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Congress Report: European Society of Cardiology (ESC) 2015

Congress Report: European Society of Cardiology (ESC) 2015
  • Cardiometabolic
  • Hypertension

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Resource type

Article

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European Society of Cardiology
ESC
Cardiovascular disease (CVD)
Environment
Air pollution
Heart
Microcirculation in CVD
Hypertension
PATHWAY-2 trial
resistant hypertension
Antihypertensives
Renin-angiotensin blockers
Calcium channel blockers
Diuretics
Spironolactone
Bisoprolol
Doxazosin
PARAMETER study
Hypertension in elderly
arterial stiffness
LCZ 696
Olmesartan
Renal denervation
combination therapy

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Practical

For the first time in 63 years the ESC Congress was held in the UK (London, 29 August to 2 September 2015), said Professor Harry Struijker-Boudier, who reports on the congress highlights

For the first time in 63 years the ESC Congress was held in the UK (London, 29 August to 2 September 2015), said Professor Harry Struijker-Boudier, who reports on the congress highlights

The ESC is the largest global cardiovascular event. This year there were:

  • >27,000 professionals from 140 countries attending
  • ~7000 presentations
  • 661 sessions on different topics ranging from basic science to clinical science and population based studies
  • >200 exhibiting companies and organisations.

 

A focus of the congress was the environment and the heart, highlighting the links between air pollution and cardiovascular disease (CVD)

The World Health Organization has estimated that one in eight global deaths could be attributed to air pollution. The Organisation for Economic Co-operation and Development (OECD) predicts that by 2050 urban pollution will be the top environmental cause of mortality.

Microcirculation in CVD

In the ESC William Harvey Lecture on Basic Science, Professor Axel Pries (Berlin) reviewed the role of the microcirculation in CVD, in particular that of glycocalyx, a gel-like layer 0.5 μm thick, influencing flow resistance, inflammation and permeability.

Hypertension was one of the focus areas in the clinical and population based sessions. The Council on Hypertension drafted an interesting programme that included results from important recent trials

The PATHWAY-2 trial evaluated optimal treatment of resistant hypertension in 314 resistant hypertensive patients.

The trial hypothesis was that resistant hypertension is a sodium-retaining state characterised by an inappropriate low plasma renin level despite treatment with at least three different antihypertensives (renin-angiotensin blockers, calcium channel blockers and diuretics). Either spironolactone or a choice of bisoprolol or doxazosin was added to this regimen.

A significantly larger degree of blood pressure lowering occurred with spironolactone than either the beta- or alpha-blocker.

Results from the PARAMETER study were presented in the Hot-line Hypertension sessions.

The effects of the angiotensin receptor blocker / neprilysin inhibitor LCZ 696 on arterial stiffness in the elderly was compared with the angiotensin receptor blocker olmesartan.

A 12-week treatment with LCZ 696 gave a stronger reduction in central aortic systolic pressure than olmesartan – 24-hour recordings showed that this occurs particularly at night. In addition, LCZ 696 reduced plasma levels of N-terminal pro-brain natriuretic peptide in contrast to olmesartan.

These data suggest that LCZ 696 may be an interesting alternative to treat hypertension in elderly with an increased arterial stiffness.

Other highlights were…

A debate on whether the renal denervation treatment of resistant hypertension is dead, and an educational session on the role of combination therapy as treatment initiation in hypertensive patients.

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