Guidelines, Their Implications, and New Clinical Evidence.
An Expanded role for CCBs?

ESH 2007 - Satellite Symposium

Introduction to the Satellite Symposium
This satellite symposium provides a concise overview of the current evidence relating to optimal treatment of hypertension, especially in relation to preventing and reducing the occurrence of cardiovascular events.
   The accumulated evidence has shown that aggressive and early reduction of blood pressure is required to provide optimal cardiovascular protection. Further, in the vast majority of patients, combination therapy is required to reach these treatment goals. The presentations in this symposium reinforce the importance of treating hypertension more seriously as a disease, and further, provides the clinician the information to do this.
   Data from outcomes studies, such as VALUE, that reinforce the need for earlier achievement of blood pressure reduction to target levels are reviewed, along with the need to lower high blood pressure in all patients. Agents that are helpful in this regard are also reviewed, such as calcium channel blockers (CCBs) that have been shown to provide “instant success in reducing blood pressure.”
   Other data reviewed support the need for combination therapy in the majority of patients to reach the recommended target blood pressure levels, such as data from the INVEST study and the meta-analysis from the Blood Pressure Lowering Trialists Collaboration.
   The rationale for combination therapy is reviewed, along with “priorital combinations”. In high-risk patients, combination therapy is of particular importance. Data show that cardiac, cardiovascular, and renal outcomes can be prevented or reduced with combination therapy. Trials reviewed in this regard include ASCOT, INVEST, ACTION, Nice-Combi study and Advance-Combi study. The ASCOT study results support combination treatment with a contemporary dihydropyridine CCB and inhibitor of the renin angiotensin system.

Introduction G. Mancia (Milan, Italy) [WEBCAST]

Hypertension guidelines –a new perspective, a betterdirection for CVD prevention L.M. Ruilope (Madrid, Spain) [WEBCAST]

Combination Therapy - Who, When & How? P.A. Meredith (Glasgow, UK) [WEBCAST]

Combined antihypertensive therapy with a CCB – achieving target blood pressure and reducing CV risk F. H. Messerli (New York, NY, USA) [WEBCAST]

Combining strategies for bloodpressure lowering and beyond - the nifedipine GITS/telmisartancombination study G. Mancia (Milan, Italy) [WEBCAST] [INTERVIEW]

The role of beta-blockers in hypertension treatment H. Haller (Berlin, Germany) [INTERVIEW]