American Society of Hypertension, May 6-9, 2009Last Updated: May 14, 2009.
The American Society of Hypertension's 24th Annual Scientific Meeting and Exposition took place from May 6 to 9 in San Francisco and attracted about 2,000 attendees from around the world.
"The meeting's general theme was that surrogate markers for getting the blood pressure down to the recommended goal actually melts away differences between classes of drugs," said incoming ASH president, George Bakris, M.D., of the University of Chicago Medical Center. "Another theme was that combinations of agents that have shown to have beneficial effects on cardiovascular endpoints seem to do better than agents that just lower blood pressure. Another major finding is that there's a huge need in the community for education."
Bakris cited results from the Avoiding Cardiovascular Events in Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial. "One of the key paradigm-changing findings is that maybe in patients that have stage 2 hypertension we should be starting with a fixed-dose combination and that should include a calcium antagonist with an ACE inhibitor."
"A second major message deals with left ventricular hypertrophy," Bakris continued. "It was thought that beta blockers have no effect and you had to use ACE inhibitors or calcium antagonists. But the Blood Pressure Control and Left Ventricular Mass Reduction (CLEVER) trial showed that if you get the blood pressure below 130, it doesn't matter what beta blocker is given."
Brent Egan, M.D., director of the Hypertension Initiative at the Medical University of South Carolina in Charleston, presented data on two studies -- one involving 12,835 adult patients with hypercholesterolemia/hyperlipidemia, the second involving 96,489 diabetic hypertensives. They found that blacks are more likely to have several uncontrolled cardiovascular risk factors despite receiving treatment, which underscores the importance of addressing racial disparities in treatment provided by community-based practices.
"These data suggest therapeutic inertia remains an obstacle to better blood pressure control, as many uncontrolled hypertensives are receiving below recommended number of medications," Egan said in a statement. "Improvement in care is urgently needed to address the burden of uncontrolled blood pressure and reduce racial disparities in order to realize more cardiovascular benefits."
The meeting also presented new data from the Bogalusa Heart Study suggesting that the association between low birth weight and hypertension becomes more significant with age, especially in white males. A separate analysis showed that pediatric variations in blood pressure predict adult hypertension, especially in blacks.
"Both sub-studies presented today show that the environmental factors children face as they age affect their chances of developing hypertension in adulthood, regardless of other risk factors. To help address this, we recommend low-dose medication for young individuals tracking above the 90th percentile, exercise and a nutritional diet for at-risk children, especially when obese, along with comprehensive health education," Gerald Berenson, M.D., professor of cardiology at the Tulane Center for Cardiovascular Health in New Orleans, said in a statement. "We have developed the public health model Health Ahead/Start Program for elementary school children and it is hoped that such measures can be implemented to help to reduce children's risk."
Farhan Aslam, M.D., of Brigham and Women's Hospital in Boston, presented research on Family Van, a mobile health program sponsored by the Harvard Medical School. Between 1998 and 2008, 10,147 women who visited the Family Van mobile screening unit were screened for hypertension, including 3091 (1,340 who were newly diagnosed) with stage 1 or higher hypertension. Of these, a majority were black (60 percent) while 7 percent were Hispanic, 5 percent were white, and 1 percent were Asian.
"Overall, African-Americans in Boston are more likely than white Boston residents to die from heart disease as they have much higher rates of hypertension -- the most common reversible cardiovascular disease risk factor," Aslam said in a statement. "The Family Van model illustrates how successful community-based interventions can be in reaching the most at-risk populations who face many barriers to adequate health care. Importantly, its focus on prevention gives Boston's neediest access to health care that is culturally appropriate and cost-effective."
ASH: Low Blood Pressure Linked to Heart Risks
THURSDAY, May 7 (HealthDay News) -- Among heart disease patients who receive aggressive cholesterol-lowering treatment, high and low blood pressure levels are associated with an increased risk of major cardiovascular events, according to research presented at the annual meeting of the American Society of Hypertension, held May 6 to 9 in San Francisco.
ASH: Best Practice Evolving in Hypertension Treatment
THURSDAY, May 7 (HealthDay News) -- In patients with hypertension, optimal initial treatment may vary because some medications are better than others at reducing the risk of heart disease, heart attack and stroke, according to new data presented this week at the annual meeting of the American Society of Hypertension, held from May 6 to 9 in San Francisco.
ASH: Web-Based Pharmacy Care Programs Effective
THURSDAY, May 7 (HealthDay News) -- In patients with hypertension, home monitoring plus participation in Web-based pharmacy care leads to improved hypertension control and increased engagement with health care teams, according to research presented this week at the annual meeting of the American Society of Hypertension, held from May 6 to 9 in San Francisco.