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Congress report: The 23rd European Meeting on Hypertension and Cardiovascular Protection 2013

Congress report: The 23rd European Meeting on Hypertension and Cardiovascular Protection 2013
  • Cardiometabolic
  • Hypertension

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Resource type

Article

Tags

Immune mechanisms
large artery function
Renal denervation
arterial stiffness
cardiovascular risk factors
Patient compliance
Compliance
Adherence

The 23rd European Meeting on Hypertension and Cardiovascular Protection 14-17 June, 2013 Milan, Italy

A report by H. Struijker Boudier,Department of Pharmacology, Maastricht University,The Netherlands

This meeting is organized by the European Society of Hypertension (ESH) and with more than 4.000 participants it is the largest meeting on hypertension world-wide. Almost 2000 abstracts were submitted which were the basis for numerous thematic oral and poster sessions. As usual in ESH meetings an important part of the program was devoted to educational activities, such as How-To and Teaching sessions, Breakfast and Topical workshops and State-of- the Art lectures.

Although the focus of the meeting is on clinical and epidemiological aspects of hypertension interesting developments were presented in the basic science sessions. In particular, immune mechanisms now emerge as important early triggers for hypertension-related target organ damage. The kidney is especially sensitive to immunological- based mechanisms of inflammation and structural damage to its microvasculature, glomeruli and tubules. During the meeting novel data were presented that underscore these mechanisms.

In the more clinically oriented sessions and workshops two topics received much attention: large artery function and renal denervation. Large artery properties have gradually grown from a rather exotic to a much debated topic at ESH meetings. Many European, but also other, groups have established robust techniques to assess arterial stiffness and have investigated its role as a cardiovascular risk factor in relation to, but also independently of high blood pressure. The challenges to influence arterial stiffness pharmacologically were discussed by Stéphane Laurent in his Björn Folkow Award Lecture.

Renal denervation is a more controversial topic. Several mini-symposia during the ESH meeting discussed technologies and preliminary results of trials on renal denervation. Many issues still need to be resolved, such as the selection of eligible patients and long-term outcome. The question remains to what degree drug-therapy resistant hypertension is in fact caused by non-compliance to pharmacotherapy. Poor patient compliance is also an issue in another much debated topic during the ESH meeting: the role of combination therapy. It is now well established that the majority of hypertensive patients need a combination of 2 or more antihypertensives to achieve target blood pressure. Single-pill fixed combinations lead to better blood pressure control and enhance compliance to therapy.

In a packed main auditorium Robert Fagard and Giuseppe Mancia presented the 2013 ESH/ESC guidelines on hypertension. Although these guidelines contained no major changes when compared with the 2007 version and 2009 update, the evidence basis for the recommendations was dealt with in much more detail. The publication of the guidelines, which can be downloaded from the ESH website, is a thorough review of clinical and epidemiological hypertension research in the last decade.

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