Table of Contents. Program Committee Page 2. Conference Description Page 3. Learning Objectives Page 3. Target Audience Page 3
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2 Table of Contents Program Committee Page 2 Conference Description Page 3 Learning Objectives Page 3 Target Audience Page 3 Continuing Medical Education Page 4 Registration Information Pages 4 Meals and Special Events Page 4 Faculty Pages 5-6 Disclosure Table Page 7 Schedule of Events Pages 8-17 Page 1
3 7 th Hypertension Summer School, 2010 Saturday, July 31 Wednesday, August 4, 2010 Portland State University Portland, OR Sponsored by the American Heart Association s Council for High Blood Pressure Research and the Council on Kidney in Cardiovascular Disease Program Committee Raymond Townsend, MD, Program Chair University of Pennsylvania Philadelphia, PA Kenneth M. Baker, MD Texas A & M University System Temple, TX Virginia Brooks, PhD Oregon Health & Science University Portland, OR Donald J. DiPette, MD, FAHA, Co-Chair University of South Carolina Columbia, SC Kenneth Bernstein, MD Cedars-Sinai Medical Center Los Angeles, CA Joey P. Granger PHD FAHA University Mississippi Med Center Jackson, MS Marcela Herrera Henry Ford Hospital Detroit, MI Stephen C. Textor, MD Mayo Clinic Rochester, MN R. Clinton Webb, PhD FAHA Medical College of Georgia Augusta, GA The American Heart Association gratefully acknowledges the educational grant provided by Pfizer, Inc. The American Heart Association is a national voluntary health agency whose mission is: Building healthier lives free of cardiovascular diseases and stroke. Page 2
4 Conference Description Merging Technology and Science This 7th Summer School will mix basic, translational and clinical science discussions with hands-on usage of technology that provides immediate assessment of vascular function and hypertension target organ assessment. Mornings will be directed to overviews of blood pressure physiology, incorporating new concepts in genetics, inflammation, obesity and animal models. Students will each have an opportunity to directly perform pulse wave analysis, carotid intimamedia thickness measurements and echocardiography. Case discussions will be used to integrate the science and the technology so that the student understands more thoroughly pathophysiologic mechanisms, opportunities for intervention and areas ripe for further investigation. Learning Objectives After completing this program, participants will be able to: Describe the physiology and pathophysiology of the circulatory system as it relates to blood pressure, kidney, and cardiovascular function. Describe the current understanding of the RAS and its role in hypertension and kidney disease Identify gaps in knowledge regarding the RAS and its role in hypertension and kidney disease Describe the current understanding of epigenetics in the development of hypertension and avenues for further exploration Identify unmet research needs in hypertension, cardiorenal risk, and preeclampsia Discuss the interrelationship between genetics and the environment in racial disparities within hypertension Identify research approaches to advance understanding of the genetic/environmental links related to hypertension and racial disparities Identify opportunities for translational research in the area of hypertension Target Audience: This course is open to all, but trainees graduate students, postdoctoral fellows, and clinical fellows who wish to pursue careers in basic or clinical hypertension research are encouraged to attend. The Hypertension Summer School will be valuable for fellows studying hypertension, nephrology, cardiology, endocrinology, general medicine, and clinical pharmacology. Established investigators or those with more experience who wish to refresh and update their knowledge in basic and clinical hypertension research are also encouraged to attend. The school will also be helpful to clinicians or basic scientists who may be changing direction in their research programs and who wish to learn the basic principles and concepts behind new techniques used in hypertension research. Page 3
5 Continuing Medical Education Accreditation - Physicians The American Heart Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The American Heart Association designates this educational activity for a maximum of AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity. All faculty participating in CME/CE activities sponsored by The American Heart Association will disclose to the audience (1) significant financial relationships with the manufacturer(s) of products from the commercial supporter(s) and /or the manufacturer(s) of products or devices discussed in their presentation, and (2) unlabeled/unapproved uses of drugs or devices discussed in their presentation. Such disclosures will be made in writing in the course presentation materials. Approximately 10 days following the program all participants will receive an with the link to evaluate the program and claim CME. Registration Saturday, July 31, :00 pm to 5:00 pm in the lobby of the Ondine building at 1912 S.W. 6 th Avenue on the corner 6 th and Hall Sunday, August 1 8:00 am to 5:00 pm at Smith Memorial Student Union Wednesday, August 4 outside room 327/328 Meals All meals unless otherwise noted in the schedule, take place at Victor's, inside the Ondine building at 1912 S.W. 6 th Avenue. The restaurant will have a roster of all attendees and faculty. You will be asked to provide your name and the conference name (AHA Summer School) for entrance to the restaurant. Special Events The opening dinner will take place Saturday evening at 6:00 pm in the Ondine building, room 218/220. The Trainee Advocacy Committee of the Council for High Blood Pressure Research is sponsoring dinner on Tuesday night. The event will kick off at 7:00 pm and takes place in the Smith Memorial Student Union, room 327/328. This event will be fun, interactive and energetic and will include a cash bar. Page 4
6 Faculty Kenneth Baker, MD Division of Molecular Cardiology Texas A&M University System Scott & White Hospital, Dept of VA Temple, TX Kenneth E. Bernstein, MD Director, Experimental Pathology Research Scientist, Biomedical Sciences Cedars-Sinai Medical Center Los Angeles, CA Virginia Brooks, PhD Department of Physiology and Pharmacology Oregon Health & Science University Portland, OR David A. Calhoun, MD Professor of Medicine University of Alabama At Birmingham Vascular Biology and Hypertension Program Birmingham, AL Donald J. DiPette, MD, FAHA Vice President for Medical Affairs Health Sciences Distinguished Professor University of South Carolina Columbia, SC David Ellison, MD, FAHA Professor of Medicine Oregon Health & Science University Portland, OR Joey Granger, PhD, FAHA Billy S. Guyton Distinguished Professor Professor of Physiology & Medicine University of Mississippi Medical Center Jackson, MS David Harrison, MD, FAHA Professor of Medicine Emory University School of Medicine Atlanta, GA Marcela Herrera, PhD Henry Ford Hospital Hypertension and Vascular Research Division Detroit, MI Richard Hoppmann, MD Dean, Univerisity of South Carolina School of Medicine Columbia, SC Constantino Iadecola, MD Cotzias Distinguished Professor of Neurology and Neuroscience Chief, Division of Neurobiology Weill Medical College of Cornell University New York, NY Norman M. Kaplan, MD, FAHA Professor of Medicine U Texas Southwestern Medical School Dallas, TX Friedrich Luft, MD, FAHA, FACP Professor of Medicine, Chief Nephrology/Hypertension Section Medical Faculty of the Charite, Humboldt University of Berlin Berlin, Germany Jane F. Reckelhoff, PhD University of Mississippi Medical Center Jackson, MS Page 5
7 Domenic Sica, MD Professor of Medicine and Pharmacology Virginia Commonwealth University School of Medicine Richmond, VA Curt Sigmund, PhD, FAHA Professor and Roy J. Carver Chair in Hypertension Research University of Iowa, Carver College of Medicine Iowa City, IA James Sowers, MD Professor of Medicine-Endocrinology University of Missouri School of Medicine Columbia, MO Alan Sved, PhD, FAHA Professor and Chair, Department of Neuroscience University of Pittsburgh Pittsburgh, PA Stephen Textor, MD Mayo Clinic Rochester, MN Kent Thornburg, PhD Professor and Director Oregon Health Sciences University Heart Research Center Portland, OR Rita Tostes, PhD Associate Professor Medical College of Georgia Department of Physiology Augusta, GA Rhian Touyz, MD, PhD, FAHA Canada Research Chair in Hypertension Ottawa Health Research Institute/University of Ottawa Ottawa, ON Raymond Townsend, MD Hypertension Summer School Program Chair University of Pennsylvania Philadelphia, PA R. Clinton Webb, PhD, FAHA Professor Medical College of Georgia Department of Physiology Augusta, GA Christopher Wilcox, MD, PhD, FAHA George E. Schreiner Professor of Nephrology Georgetown University Medical Center Washington, DC Page 6
8 Faculty Disclosure of Faculty Members Commercial Relationship(s) Kenneth Baker, Kenneth E. Bernstein, Virginia Brooks, David A. Calhoun, Donald J. DiPette, David Ellison, Joey Granger, David Harrison, Marcela Herrera Richard Hoppmann Constantino Iadecola Norman M. Kaplan Friedrich Luft Jane F. Reckelhoff Domenic Sica Curt Sigmund James Sowers Alan Sved Stephen Textor Kent Thornburg Rita Tostes Rhian Touyz Raymond Townsend Employment Research Grant CVRx; Takeda NIH (R01, P01) Novartis, Forrest, NIH, VA AHA Other Research Support Speaker s Bureau/ Honoraria ASN; ASH; NKF Expert Witness Ownership Interest Consultant/Advisory Board Novartis Pharmaceutical Novartis; Takeda Novartis; Forrest Labs Roche; GSK; Merck; Novartis; Nicox Other Educational Partnership GE Healthcare R. Clinton Webb Christopher Wilcox This table represents the relationships of faculty members that may be perceived as actual or reasonably perceived conflicts of interest as reported on the Disclosure Questionnaire, which all Faculty are required to complete and submit. Page 7
9 Schedule SATURDAY, JULY 31 12:00 5:00 PM Registration/check-in Ondine Building lobby 6:00 PM Welcome and Introduction 6:30 PM Dinner Ondine Building, room 218/220 SUNDAY, AUGUST 1 Breakfast 6:45 to 7:45 AM Victors at Ondine, Ondine Building Registration Open 8:00 AM to 5:00 PM Smith Memorial Student Union outside room 327/328 Session I Smith Memorial Student Union, room 327/328 Blood Pressure regulation in Health and Hypertension Chair: Virginia Brooks, PhD, Portland, OR 7:45 AM Introduction 8:00-8:45 AM Human Hypertension: The Big Picture Presented by: Norman M Kaplan, MD, FAHA, Clinical Professor of Medicine, U Texas Southwestern Medical School, Dallas, TX This presentation will provide students with a broad overview of Epidemiology, Diagnosis, Prognosis and Therapy of Human Hypertension. Discuss the prevalence and incidence of human hypertension Recognize the appropriate diagnostic procedures for human hypertension Review the general approaches to treatment of human hypertension 8:45-9:30 AM Blood pressure Regulation: Sympathetic Nervous System Presented by: Alan Sved, PhD, FAHA, Pittsburgh, PA Page 8
10 This presentation will provide an overview of the role of the sympathetic nervous system in cardiovascular regulation and discuss the evidence for involvement of the sympathetic nervous system in hypertension. The central neural circuits controlling selective sympathetic regulation of different tissues will be outlined, and discussed in the framework of hypertension. Discuss the data supporting a role of the sympathetic nervous system in hypertension Discuss the selective regulation of sympathetic control of different target tissues Describe the general organization of central neural circuits involved in the control of sympathetic vasomotor tone. 9:30-10:15 AM The Role of the Renin-Angiotensin System in Blood Pressure Control Presented by: Kenneth E. Bernstein, MD, Cedars-Sinai Medical Center, Los Angeles, CA 10:15-10:30 AM Break This presentation will describe the outline of the RAS and the important way it controls blood pressure. Describe the components of the RAS Describe the effects of Angiotensin II1 Describe the role of Angiotensin Converting Enzyme (ACE) 10:30-11:15 AM Blood pressure regulation: kidney Presented by: David Ellison, Md, FAHA, Portland, OR 11:15-11:45 AM Put it all together: Salt Sensitive Hypertension Presented by: Friedrich Luft, MD, FAHA, FACP, Berlin, Germany This presentation will review the epidemiological evidence in terms of cardiovascular risk, including the provocative recent in the New England Journal of Medicine. We will also discuss the data from recent clinical trials including DASH etc. and will brush up on the political polemics regarding the issue. Finally, we will discuss some new scientific data in terms of local osmoregulation that could have a bearing on the saltintake/risk issue in the future. Review the epidemiological evidence in terms of cardiovascular risk. Page 9
11 Discuss the data from recent clinical trials and the controversy surrounding the issue. Summarize new scientific data that may impact salt intake/risk issues in the future. 11:45-12:15 PM Discussion 12:15-1:30 PM Lunch Victors at Ondine, Ondine Building 1:30 5:30 PM Free Time 5:30 PM Dinner Victors at Ondine, Ondine Building 6:30 PM Introduction to Technology Workshops Introduction to Case Studies Smith Memorial Student Union, room 327/328 (Students will break out into groups for case studies and technology sessions) Groups will be assigned on site. 7:00-9:00 PM Technology Workshops Presented by: Richard Hoppmann, MD, Columbia, SC and Raymond Townsend, MD, Philadelphia, PA Students will each have an opportunity to directly perform pulse wave analysis, carotid intima-media thickness measurements and echocardiography. Case Study Groups Presented by HSS Faculty Case discussions will be used to integrate the science and the technology so that the student understands more thoroughly pathophysiologic mechanisms, opportunities for intervention and areas ripe for further investigation. Page 10
12 MONDAY, AUGUST 2 Breakfast 6:45 to 7:45am Victors at Ondine, Ondine Building Session II Smith Memorial Student Union, room 327/328 Target Organ Damage Chairs: Rhian Touyz, MD, PhD, FAHA, Ottawa, Canada and Kenneth Baker, MD, Temple, TX 7:45-8:00 AM Introduction 8:00-8:45 AM Role of Inflammation in Hypertension and Target Organ Damage Presented by: David Harrison, MD, FAHA, Atlanta, GA Explain the fundamentals of innate vs. adaptive immunity Illustrate how to study immune and inflammatory cells and responses Identify new concepts regarding involvement of inflammatory/immune cells in hypertension and related diseases 8:45-9:30 AM Vascular Smooth Muscle Function: Signaling Pathways Presented by: Rita Tostes, PhD, Augusta, GA Describe the molecular basis of smooth muscle contraction and relaxation Describe the methods available to study vascular reactivity Identify mechanisms related to abnormal vascular function in hypertension 9:30-10:15 AM Mechanisms of Cardiac Hypertrophy and Remodeling Presented by: Kenneth Baker, MD, Temple, TX 10:15-10:30 AM Break Explain some of the mechanisms of cardiac hypertrophy. Describe the contribution of hemodynamic, genetic and growth factors. Discuss possible treatment modalities. Page 11
13 10:30-11:15 AM Renal Damage Presented by: Christopher S. Wilcox, MD, PhD, FAHA, Washington, DC This presentation will review the pathophysiologic mechanisms and the consequences of hypertensive renal damage using animal models and studies in hypertensive patients. Enumerate the mechanisms that can cause kidney damage in hypertension. Discuss the clinical consequences of hypertensive kidney damage. Outline the current theory; and gaps that need to be filled. 11:15-11:45 AM Hypertension and Cerebrovascular Damage: Implications for Stroke and Dementia. Presented by: Constantino Iadecola, MD, New York, NY This presentation will show that hypertension increases the susceptibility of the brain to stroke and dementia. This effect is related to the damage that hypertension exerts on cerebral blood vessels. Explain the regulation of the cerebral circulation Describe the effect of hypertension on such regulation Describe the link between hypertension, stroke and dementia. 11:45-12:15 PM Discussion 12:15-1:30 PM Lunch Victors at Ondine, Ondine Building 1:30 5:30 PM Free Time 5:30 PM Dinner Victors at Ondine, Ondine Building 6:30 PM Introduction to Technology Workshops Introduction to Case Studies Smith Memorial Student Union, room 327/328 (Students will break out into groups for case studies and technology sessions) Groups will be assigned on site. Page 12
14 7:00-9:00 PM Technology Workshops Presented by: Richard Hoppmann, MD, Columbia, SC and Raymond Townsend, MD, Philadelphia, PA Students will each have an opportunity to directly perform pulse wave analysis, carotid intima-media thickness measurements and echocardiography. Case Study Groups Presented by HSS Faculty Case discussions will be used to integrate the science and the technology so that the student understands more thoroughly pathophysiologic mechanisms, opportunities for intervention and areas ripe for further investigation. Page 13
15 TUESDAY, AUGUST 3 Breakfast 6:45 to 7:45am Victors at Ondine, Ondine Building Session III Smith Memorial Student Union, room 327/328 Timely topics in the Clinical Realm Chairs: Stephen Textor, MD, Rochester, MN and Christopher Wilcox, MD, FAHA, Washington, DC 7:45-8:00 AM Introduction 8-8:45 AM Treatment of hypertension: drugs Presented by: Friedrich Luft, MD, FAHA, FACP, Berlin, Germany 8:45-9:30 AM Treatment of hypertension: newer strategies Presented by: Domenic Sica, MD, Richmond, VA The presentation will include a discussion of new drug classes and device therapies that are in development for the patient with difficult-to-treat hypertension. Describe the common factors behind a patient having resistant hypertension Determine the basis for device-based therapy for the treatment of hypertension Determine what drugs in which classes are most effective in lowering blood pressure in the patient with difficult-to-treat hypertension 9:30-10:15 AM Special Situations: OSA and Mineralocortoicoid Presented by: David Calhoun, MD, FAHA, Birmingham, AL This presentation will review current and emerging data liking obstructive sleep apnea (OSA), hypertension, and hyperaldosteronism. There will be a particular focus on recent studies exploring proposed causal relationships between aldosterone excess and severity of OSA in patients with resistant hypertension. After participating in this activity, participants will be able to Recognize common coexistence of obstructive sleep apnea and hyperaldosteronism in patients with resistant hypertension. Explain potential causalities of OSA and hyperaldosteronism Page 14
16 10:15 10:30 AM Break Explain therapeutic considerations to treating OSA complicated by hyperaldosteronism. 10:30-11:15 AM Special Situations: Metabolic syndrome Presented by: James Sowers, MD, Columbia, MO 11:15-11:45 AM Pathophysiology and Treatment of Resistant Hypertension Presented by: Stephen Textor, MD, Rochester, MN 11:45-12:15 PM Discussion This discussion will center on 1) role of secondary hypertensive pathways, including renovascular disease and parenchymal renal disease, 2) Assessment and characterization of volume / pressor systems and 3) optimizing interventions and drug therapy in patients with resistant hypertension. Recognize the prevalence and implications of treatment of resistant forms of hypertension Apply diagnostic principles to evaluate volume and pressor mechanisms Anticipate benefits and risks of intervention in secondary hypertension 12:15-1:30 PM Lunch Victors at Ondine, Ondine Building Session IV Smith Memorial Student Union, room 327/328 Timely topics in Basic Science: Focus on Sex Differences and Reproduction Chairs: Joey Granger, PhD, FAHA, Jackson, MS and Jane Recklehoff, PhD, Jackson, MS 1:45-2:00 PM Introduction 2:00-2:45 PM Models for identifying genetic contributors to hypertension Presented by: Curt Sigmund, PhD, FAHA, Iowa City, IA Describe the basic uses of genetic models of hypertension Explain the basic mechanisms underlying hypertension in commonly used models Page 15
17 Describe the generation and analysis of transgenic and knockout models of hypertension 2:45-3:30 PM Pathophysiology of Hypertension during Preeclampsia Presented by: Joey Granger, PhD, FAHA, Jackson, MS 3:30-3:45 PM Break The role of placental derived factors in the pathogenesis of hypertension will be presented and discussed. Explain the epidemiology of preeclampsia Describe the role of the placenta in preeclampsia Identify key factors involved in the pathogenesis of hypertension during pregnancy 3:45-4:30 PM Fetal Programming of Hypertension Presented by: Kent L. Thornburg, PhD, Portland, OR This presentation will cover the principles of developmental programming and a short history of the field. It will cover the epidemiology of hypertension and the links between disease prevalence in adult populations and early growth patterns. These relationships will then be explored in terms of biological mechanisms in early life that lead to high blood pressure in adults. The roles of nutrition, diet and obesity will be emphasized. Finally, the presentation will outline the large gaps in our understanding of developmental stressors that lead to disease vulnerability. Student input will be sought on ways to translate science into social action. Describe the principles of developmental plasticity and fetal programming Identify the fetal stressors that lead to adult hypertension Paint a theoretical picture of areas that need urgent investigation 4:30-5:15 PM Sex Differences in Blood Pressure Regulation Presented by: Jane F. Reckelhoff, PhD, Jackson, MS New data on sex differences in blood pressure control from animals and humans will be presented and discussed; what we know, what we don t know. Page 16
18 Describe sex differences in BP in human studies Identify the potential role of sex steroids in BP control 5:15-5:45 PM Discussion 7:00 PM Dinner and Special Event Smith Memorial Student Union, room 327/328 Sponsored by the Trainee Advocacy Committee of the Council for High Blood Pressure Research WEDNESDAY AUGUST 4 Breakfast 6:45 to 7:45am Victors at Ondine, Ondine Building Going Forward Smith Memorial Student Union, room 327/328 Chair: Raymond Townsend, MD, Philadelphia, PA 7:45-8:00 AM Moving forward Presented by: Raymond Townsend, MD, Philadelphia, PA 8:00-8:45 AM Writing grants Presented by: Joey Granger, PhD, FAHA, Jackson, MS 8:45-9:30 AM Mentoring Panel Panelists: Donald DiPette, MD, FAHA, Columbia, SC, Rhian Touyz, MD, PhD, FAHA, Ottawa, Canada, Joey Granger, PhD, FAHA, Jackson, MS, Marcela Herrera, Detroit, MI 9:30-10:15 AM Discussion and Wrap up Page 17
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