine baron@medicine.ucsf.edu
More informationHypertension diagnosis (see detail document) Diabetic. Target less than 130/80mmHg
Hypertension diagnosis (see detail document) Non-diabetic Diabetic Very elderly (older than 80 years) Target less than 140/90mmHg Target less than 130/80mmHg Consider SBP target less than 150mmHg Non-diabetic
More informationHypertension Management in Minorities: Closing the gap
Hypertension Management in Minorities: Closing the gap Gbemiga Sofowora, MBChB, Msc, FACC Summary Epidemiology Hypertension Target organ damage Death Pathophysiology Factors linked to poor BP control in
More informationThe underestimated risk of
Earn 3 CPD Points online The underestimated risk of hypertension Dr David Webb Johannesburg Introduction The high and increasing worldwide burden of hypertension is a major global health challenge. Hypertension
More informationKidney Disease, Hypertension and Cardiovascular Risk
1 Kidney Disease, Hypertension and Cardiovascular Risk George Bakris, MD, FAHA, FASN Professor of Medicine Director, Hypertensive Diseases Unit The University of Chicago-Pritzker School of Medicine Chicago,
More informationHYPERTENSION: UPDATE 2018
HYPERTENSION: UPDATE 2018 From the Cardiologist point of view Richard C Padgett, MD I have no disclosures HYPERTENSION ALWAYS THE ELEPHANT IN THE EXAM ROOM BUT SOMETIMES IT CHARGES HTN IN US ~78 million
More informationΑΡΥΙΚΗ ΠΡΟΔΓΓΙΗ ΤΠΔΡΣΑΙΚΟΤ ΑΘΔΝΟΤ. Μ.Β.Παπαβαζιλείοσ Καρδιολόγος FESC - Γιεσθύνηρια ιζμανόγλειον ΓΝΑ Clinical Hypertension Specialist ESH
ΑΡΥΙΚΗ ΠΡΟΔΓΓΙΗ ΤΠΔΡΣΑΙΚΟΤ ΑΘΔΝΟΤ Μ.Β.Παπαβαζιλείοσ Καρδιολόγος FESC - Γιεσθύνηρια ιζμανόγλειον ΓΝΑ Clinical Hypertension Specialist ESH Hypertension Co-Morbidities HTN Commonly Clusters with Other Risk
More informationHypertension Management: A Moving Target
9:45 :30am Hypertension Management: A Moving Target SPEAKER Karol Watson, MD, PhD, FACC Presenter Disclosure Information The following relationships exist related to this presentation: Karol E. Watson,
More informationRecent Hypertension Guidelines
Recent Hypertension Guidelines Lawrence J. Fine, MD, DrPH, FAHA Division of Cardiovascular Sciences NHLBI/NIH February 19, 2014 Disclosures: Member of Panel Appointed to the Eighth Joint National Committee
More informationManagement of Lipid Disorders and Hypertension: Implications of the New Guidelines
Management of Lipid Disorders and Hypertension Management of Lipid Disorders and Hypertension: Implications of the New Guidelines Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine
More informationHypertension Update 2009
Hypertension Update 2009 New Drugs, New Goals, New Approaches, New Lessons from Clinical Trials Timothy C Fagan, MD, FACP Professor Emeritus University of Arizona New Drugs Direct Renin Inhibitors Endothelin
More informationManagement of High Blood Pressure in Adults
Management of High Blood Pressure in Adults Based on the Report from the Panel Members Appointed to the Eighth Joint National Committee (JNC8) James, P. A. (2014, February 05). 2014 Guideline for Management
More informationPreventing and Treating High Blood Pressure
Preventing and Treating High Blood Pressure: Finding the Right Balance of Integrative and Pharmacologic Approaches Robert B. Baron MD Professor of Medicine Associate Dean for GME and CME Blood Pressure
More informationNew Lipid Guidelines. PREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN: Implications of the New Guidelines for Hypertension and Lipids.
PREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN: Implications of the New Guidelines for Hypertension and Lipids Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Disclosure No relevant
More informationHypertension 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 information2014 HYPERTENSION GUIDELINES
2014 HYPERTENSION GUIDELINES Eileen M. Twomey, Pharm.D., BCPS 1 Learning Objectives Describe specific blood pressure thresholds at which antihypertensive therapy should be initiated and blood pressure
More informationCombination therapy Giuseppe M.C. Rosano, MD, PhD, MSc, FESC, FHFA St George s Hospitals NHS Trust University of London
Combination therapy Giuseppe M.C. Rosano, MD, PhD, MSc, FESC, FHFA St George s Hospitals NHS Trust University of London KCS Congress: Impact through collaboration CONTACT: Tel. +254 735 833 803 Email:
More informationModern Management of Hypertension
Modern Management of Hypertension Robert B. Baron MD Professor of Medicine Associate Dean for GME and CME Declaration of full disclosure: No conflict of interest Current Status of Hypertension Prevalence
More information신장환자의혈압조절 나기영. Factors involved in the regulation of blood pressure
신장환자의혈압조절 K/DOQI Clinical practice guidelines on Hypertension and Antihypertensive agents in CKD 나기영 Factors involved in the regulation of blood pressure Renal function curve MAP (mmhg) Central role of
More informationManagement of Hypertension
Clinical Practice Guidelines Management of Hypertension Definition and classification of blood pressure levels (mmhg) Category Systolic Diastolic Normal
More informationManaging Hypertension in Diabetes Sean Stewart, PharmD, BCPS, BCACP, CLS Internal Medicine Park Nicollet Clinic St Louis Park.
Managing Hypertension in Diabetes 2015 Sean Stewart, PharmD, BCPS, BCACP, CLS Internal Medicine Park Nicollet Clinic St Louis Park Case Scenario Mike M is a 59 year old man with type 2 diabetes managed
More informationHypertension. Risk of cardiovascular disease beginning at 115/75 mmhg doubles with every 20/10mm Hg increase. (Grade B)
Practice Guidelines and Principles: Guidelines and principles are intended to be flexible. They serve as reference points or recommendations, not rigid criteria. Guidelines and principles should be followed
More informationChallenges in Hypertension: Incorporating Evolving Clinical Data Into Practice
Challenges in Hypertension: Incorporating Evolving Clinical Data Into Practice Faculty Jan Basile, MD Professor of Medicine Seinsheimer Cardiovascular Health Program Division of General Internal Medicine
More information2/10/2014. Hypertension: Highlights of Hypertension Guidelines: Making the Most of Limited Evidence. Issues with contemporary guidelines
Hypertension: 214 Highlights of Hypertension Guidelines: Making the Most of Limited Evidence Michael A, Weber, MD Editor-in-Chief, The Journal of Clinical Hypertension, Professor of Medicine, Division
More informationInt. J. Pharm. Sci. Rev. Res., 36(1), January February 2016; Article No. 06, Pages: JNC 8 versus JNC 7 Understanding the Evidences
Research Article JNC 8 versus JNC 7 Understanding the Evidences Anns Clara Joseph, Karthik MS, Sivasakthi R, Venkatanarayanan R, Sam Johnson Udaya Chander J* RVS College of Pharmaceutical Sciences, Coimbatore,
More informationLong-Term Care Updates
Long-Term Care Updates August 2015 By Darren Hein, PharmD Hypertension is a clinical condition in which the force of blood pushing on the arteries is higher than normal. This increases the risk for heart
More informationVA/DoD Clinical Practice Guideline for the Diagnosis and Management of Hypertension - Pocket Guide Update 2004 Revision July 2005
VA/DoD Clinical Practice Guideline for the Diagnosis and Management of Hypertension - Pocket Guide Update 2004 Revision July 2005 1 Any adult in the health care system 2 Obtain blood pressure (BP) (Reliable,
More informationDISCLOSURES OUTLINE OUTLINE 9/29/2014 ANTI-HYPERTENSIVE MANAGEMENT OF CHRONIC KIDNEY DISEASE
ANTI-HYPERTENSIVE MANAGEMENT OF CHRONIC KIDNEY DISEASE DISCLOSURES Editor-in-Chief- Nephrology- UpToDate- (Wolters Klewer) Richard J. Glassock, MD, MACP Geffen School of Medicine at UCLA 1 st Annual Internal
More informationT. Suithichaiyakul Cardiomed Chula
T. Suithichaiyakul Cardiomed Chula The cardiovascular (CV) continuum: role of risk factors Endothelial Dysfunction Atherosclerosis and left ventricular hypertrophy Myocardial infarction & stroke Endothelial
More informationCHALLENGES OF HYPERTENSION IN THE COALFACE
CHALLENGES OF HYPERTENSION IN THE COALFACE Y VERIAVA CENTRE FOR RURAL HEALTH SCHOOL OF CLINICAL MEDICINE FACULTY OF HEALTH SCIENCES UNIVERSITY OF WITWATERSRAND SYSTOLIC AND DIASTOLIC BLOOD PRESSURES (BP)
More informationTodd S. Perlstein, MD FIFTH ANNUAL SYMPOSIUM
Todd S. Perlstein, MD FIFTH ANNUAL SYMPOSIUM Faculty Disclosure I have no financial interest to disclose No off-label use of medications will be discussed FIFTH ANNUAL SYMPOSIUM Recognize changes between
More informationUsing the New Hypertension Guidelines
Using the New Hypertension Guidelines Kamal Henderson, MD Department of Cardiology, Preventive Medicine, University of North Carolina School of Medicine Kotchen TA. Historical trends and milestones in
More informationVolume 6; Number 1 January 2012 NICE CLINICAL GUIDELINE 127: HYPERTENSION CLINICAL MANAGEMENT OF PRIMARY HYPERTENSION IN ADULTS (AUGUST 2011)
Volume 6; Number 1 January 2012 NICE CLINICAL GUIDELINE 127: HYPERTENSION CLINICAL MANAGEMENT OF PRIMARY HYPERTENSION IN ADULTS (AUGUST 2011) What s new in hypertension? NICE has issued an updated Clinical
More informationFirst line treatment of primary hypertension
First line treatment of primary hypertension Dr. Vijaya Musini Assistant Professor, Dept. Anesthesiology, Pharmacology and Therapeutics Manager, Drug Assessment Working Group Therapeutics Initiative Editor,
More informationExplore the Rationale for the Dual Mechanism CCB/ARB Approach in Hypertension Management
Explore the Rationale for the Dual Mechanism CCB/ARB Approach in Hypertension Management Jeong Bae Park, MD,PhD Dept of Med/Cardiology, Cheil General Hospital, Kwandong University College of Medicine Apr
More informationHypertension and obesity. Dr Wilson Sugut Moi teaching and referral hospital
Hypertension and obesity Dr Wilson Sugut Moi teaching and referral hospital No conflict of interests to declare Obesity Definition: excessive weight that may impair health BMI Categories Underweight BMI
More informationEFFICACY & SAFETY OF ORAL TRIPLE DRUG COMBINATION OF TELMISARTAN, AMLODIPINE AND HYDROCHLOROTHIAZIDE IN THE MANAGEMENT OF NON-DIABETIC HYPERTENSION
EFFICACY & SAFETY OF ORAL TRIPLE DRUG COMBINATION OF TELMISARTAN, AMLODIPINE AND HYDROCHLOROTHIAZIDE IN THE MANAGEMENT OF NON-DIABETIC HYPERTENSION Khemchandani D. 1 and * Arif A. Faruqui 2 1 Bairagarh,
More informationWhat in the World is Functional Medicine?
What in the World is Functional Medicine? An Introduction to a Systems Based Approach of Chronic Disease Meneah R Haworth, FNP-C Disclosure v I am a student of the Institute for Functional Medicine. They
More informationObjectives. 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 informationJared 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 informationTreating Hypertension in 2018: What Makes the Most Sense Today?
Treating Hypertension in 2018: What Makes the Most Sense Today? Daniel Blanchard, MD Professor of Medicine UC San Diego Cardiovascular Center La Jolla, California 1 2 Speaker Disclosures Consultant and/or
More informationHow clinically important are the results of the large trials in hypertension?
How clinically important are the results of the large trials in hypertension? Stéphane LAURENT, MD, PhD, FESC Pharmacology Department and PARCC / INSERM U970 Hôpital Européen Georges Pompidou, Université
More informationDirector of the Israeli Institute for Quality in Medicine Israeli Medical Association July 1st, 2016
The differential effect of Atherosclerosis on end organ damage in adult and elderly patients with CVRF: New Algorithm for Hypertension Diagnosis and Treatment R. Zimlichman, FAHA, FASH, FESC, FESH Chief
More informationModern Management of Hypertension: Where Do We Draw the Line?
Modern Management of Hypertension: Where Do We Draw the Line? Robert B. Baron MD Professor of Medicine Associate Dean for GME and CME Declaration of full disclosure: No conflict of interest Blood Pressure
More informationHypertension: Update
Hypertension: Update Meenakshi A Bhalla MD,FACC Associate Professor of Medicine Director Preventive Cardiology Advanced Heart Failure and Transplant Cardiology University of Kentucky Faculty Disclosure
More informationNew Antihypertensive Strategies to Improve Blood Pressure Control
New Antihypertensive Strategies to Improve Blood Pressure Control Antonio Coca, MD, PhD,, FRCP, FESC Hypertension and Vascular Risk Unit Department of Internal Medicine. Hospital Clínic (IDIBAPS) University
More informationThe Road to Renin System Optimization: Renin Inhibitor
The Road to Renin System Optimization: Renin Inhibitor A New Perspective on the Renin-Angiotensin System (RAS) Yong-Jin Kim, MD Seoul National University Hospital Human and Economic Costs of Hypertension
More informationABSTRACT. Special Communication February 5, 2014
Page 1 of 20 Special Communication February 5, 2014 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National
More informationIncidental Findings; Management of patients presenting with high BP. Phil Swales
Incidental Findings; Management of patients presenting with high BP Phil Swales Consultant Physician Acute & General Medicine University Hospitals of Leicester NHS Trust Objectives The approach to an incidental
More informationSupplementary Online Content
Supplementary Online Content James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report by the panel appointed to the Eighth Joint National
More informationHypertension JNC 8 (2014)
Hypertension JNC 8 (2014) Renewed: February 2018 Updated: February 2015 Comparison of Seventh Joint National Committee (JNC 7) vs. Eighth Joint National Committee (JNC 8) Hypertension Guidelines Methodology
More informationUnderstanding the importance of blood pressure control An overview of new guidelines: How do they impact daily current management?
Understanding the importance of blood pressure control An overview of new guidelines: How do they impact daily current management? Slides presented during CDMC in Almaty, Kazakhstan on Saturday April 12,
More informationHypertension mechanisms
הטיפול בלחץ דם בעזרת תרופות מישלב Hypertension mechanisms ESH Task Force Document. J Hypertens 2009 The history of development of antihypertensive drugs ESH Task Force Document. J Hypertens 2009 הטיפול
More informationIs 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 informationTreating Hypertension in Individuals with Diabetes
Treating Hypertension in Individuals with Diabetes 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 by any
More informationBest 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 informationUse of Beta-blocker Monotherapy in Hypertension: Situation in a Local General Outpatient Clinic
Use of Beta-blocker Monotherapy in Hypertension: Situation in a Local General Outpatient Clinic Dr. Dao Man Chi Resident Department of Family Medicine and Primary Health Care, KWC HA Convention 2014 Introduction
More informationMasked Hypertension. Why Should We Care? Dr. Peter J. Lin Director Primary Care Initiatives - Canadian Heart Research Centre
Masked Hypertension Why Should We Care? Dr. Peter J. Lin Director Primary Care Initiatives - Canadian Heart Research Centre PRESENTER DISCLOSURE Faculty: Dr. Peter Lin Relationships with commercial interests:
More information2003 World Health Organization (WHO) / International Society of Hypertension (ISH) Statement on Management of Hypertension.
2003 World Health Organization (WHO) / International Society of Hypertension (ISH) Statement on Management of Hypertension Writing Group: Background Hypertension worldwide causes 7.1 million premature
More informationHypertension update a practical guide. Brian Rayner, Division of Hypertension, University of Cape Town
Hypertension update a practical guide Brian Rayner, Division of Hypertension, University of Cape Town Overview Introduction and importance Definitions and targets BP measurement Basic tests Non pharmacological
More informationALLHAT. Major Outcomes in High Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic
1 U.S. Department of Health and Human Services National Institutes of Health Major Outcomes in High Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker
More informationHypertension in 2015: SPRINT-ing ahead of JNC-8. MAJ Charles Magee, MD MPH FACP Director, WRNMMC Hypertension Clinic
Hypertension in 2015: SPRINT-ing ahead of JNC-8 MAJ Charles Magee, MD MPH FACP Director, WRNMMC Hypertension Clinic Conflits of interest? None Disclaimer The opinions contained herein are not to be considered
More information