Hypertension at the Intersection of Diabetes, Obesity and Renal Failure

Friday 17th June 2005

Hypertension at the Intersection of Diabetes, Obesity and Renal Failure

Milan, Italy

Hypertension remains a worrisome and important contributor to cardiovascular disease, despite decades of improving awareness and care. Partly this can be ascribed to inadequate blood pressure control at important times in the circadian cycle. Recent studies have demonstrated the prognostic power of 24-h ambulatory blood pressure monitoring, and the differential effects of antihypertensives in the risky, early morning period.

Hypertension also interacts with other co-morbidities through physiological and neurohormonal effects. Adipose tissue is now recognized as metabolically active and centrally involved in the production of key hormones. Critically, it both expresses and responds to components of the renin-angiotensin-aldosterone system (RAAS), leading to the hypothesis that RAAS blockade may bring benefits beyond the direct effects on blood pressure.

Diabetes and renal dysfunction likewise interact with hypertension and with the RAAS, opening up the possibility of focused intervention in patients with these symptoms. High-risk patients, therefore, offer both a challenge and an opportunity for treatment. Our last topic will examine the evidence for the differential cardiovascular effects of antihypertensive drugs in these patients.

This symposium explored these cutting-edge issues, with presentations on the poor blood pressure control that can result from the early morning blood pressure surge, the rationale for angiotensin receptor blockade in patients with obesity or diabetes, and the role for different antihypertensive agents in other high-risk patients.

Faculty

Symposium Chairmen

• Enrico Agabiti Rosei - Università de Brescia, Brescia, Italy
• Luis Miguel Ruilope - Hospital 12 de Octubre, Madrid, Spain

Speakers

• Roland Schmieder - Universität Erlangen-Nürnberg Nürnberg, Germany
• Arya Sharma - McMaster University, Hamilton, Canada
• William White - University of Connecticut School of Medicine, Farmington, USA

Agenda

• Welcome and introduction - Enrico Agabiti Rosei (Italy) and Luis Miguel Ruilope (Spain)
• Early morning blood pressure surge: the culprit for lack of blood pressure control - William White (USA)
• The rationale for angiotensin blockade in the management of obese hypertensives - Arya Sharma (Canada)
• Hypertension, diabetes and renal disease - how to tackle this unholy alliance? - Roland Schmieder (Germany)
• Do different drugs have different cardiovascular effects in high-risk patients? - Enrico Agabiti Rosei (Italy)
• Questions and closing remarks - Enrico Agabiti Rosei (Italy) and Luis Miguel Ruilope (Spain)

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