The Global Burden of Disease study confirmed recently that when 84 behavioural,
environmental, occupational and metabolic risk factors were compared, systolic
blood pressure was found to be the leading risk factor accounting for 10.4 million deaths.
It is therefore paramount that important action steps are taken to address the global challenge
that hypertension poses. This was the task given to the Lancet Commission of Hypertension,
namely to identify 10 high impact action steps to address the global burden of raised blood pressure on current
and future generations. In this action plan we recognised firstly the importance of the lifecourse strategy
and how external conditions – from pre-conception and fetal to exposures during childhood
can have a significant effect on cardiovascular risk.
In this lecture some key actions will be discussed in more detail.
Collectively the burden of hypertension in any country or region remains of high priority to all,
as the consequences of cardiovascular disease and death impact widely.
With the detailed knowledge we have on factors contributing to hypertension,
it is the obligation and responsibility of every single person working in this field to educate,
empower and collaborate to act now and make a difference to current and future generations.
Keio University School of Medicine
Japanese Society of Hypertension Future Plan: Moon-Shots For Conquering Hypertension in Japan
Japanese Society of Hypertension (JSH) has newly established
“Future Plan” to conquer hypertension (Hypertens Res 41;989–990, 2018) With this plan,
we will explore/perform the best clinical practices for hypertension management
and develop positive initiatives for realizing a lively and happy society nationwide.
The Slogan is “Good Blood Pressure for Lively 100 Years”
and the goal is to decrease the number of hypertensive individuals by seven million over the next decade,
thereby extending the healthy life expectancy. We have three directions; 1.Medical system:
establishment of a lifetime-care system for individuals with hypertension.
2. Academic research: promotion of research in hypertension and embodiment of “Future Medicine”
3. Social edification: development of a social model for self-controlled blood pressure. Recognizing that conquering
hypertension should be based on “convergence science”, we especially focus on “Digital Hypertension”
by using artificial intelligence, big-data, and telemedicine via the IoT and on the formation of a multidisciplinary
network that involves the cooperation of specialists, primary care physicians, medical teams, academic societies,
administrative agencies, and insurance providers (Population Health Management).
University of British Columbia, BC Children’s Hospital
Blood Pressure Management in Children and Adolescents: Important Updates
Several prominent hypertension workgroups have developed recent guidelines for the diagnosis,
investigation and management of hypertension in children and adolescents.
Most importantly, the American Academy of Pediatrics Subcommittee on Screening and Management of High Blood Pressure
in Children developed guideline recommendations which are an update to the previously
widely used Fourth Report. Included in this guideline are tools
for improving recognition of elevated blood pressure in children,
updated normative blood pressure tables, and revision of the blood pressure classification for children and adolescents.
These important updates will be discussed along with the potential impact of the new recommendations on clinical practice.
Javier Eduardo Stern
Neuroscience Institute, Georgia State University
Thinking Outside The Cleft: Regulation of CNS Presympathetic Neuronal Activity in Health and Cardiovascular Disease States
Accumulating evidence supports a key contribution of hypothalamic presympathetic and neurosecretory neurons
to the exacerbated neurohumoral drive characteristic of cardiovascular disease states,
including hypertension. Still, the precise mechanisms that regulate their level of activity,
both under physiological and pathological conditions, remain unknown.
In recent years, we and other laboratories have shown that glial cells, particularly astrocytes and microglia,
regulate hypothalamic neuronal activity targeting unconventional non-synaptic mechanisms,
including extrasynaptic glutamate/GABA signaling. In my presentation,
I will summarize recent work from our laboratory highlighting the critical
contribution of both astrocytes and microglia to the regulation of
hypothalamic neuronal function both in health and cardiovascular disease states.
Hippokration Hospital, Athens
The Future of Renal Denervation in Hypertension Management
King Georges Medical University
Blood Pressure Variability and Its Clinical Implications
Physicians and scientists have been distracted from consideration of variability of blood pressure by giving
obsession attention to mean BP (MBP).
The hypertension guidelines insist on reduction of Mean Arterial blood pressure (MBP)
per se and remove BP variability from consideration.
Now growing evidences indicate that blood pressure variability (BVP)
is an independent predictor of hypertensive target organ damage and cardiovascular events.
This can be short term or Long term variability.
Several mechanisms have been considered to unravel BPV mystery like impairment of autonomic or hormonal regulation,
renal dysfunction and increased arterial stiffness.
New studies shows that Asians show greater morning surges in blood pressure and a steeper slope illustrating
the link between higher blood pressure and the risk of CVD events. All three components of perfect 24 hr.
BP control, the 24 hr. BP level, nocturnal BP dipping and BPV need to be addressed to tackle CVD risk.
Targeting BPV by antihypertensive agents in addition to controlling mean blood pressure values,
to achieve maximum cardiovascular protection is an exciting area of research.
Yook Chin Chia
University of Malaya
Recent Advances in Hypertension Research
In this lecture, several recent exciting scientific findings in hypertension research will be reviewed and highlighted.
Shanghai Jiaotong University
China Health and Nutrition Survey -
blood pressure measurement standard protocol and replacement of mercury device for non-mercury era
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