International Conference on Cardiovascular Diseases and Therapeutics November 21-22, 2018 Paris, France

Venue: Holiday Inn Paris - Marne la Vallée

Biography:

Rola Bou Serhal has completed her Research Master’s in Public Health, Epidemiology and Biostatistics branch from the Lebanese University. She holds a BS in Nursing from the Lebanese University too. She is a Clinical Research Assistant at the Clinical Research Center of Saint Joseph University (USJ). This is her first publication in a promising research career that she is building.

Abstract:

Background: Hypertension control reduces cardiovascular risk. Yet, lack of adherence to medication reduces this control. Therefore, tools to measure medication adherence are needed. A new Lebanese scale measuring medication adherence considered socioeconomic and cultural factors not taken into account by the eight-item Morisky Medication Adherence Scale (MMAS-8).

Objectives: The main objectives of this study were to validate the new adherence scale and its prediction of hypertension control, compared to MMAS-8, and to assess adherence rates and factors.

Methodology: A cross-sectional study, including 405 patients, was performed in outpatient cardiology clinics of three hospitals in Beirut. Blood pressure was measured, a questionnaire filled, and sodium intake was estimated by a urine test. Logistic regression defined predictors of hypertension control and adherence.

Results: A percentage of 54.9% had controlled hypertension and 82.4% were adherent by the new scale which showed good internal consistency, adequate questions (KMO coefficient = 0.743), and four factors. It predicted hypertension control (OR = 1.217; p value = 0.003), unlike MMAS-8, but the scores were correlated (ICC average measure = 0.651; p value < 0.001). Stress and smoking predicted non-adherence.

Conclusion: This study elaborated a validated, practical, and useful tool measuring adherence to medications in hypertensive patients.

Biography:

Laura Azevedo is a brazilian infectious diseases physician, completed her MSc of Public Health in Developing Countries at LSHTM and has recently started a PhD of economic evaluation of health interventions at University of São Paulo.  She works as medical coordinator in an emergency care unit and as data analysis supporter for the regional health care network. There, she works for SPDM, a health organization responsible for the management of all health care units of this district in the outskirts of the biggest city in Brazil - São Paulo.

Abstract:

The line of care for hypertensive and diabetics (LCHD) aims to be the guide of care in primary health care. Care systematization, cardiovascular risk classification and return flowchart require standards so that all the information is collected uniformly, whether in the reception, medical or nursing consultations or in attendance by the multiprofessional team.  The objective of this study was to present the forms of a LCHD. Experience report on the forms of a LCHD implemented in 2012 at the Vila Maria Vila Guilherme Health Network. The first version of the service form being capable of structuring the LCHD logic was developed in 2013. In 2015, it was revised and brought more objectivity maintaining the vital signs, anthropometric measurements, laboratory results, emergency or hospitalization care, diabetic foot evaluation and information on physical activities. In the same year, the need of sharing the management of care with the user, a singular therapeutic project form was developed, which symbolized a contract between the patient and the professional. At the end of 2017, in addition to contributing to the follow-up of the disease, ensure continuity of care and communication between the team, the return-on-consultation records stood out, since it was a priority to ensure compliance with the LCHD flowchart. More efficient attendances, more accurate monitoring of patients and to extract the characterization of the epidemiological profile are real contributions from LCHD's structured and constantly updated records. Although today, six years after its first version, difficulties in its fulfillment are found and these are essential for the execution of the LCHD.

Biography:

Mafalda Castelão  is currently working in the Department of Pediatrics, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.

Abstract:

Introduction: The world is in the grip of an obesity crisis, associated with a substantial increase in the prevalence of hypertension among youth. Obesity and elevated blood pressure (BP) in adolescents are both risk factors for cardiovascular disease that track into adulthood. New guidelines on pediatric hypertension were published that may change the previous diagnoses of hypertension.

Objective: The main objective of this study was to evaluate the prevalence of hypertension and the impact of the updated European guidelines on excess weight adolescents.

Methods: Retrospective cohort study (2011-2018) of overweight and obese adolescents, with BP measurements on at least three separate visits.

Results: Three hundred eleven (311) adolescents (48% male; 15.1±1.63 years old; BMI 32.2±5.85 kg/m²) were included. Hypertension was identified in 15% and 9% according to the 2009 and 2016 European Society of Hypertension (ESH) guidelines, respectively (p=.003). The prevalence of hypertension above the age of 16 was reduced by 76% (p<.001), mostly among males (p=.004). The estimates of high-normal BP decreased from 29% to 15% (p<.001), reclassifying as normotensive predominantly adolescents with a lower BMI (33.4±5.81 vs 35.7±7.22; p=.025). The overall prevalence of abnormal BP decreased by 45% (from 44% to 24%; p<.001), irrespective of gender, age or BMI.

Conclusions: The new ESH guidelines classified nearly half less adolescents with elevated BP and hypertension, with more than two thirds of the older adolescents reclassified as normotensive. Nevertheless, the prevalence of hypertension remained extremely high as compared to the healthy weight youth. Recognition of the premature beginning of cardiovascular disease among this at-risk population is a key public health target to reduce adult morbidity and mortality.

Biography:

Foroohar Foroozan is system software and signal processing scientist at Analog Devices Inc. (ADI) leading the algorithm design for vital signs and in-home monitoring systems for the healthcare business unit in Toronto. The mission of this technology development group is to deliver the embedded platform, cloud, and analytics technologies required to meet the ADI IoT product and service ambitions. She is also collaborating with the Echo2Bits healthcare team for Point-of-Care ultrasound imaging systems. She was a postdoctoral fellow at Sunnybrook Research Institute working on 3D super-resolution ultrasound imaging for brain vascular mapping from 2012 to 2013 with a PCT patent pending. She was also a lecturer at the University of Ontario Institute of Technology, teaching both graduate courses from 2011 to 2012. She received her PhD degree in computer science from Lassonde School of Engineering, York University, Toronto, Canada in 2011. Her area of interest is in signal processing and algorithms in biomedical systems with focus on body area sensors for vital signs systems, in-home monitoring systems for assisted living and biomedical imaging. Dr. Foroozan’s work on compact ultrasound imaging system was awarded at the Sunnybrook-Schulich Innovation program in 2014, with a PCT patent. She is a member of the Professional Engineering Society of Ontario (PEng.) and a senior member of the IEEE.

Abstract:

Problem: Continuously monitoring the Blood Pressure (BP), specially for people of advanced age and those who are at a high risk of developing cardiac disease is very important. Currently, continuous BP measurements, including nocturnal, require surgical insertion of an intra-arterial monitor, only occurring in an ICU environment. Non-invasive BP measurements are limited to cumbersome products requiring deliberate inflation & producing only spot measurements, often negatively impacted erroneous procedures during measurement. Medical providers, patients and pharma need continuous, real life measurements without expensive, bulky invasive equipments.  In this work, 24H unobtrusive monitoring of cardiovascular health is implemented using wrist-based Photoplethysmography (PPG) signals, in which we produce 24H BP graphs and Personal Health Maps (PHM).

Methodology: We suggest PHM for each patient to provide at a glance the position of the patient in the Health Space 24H. The algorithm is based on Fuzzy clustering, where each patient is assigned with a different level of membership in different pathological and healthy conditions. The PHM shows the trace of a patient’s PPG pulse shape during day and night in one glance. In one study in Calcutta hospital, 30 hypertensive and diabetic patients were monitored at home 24H both with an Ambulatory Blood Pressure Monitoring (ABPM) device which records the BP every 15 min together with a continuous PPG  recordings in order to estimate the BP and Cardiac Output  (CO) continuously. In a second clinical trial, we compared our Hemodynamics prediction to that of a continuous Hemodynamics CNAP device, during Hemodialysis in Fresenius Kidney Center, in St. Louis hospital. Using 2-4 light wavelengths allowed us also to interrogate the capillary bed at different penetration levels to estimate features related to the microcirculation.

Findings: We implemented Fuzzy clustering algorithm to cluster the pulse shapes in the feature space. We discovered that different health conditions fell into different clusters and it changes during 24H.

Conclusions & Significance: We showed that different health conditions can be defined by the PPG pulse shape clustering, which also generates a continuous Health space. Cluster centroids that represent various pulse shapes belong to different health conditions. This provides a powerful tool to monitor progress or deterioration of a patient in a quantitative way. It is quite crucial for people suffering from hypertension to monitor their BP continuously and get timely medical intervention, so that serious cardiovascular complications shall be prevented. This method can also solve the problem of nocturnal cardiac monitoring at home.

Biography:

Joao Brocas is a Wearable’s Expert and a globally recognized top 100 Global Digital Health Influencer. His passion lies in helping others, sharing experiences, transferring knowledge, working collaboratively and passing on the latest innovation trends from the digital health world as a Thought Leader in wearable’s, digital health, IoT and healthcare innovation, including AI (artificial intelligence), robotics and ML (machine learning). He has explored the intersection of technology in modeling business models and shaping consumer behavior. Also, he analyses the impact of disruptive innovations and shares future trends in the marketplace.

Abstract:

The world has reached an unprecedented point in new digital technology developments, where novel wearable technologies will now be able to revolutionize everyday management of chronic disease. Cardiovascular disease is the world’s single biggest killer. As such, this is an area significantly appropriate for the introduction of remote monitoring medical wearable technologies. Joao Brocas, a recognized expert in digital technology, will explain how the modern consumer wants to interact with this dynamic new world, as well as what challenges and opportunities lie ahead and why this is one of the world’s most exciting area for consumer engagement. Joao will also highlight the revolutionary manner in how TLT’s new digital platform technology and the revolutionary ViCardio product will drive the future of this sector.

Biography:

Laura Azevedo is a brazilian infectious diseases physician, completed her MSc of Public Health in Developing Countries at LSHTM and has recently started a PhD of economic evaluation of health interventions at University of São Paulo.  She works as medical coordinator in an emergency care unit and as data analysis supporter for the regional health care network. There, she works for SPDM, a health organization responsible for the management of all health care units of this district in the outskirts of the biggest city in Brazil - São Paulo.

Abstract:

The hypertension line of care (HLC) contemplates the continual care and interconnects to the hypertension carriers on the health care system. Therefore, it is essential that the technical team have adherence to the line. Thus, health care managers proposed the production of an educational video (EV) about HLC for the professionals. The theoretical reference for the production of the EV about the HLC was the format of Fleming, Reynolds and Wallace. The EV production took place in June 2018 in the Rede Assistencial de Saúde Vila Maria and Vila Guilherme with institutional resources and the acquisition of the video software VideoScribe®. In pre-production, the script was written by two specialists, one in education and another in public health. It was based on the story of a fictional character, 64 years old Dona Joana, who after moving from her home has a headache and seeks the health service, initiating the investigation of hypertension. It is narrated her attendance in the center of specialty, in the hospital and her return to the basic unit of origin that accompanies her continuously. An experienced nurse, a reference to HLC, analyzed the script. The video production and audio recording were done. In post-production the EV was released, with 4:11, on Youtube® (https://www.youtube.com/watch?v=ZwXV0RaY4mo) with the option of automatic subtitles on a variety of languages, counting 600 views since the publication. It is possible to make an EV with few resources and contribute in a simple and effective way with the qualification of the professionals for the integral care of the patients with hypertension.

Biography:

Shashi Mawar has an experience of 18 years in various positions in the field of medicine. Presently she is a lecturer at the College of Nursing, AIIMS, New Delhi. She is a lifetime member of Trained Nurses Association of India, Nursing Research Society of India, Indian Association of Neonatal Nurses and Indian Association of Preventive and Social medicine. She has participated as a coordinator, panelist and resource person at various National and International forums. She has authored several papers in both national and international publications.

Abstract:

Introduction

Hypertension exerts a substantial public health burden on cardiovascular health status and health care system in India. It has been estimated that among adults>50 years of age, the lifetime risk of developing hypertension approaches 90%.  BP is frequently underdiagnosed and undertreated among elderly therefore a community based screening followed by a nurse led BP control program was taken up.

Methods

A cross sectional survey to assess the prevalence of hypertension among 1386 elderly.  Quasi experimental design to assess the effectiveness of nurse led program on management of hypertension. Purposive sampling adopted to enrol 378 HT patients. Study group and control group were divided on the basis of blocks.

Community based nurse led program is a holistic program covering life style modification, stress management, dietary modification, physical activity and medication adherence.

Results : Overall prevalence of HT was 34.6% with 31% among males and 36% among females. Mean age was 64.5. Both groups were homogenous in respect to all risk factors at baseline. There was a significant difference in SBP at 6 months p=0.04(95%CI: 0.04-4.01) and 1 year p<0.001 (95%CI: 2.4-5.9) among study group subjects. Mean BP reduced by 6 mmHg at the end of one year among study group. Significant difference in total cholesterol, TGL and VLDL levels was also found. Mean reduction of 13.1 in total cholesterol among study group p=0.003 (95%CI: 2.3-11.6)

Conclusion: Community based nurse led program is effective in managing BP.

Biography:

Percia earned her degree in medicine from Federal University of Pernambuco, Brazil in  2002. She is currently a resident in Internal Medicine (Nephrology) at São Paulo University, Brazil. She has a Fellowship in Critical Care Nephrology from Vicenza. Additionally, she has experience in Intensive Care Medicine and basic research.

Abstract:

Arterial Hypertension is an important cardiovascular risk factor. Patients on dialysis have an increase cardiovascular risk when compared with general population. The last  Brazilian census of Nephrology published in 2017 showed that arterial hypertension remains as the first cause of chronic kidney disease leading to dialysis in Brazil.

P.Medeiros el al analyzed 67 patients from a single center  and found that only 35,8% of patients on haemodialysis (HD) achievied the target blood pressure (BP), including here patients using at least one class of anti-hypertensive drug. In this study hypertension was definided as Systolic BP pre HD <140mmHg and Diastolic BP pre HD<90mmHg.

The CORDIAL study perfomed between 2010-2011 collected data from 1200 patients  and found a prevalence of hypertension of 87,4%. The definition of hypertension was the same as defined above plus the use of any anti-hypertensive drug.

There are still a lack of data about BP control in haemodialysis patients in Brazil but the data available show a high prevalence of hypertension on this population. Lowering blood pressure objecting blood pressure control should be pursue to reduce cardiovascular events and mortality in patients on dialysis.

Biography:

Wafaa Mahmoud Abdel-Rehim works as Assistant Professor of Biochemistry at Medical Research Institute under Alexandria University, Egypt. She published more than 20 papers in reputed journals including Journal of Cellular Biochemistry in 2017 and Biological Chemistry in 2016.

Abstract:

Background: Klotho is recognized as an anti-aging protein, protects the cardiovascular system through endothelium derived NO. Klotho deficiency disturbs endothelial integrity but the molecular mechanism is not fully clarified.

Objective: The objective of this study was to observe the relationship between Klotho protein and biochemical marker of oxidative stress, endothelial dysfunction and arterial aging in non-treated and ACEI-treated patients with essential hypertension (EH).

Subjects & Methods: Eighty subjects with essential hypertension, divided into two groups and the first didn’t receive any hypertensive treatment (n=40) while the other (n=40) received angiotensin converting enzyme inhibitors (ACEIs) and 20 age and sex matched controls were included in the study. Serum levels of nitric oxide (NO), malondialdehyde (MDA), vascular endothelial growth factor-A (VEGF-A) and Klotho protein were measured. Carotid Intima- Media Thickness (CIMT) was determined by ultrasonography for all participants.

Results: Mean values of MDA, VEGF-A and CIMT revealed significant increment while those of NO and Klotho showed significant reduction in non-treated EH patients compared to controls. Mean levels of MDA, VEGF-A and CIMT showed significant reduction while those of NO and Klotho exhibited significant elevation in ACEI-treated patients compared to corresponding values of non-treated ones. Significant negative correlation between serum MDA concentration and NO levels and positive correlation between Klotho level and NO were observed in the present study.

Conclusion: Soluble Klotho may become an important target in vascular medicine, mainly in situations where senescence and stress are responsible for accelerated vascular damage in hypertension. The addition of exogenous Klotho may prevent the oxidative stress that induces premature senescence.

Biography:

Yochai Birnbaum has completed his MD from the Hebrew University of Jerusalem, Israel. He is the John S Dunn Chair, Professor of Medicine at Baylor College of Medicine, Houston, Texas, USA. He has published more than 320 papers in reputed journals and has been serving as an Editorial Board Member of six journals.

Abstract:

Clinicians rely more and more on the computerized interpretation of the 12-lead electrocardiogram (ECG). However, the current computerized algorithms are deficient for interpretation of ECGs of patients with implantable devices such as permanent pacemakers and defibrillators. Misinterpretation of the ECGs could lead to significant delays in recognizing device malfunction or underlying serious medical conditions, including arrhythmia. Systematic approach that includes understanding the basic principles of ECG interpretation, the common timings and algorithms of the devices can improve ECG interpretation and patient care. One common problem is missing underlying atrial fibrillation of flutter. As the heart rate of patients with underlying atrial flutter can be regular in patients with pacemaker, missing this diagnosis on ECG interpretation can lead to significant delay in initiation of anti-coagulation therapy for prevention of stroke. In the presentation we will show a series of ECGs of patients with devices and discuss the approach to interpretation.

Biography:

Anas AbuZaitoun and Wala Awad are both computer engineering students at An-Najah National University. They will be graduating in less than 2 years, and they have a great interest in new technologies and machine learning in particular. Anas AbuZaitoun is not the typical type of students, he has been the organizer of GDG – Nablus branch for two years so far, and he is an active IEEE member. He is an Android developer, and he worked on many projects before, including mobile apps and desktop apps. He also attended Google’s I/O festival in San Jose this year.

Wala Awad is an active member in both GDG and IEEE, and she is an Android developer as well. She is willing to get her master’s degree on machine learning as soon as she graduates. They have been participating in technical competitions that will employ both hardware and software.

Abstract:

Electrocardiography has been used extensively in diagnoses in almost all healthcare facilities. Upgrading this tool will reform diagnosis, and is expected to improve diagnosis and patient care. Thus, this project was designed to maximize potential benefits gained when machine learning technology is incorporated into ECG analysis. ECGML- electrocardiography using machine learning is a project created to enhance the performance of the typical ECG scanner by widening the area of its results and improving its accuracy. Using this technology, ECG can be used to not only show basic information about the heart but also to help diagnosing more than fifteen other arrhythmias precisely. Machine learning and Google’s Tensorflow were used to create a program that - when trained enough- will be able to diagnose those arrhythmias in the most accurate way possible. It is an easier and a faster way to be used in this field rather than the typical way.

Biography:

Prof. Egeland holds a Ph.D. in Chronic Disease Epidemiology from the University of Pittsburgh, Pennsylvania with considerable expertise in epidemiological methods and analyses of complex data in cross-disciplinary research involving cardio-metabolic diseases, reproduction, and nutritional health. She currently works as Senior Researcher at the Norwegian Institute of Public Health and is Adjunct Professor at the Dept. of Global Public Health and Primary Care, University of Bergen, Norway.  She has over 135 publications including book chapters; is currently engaged in registry-based research, and leads several research projects spanning disciplines in life-course epidemiology. 

Abstract:

Prognosis of unspecified chest pain is important given the high frequency of chest pain leading to emergency medical care. The 1-yr prognosis of patients (aged 20-89 years) discharged with a primary diagnosis of unspecified chest pain (ICD-10, R072-R074) in 2010-2012 was evaluated using Norwegian health care administrative data sources.  For evaluation of incident events, patients with a prior 2-yr history of chest pain or cardiovascular disease (CVD) were excluded.  Nelson-Aalen cumulative hazards of incident ischemic heart disease (IHD) and monthly hazards of mortality following discharge were evaluated. Mortality was also compared to the general population by standard mortality ratios (SMR). There were 59,569 patients identified; the majorities were referred to hospital or outpatient clinics by community emergency medical centers. The hazards of mortality and the percent of deaths attributed to cardiovascular disease (CVD) were highest within the first 2 months post discharge.  Cumulative hazards of IHD for men aged 45-64 and 65-74 years was 12% and 20%, and for women 6% and 10%, respectively by age group.  Men and women under 65 yrs. of age had significantly higher non-CVD mortality than expected: SMR (95% CI) for men > 65 yrs. of age was 1.35 (1.2-1.6); for men < 65 yrs. of age was 1.53 (1.21-1.91); and for women < 65 yrs. of age the SMR was 1.54 (1.17-1.98). The prognostic data indicates that patients discharged with unspecified chest pain are an at-risk group in terms of early post-discharge mortality, incident IHD, and non-CVD mortality.

Biography:

Laura Azevedo is a brazilian infectious diseases physician, completed her MSc of Public Health in Developing Countries at LSHTM and has recently started a PhD of economic evaluation of health interventions at University of São Paulo.  She works as medical coordinator in an emergency care unit and as data analysis supporter for the regional health care network. There, she works for SPDM, a health organization responsible for the management of all health care units of this district in the outskirts of the biggest city in Brazil - São Paulo.

Abstract:

The line of care (LC) is defined as a set of knowledge and resources those are needed to cope with specific conditions in the life cycle. The hypertension has a specific LC, named HLC and the great challenge consists on the reduction of the cardiovascular risk classification of the patients. This study was done to demonstrate the efficiency of the HLC. A cross-sectional descriptive study was performed in a Brazilian basic health care unit. The data were collected between January and October of 2017. The sample was composed of 28 users those were hypertension carriers, having an inclusion criteria for the registration in the HLC in January 2017 and has a ‘very high additional risk’ classification on the occasion of its inclusion in the HLC. The results showed a progressive decrease in cardiovascular risk. There was a reduction of 82.15% (N=23) of the ‘very high additional risk’ ratings. It is inferred that the reduction was not greater due to the risks that could not be controlled or excluded from the classification metrics like prior cardiovascular events and acute myocardial infarction. These users were downgraded to high risk 53.57% (N=15) and moderated risk 28.57% (N=8). It is observed a greater adhesion of the patients to the medical and nursing consultations, educational group of the HLC and to the Singular Therapeutic Project. It is concluded that the HLC is effective in reducing the very high cardiovascular additional risk classification of the follow-up users, contributing significantly to the reduction of morbimortality in hypertension users.

Biography:

Shashi Mawar has an experience of 18 years in various positions in the field of medicine. Presently she is a lecturer at the College of Nursing, AIIMS, New Delhi. She is a lifetime member of Trained Nurses Association of India, Nursing Research Society of India, Indian Association of Neonatal Nurses and Indian Association of Preventive and Social medicine. She has participated as a co-ordinator, panellist and resource person at various National and International forums. She has authored several papers in both national and international publications.

Abstract:

In India Hypertension is one of the most significant public health problem and a common lifestyle disease. The burden of the disease is more among elderly population.

In India 100 million patients are with hypertension. Overall estimates for the prevalence of awareness, treatment, and control of blood pressure (BP) are 25.3%, 25.1% and 10.7% for rural Indians and 42.0%, 37.6% and 20.2% for urban Indians respectively. (J Hypertens. Jun 2014; 32(6): 1170–1177).  Epidemiological studies on hypertension suggest that less than half of the hypertensive persons in a population know that they have increased blood pressure.

Screening for HT is not a routine - opportunistic or systematic in Indian set up.   Home based screening for elderly is the need of the time as this group is vulnerable to develop HT and are dependent on family members for hospital visits as well as finance. Due to poor access to health care, the high cost of treatment, social stigma, and low awareness they tend to ignore the disease.

Several challenges encompass the management of HT. Among older adults HT is frequently underdiagnosed and undertreated.

Increased awareness, treatment, and control of high blood pressure are critical for the reduction of mortality and morbidity. There is a need to shift focus from expensive tertiary care for non-communicable diseases to primary and secondary prevention provided by nurses at community level would be cost effective.  It is suggested that community screening programs combined with simplified diagnostic evaluation and intense patient education and follow-up may greatly increase the success rate.

The population approach directed at the whole population, irrespective of individual risk levels involves multifactorial approach, based on the community based multimedia program involving nonpharmacotherapeutic interventions

A multimedia approach for hypertension management involve all aspects of care, including (1) detection, referral, and follow up; (2) diagnostics and medication management; (3) patient education, counseling, and skill building; (4) coordination of care; (5) population health management; and (6) performance measurement.

Community based multimedia program can be practiced and implemented at large scale to control HT among elderly. This basically focuses on individual needs of elderly including socialisation and reducing stress through self help groups which is very important as most of the elderly are depressed due to lack of socialisation and family support.

Effective evidence based strategies for blood pressure control

Numerous studies have identified effective evidence based strategies in the control of high blood pressure used by nurses. Good quality studies demonstrated that, use of treatment algorithms, nurse prescribing, community monitoring are effective evidence based strategies that significantly reduced both systolic and diastolic blood pressure (Clark et al., 2010; Denver et al., 2003; Kotseva et al., 2010).

Numerous studies demonstrated that nurses’ role in patient education significantly improved patients’ health lifestyle behaviors, medication adherence self-efficacy, and reduced body mass index. These are regarded as important facets for long term control of blood pressure in communities (Clark et al., 2010; Fahey et al., 2005; Glynn et al., 2010; Hacihasanoglu and Gozum, 2011).

At present in India average population served per government allopathic doctor is 11,039.  Therefore nurses should be considered as intermediate strategy to manage non communicable diseases like HT using the task shifting policy to meet the human resource crisis. Nurses need to be adequately prepared for practicing the expanded roles. Such preparations must use evidence based strategies that provide nurses the opportunity to reflect on their own practices.

Hypertension control among elderly in India can be achieved by better government policies, political focus and social determinants of health such as education, development health system, proper health care financing, free or low-cost BP medicines, education for health care providers, free primary care, use of innovation in technology, collaboration with various stakeholders and patient empowerment.

Biography:

Le Fang has received his PhD degree from Shandong University, School of Public Health in China. He is the Section Chief in Department of Non-communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, China. He has published more than 15 papers in the field of non-communicable disease epidemiology and mental health.

Abstract:

Risk factors for cardiovascular disease (CVD) may differ among different population and race. In order to explore the risk factors for CVD among the Chinese population, total 25640 residents aged 50-74 years from two cities in Zhejiang province, China were included in this study. The data of their health records and CVD surveillances during year 2012-2015 were used and logistic regression model were employed for risk factor prediction. CVD surveillance included both coronary heart disease and stroke. Totally, 20534 cases were used for training sample and 5106 cases for test sample. The median time for following is two and a half years. By the end of the following, 742 cases had CVD event. The results showed that gender, age, diabetes, smoking, systolic pressure, total cholesterol (TC), high density lipoprotein (HDL) were predictors for CVD among Chinese population.

Biography:

Prof. Dr. Ersin AKPINAR completed his specialty training in family medicine at Adana Numune Research and Training Hospital. He started working at Cukurova University Medical Faculty Departmeny of Family Medicine in January 2000 and was appointed as a full clinical professor of family medicine in 2013. He studied at The Universite Libre de Bruxelles in Brussels between 2004-2005 at the Department of Family Medicine, at the University of Illinois at Chicago in 2005, The United States Department of Medical Education for a period of two months fellowship in Clinical Decision Making fellowship, in Akademisches Lehrkrankenhaus der Universität Duisburg-Essen Sankt Clemens Hospitale Sterkrade in 2010, Germany for the project of The Research and residency education needs for improving the quality of gastrointestinal diseases care in family medicine and at the University of Michigan Department of Learning Health Science in United States at 2014 for a period of three months fellowship in Relevance and usability of high technologic patient simulators for clinical decision making and better clinical skills in undergraduate medical education curriculum fellowship. The main areas of interest in primary care of acute and chronic diseases, hypertension, cardiovascular risk analysis, sexuality, and sexual dysfunctions, medical education, learning models, the electronic patient record programs, social media, digital health and innovation. He still works on many university-funded research projects.

Abstract:

Sustained high blood pressure (BP) is a leading risk factor for developing heart disease, stroke, and renal disease. Globally, over 1 billion people have hypertension. As populations age and adopt more sedentary lifestyles, the worldwide prevalence of hypertension will continue to rise towards 1.5 billion by 2025. The positive association between BP and cardiovascular disease (CVD) risk has been well established. Classification of BP levels into categories supports clinical decision making, public health surveillance, and public and private programmatic activities.

As substantial progress has been made in understanding the epidemiology, pathophysiology, and risk associated with hypertension, and a wealth of evidence exists to demonstrate that lowering blood pressure (BP) can substantially reduce premature morbidity and mortality, a great number of guidelines have been issued in recent years by the European Society of Cardiology (ESC) and by the European Society of Hypertension (ESH), as well as by other societies and organisations. Because of the impact on clinical practice, quality criteria for the development of guidelines have been established in order to make all decisions transparent to the users in 2018 The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) Guidelines for the management of arterial hypertension.

A number of proven, highly effective, and well-tolerated lifestyle and drug treatment strategies can achieve this reduction in BP. Despite this, BP control rates remain poor worldwide and are far from satisfactory across Europe. Consequently, hypertension remains the major preventable cause of CVD and all-cause death globally and in our continent

What is new and what has changed in New 2018 Arterial Hypertension Guidelines? will be the main theme of this session.

Biography:

Marcello Finardi Peixoto obtained his medicine degree from Federal University of Sao Paulo Medical School. His Residency training was in Psychiatry at Santa Casa of Sao Paulo. He received a Master of Science degree in Nephrology from Federal University of Sao Paulo Medical School, where he also did a specialization in Psychopharmacology. He joined a Scientific Initiation Program during his Medical training when he published his first two original articles. He has been practicing since 2003 in his own private practice center. His current interests include mental disorders, particularly mood and anxiety disorders and its relation to general medical diseases.

Abstract:

Objective: The objective of the study was to test the role of escitalopram on blood pressure and heart rate of individuals with hypertension and depression.

Methods: A total of 30 individuals participated in this study and the individuals were being treated for hypertension and were diagnosed with major depression. Escitalopram (10-20 mg) was administered to 15 individuals, while the other 15 received placebo. These individuals were followed for eight weeks with regular monitoring of blood pressure and heart rate. Scores on the Hamilton Depression Rating Scale were evaluated within the first, second, fourth and eighth weeks of the study onset.

Results: Comparing with placebo, heart rate was lower in the escitalopram group (66.79±9.85 vs. 74.10±9.52 bpm, p=0.044). There was not a significant decrease of systolic blood pressure (140.80±16.48 vs. 139.61±18.92 mmHg, p=0.85) and diastolic blood pressure (80.55±12.64 vs. 80.18±16.36 mmHg, p=0.94).

Conclusion: Escitalopram decreases heart rate but not blood pressure in individuals with hypertension and depression.