The American Society of Hypertension's 26th Annual Scientific Meeting and Exposition was held from May 21 to 24 in New York City, and attracted approximately 2,500 participants from around the world. The conference highlighted recent advances in the prevention, detection, and treatment of hypertension and related cardiovascular conditions. The conference featured scientific abstracts and presentations which focused on the pathobiology of hypertension, translational issues in hypertension, and hypertension treatment.
In one study, William Cushman, M.D., of the University of Tennessee College of Medicine in Memphis, and colleagues found that fixed-dosed combination treatment with azilsartan medoxomil and chlorthalidone more effectively lowered systolic blood pressure as compared with fixed-dose combination treatment with olmesartan medoxomil and the thiazide diuretic hydrochlorothiazide.
"The results were encouraging. Both the 40 and 80 mg doses of the azilsartan medoxomil and chlorthalidone combination improved blood pressure reduction over the fixed-dose combination treatment of olmesartan medoxomil and hydrochlorothiazide. The tolerability of the 40 mg combination was similar to that of olmesartan medoxomil plus hydrochlorothiazide; however, the 80 mg combination had more adverse effects," Cushman said. "This combination of azilsartan medoxomil plus chlorthalidone, especially in the 40 to 25 mg dosage, offers the promise of a very effective and well-tolerated treatment for hypertensive patients."
In another study, Praveen Veerabhadrappa, M.D., of Temple University in Philadelphia, and colleagues found an increased prevalence of masked hypertension among African-Americans.
"The data we presented at the meeting [were] preliminary data from an ongoing study. We recruited 38 African-American subjects and compared their in-office blood pressure to their blood pressure out of the office to assess the prevalence of masked hypertension," Veerabhadrappa said.
The investigators found an increased prevalence of masked hypertension, with 45 percent of subjects having normal in-office blood pressure and elevated out-of-office blood pressure.
"It is important to identify patients, especially African-American patients, with masked hypertension, as this typically is a precursor to sustained hypertension, which, in combination with other cardiac risk factors, likely increases the risk of cardiovascular disease," Veerabhadrappa said. "We can't be complacent with a normal blood pressure for an African-American in the office. We are going to have to do more ambulatory blood pressure monitoring and home monitoring."
Franz H. Messerli, M.D., of the Columbia University College of Physicians and Surgeons and St. Luke's-Roosevelt Hospital in New York City, and colleagues found that alcohol intake was associated with an increased risk of developing hypertension, especially among men.
In a meta-analysis, the investigators evaluated a total of 16 prospective studies, which included 158,142 men and 314,258 women.
"We found that there were gender differences in response to daily alcohol consumption of between 10 to 20 grams of alcohol, in that women had a lower risk of hypertension. However, with more than 30 grams of alcohol per day, the risk of hypertension increased with the dose in men and women alike. Thus, more than two drinks a day, regardless of whether beer, wine, or liquor, may be a significant risk factor for high blood pressure," Messerli said.
In another meta-analysis, Esther Lopez-Garcia, Ph.D., of the Universidad Autónoma de Madrid in Spain, and colleagues found that caffeine intake of 200 to 300 mg was associated with an acute increase of blood pressure that lasted for at least three hours.
"In those patients with blood pressure well controlled, it may be safe to consume coffee, but more research is needed. We have seen that habitual consumption does not seem to increase blood pressure in clinical trials of two weeks of duration and that habitual hypertensive patients do not have an increased risk of having a heart attack or stroke than non-coffee-consumers. However, we need more clinical trials that characterize how blood pressure changes with coffee intake in the longer-term (more than one day) because the studies we found were insufficient to be totally sure," Lopez-Garcia said.
Lopez-Garcia recommended that patients with uncontrolled blood pressure should avoid consuming large doses of caffeine, as caffeine intake clearly increased blood pressure in an acute way, and for patients with uncontrolled blood pressure, this increase may be harmful.
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