Hypertension Busan 2020

in Conjunction with the 52nd Scientific Meeting of the
Korean Society of Hypertension

2020.8. 7 (Fri) - 8 (Sat) BEXCO, Busan, Korea

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Speakers

Abdul Rashid Rahman

Consultant Physician,
Visiting Professor and Medical Director / Malaysia

Session KSH/Malaysian Society of Hypertension Joint Symposium
[How to manage prehypertension epidemics and risk factor clustering]
Lecture Title National Governmental Policy to Enhance Hypertension Control in Malaysia
Lecture
Introduction
Hypertension remains a public health scourge globally and especially in developing countries. In the Asia Pacific Region, prevalence, awareness, treatment and control rates lag far behind that of Canada, USA and UK. In some parts of Asia concerted efforts are being made to address the short fall with varied results. In Malaysia efforts to understand the true burden of hypertension began in earnest 3 decades ago beginning with understanding the epidemiology, implementing public health education strategy, targeted screening program, drafting national treatment guidelines and continuous audits of performance. Results of this efforts will be discussed and shortcomings highlighted for future improvement.
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Apichard Sukonthasarn

Bangkok Hospital Chiang Mai / Thailand

Session Optimizing Hypertension Management in the Elderly
Lecture Title BP Variability and Cognitive Function
Lecture
Introduction
BP variability was a known CV risk predictor. There are experts trying to prove that BP variability is the factor that cause the CV events but some argue that it may be only an epiphenomenon. The information about BP variability and cognitive function is rare but interesting. The data about this subject will be reviewed and the suggestion will also be given during this discussion.
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Eugene Yang

University of Washington School of Medicine / USA

Session Meet the Expert II: Keywords in the Patient Centeredness in Hypertension [Eng]
Lecture Title Team-based Approach to Blood Pressure Management- Review of 2017 ACC/AHA Hypertension Guidelines
Lecture
Introduction
Blood pressure control remains low in the United States despite efforts to increase education and awareness- With implementation of the 2017 ACCIAHA guidelines, BP control rates have now fallen below 50%. In this presentation, we will review the updated American BP guideline recommendations for team-based care deliver systems for hypertension management and highlight recent studies that demonstrate the efficacy of these approaches.
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Fumiaki Ikeno

Stanford University / USA

Session New Approach in Hypertension and Cardiovascular Diseases
Lecture Title The Trend of New Technology of Cardiovascular Field from Silicon Valley
Lecture
Introduction
Most of the new medical technologies come out of Silicon Valley. Today, I will explain the trend of medical technologies from the Silicon Valley.
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George Stergiou

University of Athens, Sotiria Hospital, Athens / Greece

Session New approach to blood pressure monitors in the Mercury-free era
Lecture Title The emerging era of wearable cuffless blood pressure monitors
Lecture
Introduction
Recent developments in blood pressure measurement technology have provided several cuffless wrist-wearable devices, which can take repeated or even continuous measurements during the 24-hour period for days or weeks, providing thereby a detailed evaluation of the dynamic blood pressure profile and behavior and avoiding the disturbance of limb compression induced by classic cuff-based blood pressure monitors. The cuffless wearable devices have a sensor which evaluates the pulsation of arterioles and estimates blood pressure based on pulse wave velocity (PWV), which is calculated using the principal of pulse transit time (PTT) or pulse arrival time (PAT), namely the time required for a pulse wave to travel a fixed point-to-point distance through the arterial tree. The International Standardization Organization (ISO) is currently developing a standard specifically for the validation of cuffless wearable blood pressure measuring devices. Further to the evaluation of baseline blood pressure measuring accuracy, the ISO standard addresses additional issues specific to wearable devices, including the evaluation of sustained accuracy until recalibration is required and the ability to accurately track blood pressure changes. In conclusion, the cuffless wearable devices are very promising, yet at the present time their usefulness in clinical hypertension management is uncertain.
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Gianfranco Parati

University of Milan-Bicocca / Italy

Session Plenary Lecture
Lecture Title Blood Pressure Variability: a Target for Treatment in Hypertension?
Lecture
Introduction
A large body of evidence suggests that the risk associated to hypertension may not only depend on the magnitude of average BP levels elevation, but also on the presence of an increased BP variability (BPV). Indeed, increased BPV either in the short term (24 hours), in the midterm (day-by-day), or in the long term (visit-to-visit), may predict development, progression, and severity of cardiac, vascular, and renal organ damage, as well as cardiovascular events and mortality. Whether BPV indices might represent useful parameters in clinical practice and whether an increased BPV should be a target for treatment, this is still a matter of discussion, however. This lecture will review the available data on mechanisms, methodological aspects, clinical relevance and therapeutic implications of BPV.
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Timothy Anstiss

Centre for Coaching, Henley Business School / UK

Session Meet the Expert II: Keywords in the Patient Centeredness in Hypertension
Lecture Title Conventional Education versus Coaching
Lecture
Introduction
Patients spend over 8,000 hours every year with their hypertension, compared to just a few hours each year with their doctor. If we want our patients to better manage their own health we need to find ways to motivate and empower them to change – e.g. their diet, stress levels, physical activity or weight. Telling people to change may not be the best way to help them. Health Coaching and Shared Decision making may help you get better results. In this lecture I give some tips on how to get better clinical outcomes via behavior change techniques.
Session Special Lecture
Lecture Title Getting Your Patient to Look After Their Health. A Quick Taste of Motivational Interviewing
Lecture
Introduction
In this lecture I will give a demonstration of two different styles of talking with people about making a behavior change, and we will discuss good conversational practice in activating and empowering patients to control their blood pressure and reduce their risk of complications.
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Toru Kikuchi

Saitama Medical University / Japan

Session Update on evaluation and management of pediatric hypertension
Lecture Title Diagnostic criteria of pediatric hypertension in Japan: BP reference values, BP classification
Lecture
Introduction
Accurate blood pressure measurement is essential for the diagnosis of hypertension. Even in children, right brachial blood pressure should be measured in a sitting position. The selection of an appropriate size cuff is also important. The cuff should be selected according to the size of the child’s upper arm rather than their age, and one with an inflatable bladder width exceeding 40% of the arm circumference and a length sufficient to cover 80% or more of the arm circumference should be used. Blood pressure should be consecutively measured ≥3 times, and the mean of two stable measurements should be adopted. If the blood pressure values measured at ≥3 different opportunities are above criteria, childhood hypertension could be diagnosed. In the Japanese Society of Hypertension 2019 Guidelines for the Management of Hypertension, criteria were established based on the data obtained on blood pressure screening using an automatic blood pressure meter by oscillometric methods. Diagnostic criteria: 6 to 8 years of age, ≥130/80 mmHg; and 9 to 11 years of age, ≥135/80 mmHg; and 12 to 14 years of age boys, ≥140/85 mmHg; and 12 to 14 years of age girls, ≥135/80 mmHg; and 15 to 17 years of age, ≥140/85 mmHg.
Session Update on evaluation and management of pediatric hypertension
Lecture Title Evaluation and management of pediatric hypertension in Japan
Lecture
Introduction
Hypertension detected on blood pressure screening is mostly essential hypertension. A diagnosis of childhood essential hypertension is made based on the absence of symptoms suggestive of secondary hypertension, adolescence, a mild degree of hypertension, obesity, family history, and low birth weight. Children under 10 years old should be excluded from the diagnosis of essential hypertension. The mechanism of essential hypertension in children involves insulin resistance and excessive salt ingestion, as adults. The possibility of secondary hypertension increases with a younger age or higher blood pressure. Hypertension related to renal diseases accounts for 60-80% of children with secondary hypertension. Problems with essential hypertension in children and adolescents include target organ damage and tracking into adult essential hypertension. Childhood essential hypertension is related to obesity in many cases. Lifestyle modifications, such as diet, exercise, salt reduction, should be primarily performed. Drug therapy is indicated for children with hypertension meeting the following criteria: persistent hypertension despite non-drug therapy involving lifestyle modifications, symptomatic hypertension, secondary hypertension requiring drug therapy, the concomitant development of target organ damage, the presence of CKD or diabetes mellitus. For drug therapy, such as angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and Ca channel blockers are recommended.
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Yasuharu Tabara

Kyoto University Graduate School of Medicine / Japan

Session Optimizing Hypertension Management in the Elderly
Lecture Title Sleep Blood Pressure Management, Findings from the Nagahama Study
Lecture
Introduction
High sleep blood pressure is known to be a risk factor for cardiovascular outcomes independently of awaking blood pressure. However, factors influencing on sleep blood pressure has not been fully understood. The Nagahama study is a general population-based cohort study consists of 11,325 Japanese community-residents with multi-day measured sleep blood pressure. In this lecture, we introduce recent findings from the Nagahama study regarding sleep blood pressure measurements, variability, and factors influencing on sleep blood pressure to help better management of 24-h blood pressure.
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Yook Chin Chia

Sunway University / Malaysia

Session KSH/Malaysian Society of Hypertension Joint Symposium
[How to manage prehypertension epidemics and risk factor clustering]
Lecture Title Lifestyle Modification in Prehypertension
Lecture
Introduction
The word prehypertension was first introduced in May 2003 with the launch of the JNC-7. Prehypertension is defined as values of blood pressure (BP) readings between systolic 120–139 and/or diastolic 80–89 mmHg In the latest American hypertension guidelines of 2017, prehypertension has now been accepted as a diagnosis of Stage 1 hypertension. Part of the reasons for lowering the BP threshold from a systolic BP of ≥140 mmHg to ≥130 mmHg to define clinical hypertension was that cardiovascular disease (CVD) risk is actually a continuum across blood pressure. Furthermore it was being recognised that blood pressure readings between what is deemed optimal (ie ≤120/80 mmHg) and what is defined as clinical hypertension ( (BP ≥140/90 mmHg) is already associated with increased CVD risk and actual CVD events.
The prevalence of prehypertension is high and the progression to hypertension is also high. Prehypertension is also commonly associated with other CVD risk factors namely dyslipidaemia, dysgylcaemia and overweight/obesity. Eighty-five percent of prehypertensives have one other or more CVD risk factor compared to normotensives The aim of managing prehypertension is to lower the BP, prevent progression to hypertension and to prevent BP related CVD deaths. Lifestyle changes can reduce BP and this by itself can lower CVD risk. Currently there are no good outcome trials regarding the treatment of prehypertension with anti-hypertensive agents. Until more evidence about other modalities of treatment become available life-style modifications is a sensible and cost-effective way to manage prehypertension.
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Yuqing Zhang

Fu Wai Hospital, Chinese Academy Medical Sciences and
Peking Union Medical College / China

Session Ambulatory blood pressure monitoring in special population group
(Blood pressure working group)
Lecture Title Ambulatory blood pressure monitoring in diabetes or autonomic dysfunction 
Lecture
Introduction
Ambulatory blood pressure monitoring (ABPM) has been widely used in the management of hypertension and related diseases since several decades ago. It plays an important role in the diagnosis and treatment of hypertension. The blood pressure variability in patients of diabetes and those with autonomic dysfunctions varies more greater than those without these abnormalities. Thus, the application of ABPM may be an important tool in the management of abnormal blood pressure in these special population. This lecture is mainly focus on some important aspects ABPM in these patients.
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