Physicians' Academy for Cardiovascular Education

Prof. Neil R Poulter

Slides (presentation) - Jan. 20, 2010

Diabetes and Hypertension
Global Mortality 2000: Impact of hypertension and other health risk factors
Hypertension:SizeoftheProblem-GlobalProspects
Globalprojectionsfordiabetes(millions)2007-2025
Management of hypertension: the issues
Measurement
Management of hypertension: the issues
Absolute Risk of CVD Over 5 Years in Patients by Systolic Blood Pressure at Specified Levels of Other Risk Factors*
ESH-ESCGuidelines2007
Non-diabetic Men
Dia 11
Management of hypertension: the issues
Lifestylemeasures:BHSIV
Management of hypertension: the issues
BPtreatmentthreshold
ESH-ESCGuidelines2007
Management of hypertension: the issues
First-line therapy
UK Prospective Diabetes Study
Lessons from UKPDS
Subgroups:AmlodipinevsChlorthalidone
Subgroups:LisinoprilvsChlorthalidone
Multiple Antihypertensive Agents are Needed to Reach BP Goal
“Monotherapyisusuallyinadequatetherapy”BHSIV
ESH-ESCGuidelines2007Treatmentalgorithms
2007ESH/ESCGuidelinesCombinationbetweensomeclassesofantihypertensivedrugs
Choosingdrugsforpatientsnewlydiagnosedwithhypertension:NICE/BHS
 
Interpretation
Managementofhypertensioninpatientswithdiabetes
A + D induces more New-Onset Diabetes than A + C
New-onsetdiabetesmellitus
Event rates (per 1000 pyrs) according to glycaemic status after 1 year from randomisation
Placebo-controlled trials and NOD
Diabetologic potential of antihypertensive agents: Summary
ACCOMPLISH: Design
Primary and Other Endpoints
Management of hypertension: the issues
BP Targets
BP Targets in Various Guidelines
Effects of Antihypertensive Drug Treatment on SBP in Hypertensive Patients With Diabetes
Significant Benefits From Intensive Blood Pressure Reduction in Diabetics (HOT)
[Stroke]
:MajorCVevents
Dia 45
Randomised study treatments
Blood pressure reduction
Summary
ADVANCEincontext:UKProspectiveDiabetesStudy
Management of hypertension: the issues
Recentguidelinesforlipidloweringinpatientswithhypertension‘Thresholds’in1oprevention

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