Prevention, Hypertension,and highlights from Vienna'

1
Prevention, Hypertension,and highlights from
Vienna.

• With thanks to I.N.C.A. and Bristol Myers Squibb.
• Series of short stories !
• Anne Gallagher
• November 8th 2007.

2
ESC Congress 2007, Vienna

• 5 days (Sat- Weds)
• gt40,000 registered
• 22,000 attended on the Sunday
• gt9,500 abstracts submitted, 3,500 presented over
  the 5 days
• Traditional posters 2,700
• 30 concurrent presentations15 min

3
Definitions and classification of B.P. (mmHg)

• Optimal
• Normal
• High normal
• Grade 1 htn
• Grade 2 htn
• Grade 3 htn
• Isolated systolic hypertension

• Systolic Diastolic
• lt120 and lt80
• 120-129 80-84
• 130-139 85-89
• 140-159 90-99
• 160-179 100-109
• gt180 gt110
• gt140 lt90

4
Total Cardiovascular risk

• Classification to incorporate total CV risk
  factors, organ damage and concurrent disease.
• Decisions on treatment will be determined by
  total risk
• Total risk c.v. event within 10 yrs

5
2007 Hypertension guidelines

• Protection comes from BP reduction, and only in
  part from type of drug.
• Assessment of subclinical organ damage, inc.
  ankle-bracheal ratio and pulse wave velocity
• Lifestyle changes
• Optimal or almost BP control
• Combination

6
Overwhelming case for ABPM as routine practice

• 20 white coat hypertension
• 10 masked hypertension
• ? ABPM post CV event
• ABPM guiding drug treatment
• special populations diabetes,
• pregnancy, elderly.
• Integral part of good practice
• Hypertension AHA Aug. 2007 Eoin O Brien

7
Euroaction

• Cluster of randomised control trials
• Multidisciplinary family-based preventive
  cardiology programs
• 6 European countries, pairs of general hospitals
  and general practices
• Smoking Hypertension - Lipids - Physical
  Activity

8
Results

• Smoking 645 couples, 517 F 128 M, (partners not
  smoking) 71.1 v55.8
• Blood pressure, lipids, glucose 1965
  intervention, 1999 random. More patients achieved
  BP, lipids,not glucose levels treatment group
• Physical activity 995 T, 223 random significant
  changes over 1 year- achieving targets,
  importance of family-based interventions

9
Euroheart

• 3-year project, dev by ESC Eur Heart Network
• 30 partners, 21 European countries
• April 2007 March 2010
• General objective determine areas of policies
  and public health interventions to contributr
  to prevent avoidable deaths and disability across
  Europe
• European Heart Health Charter - launched

10
Physical activity

• Aerobic fitness
• Peak O2 uptake most accurate predictor of
  all-cause mortality (Kavanagh 2002)
• Vanhees, Seals. Benefits of physical activity
  for middle-aged and older adults.
• 7 days to get 5 !