Invited Faculty (In first name alphabetical order)
Immediate Past President, Philippine Society of Hypertension
Population-directed Initiatives at Hypertension Control in the Philippines
Today, one in every 4 Filipinos is hypertensive,
and only 30% of those diagnosed hypertensive have controlled or normalized blood pressure.
This means that more than half of my countrymen who are receiving treatment
for hypertension will still be at risk for events like stroke, heart attack,
heart failure and renal failure. Since 2 years ago,
the Philippine Society of Hypertension started to collaborate with agencies
for its population-directed initiatives at screening, diagnosing, treating,
and improving control rates. These are the a) MMM 17, 18 & 19 ISH-led May Measurement Month b)
Philippine Department of Health and its Philpen Project and c) WHO-DOH-PSH Resolve to Save Lives.
Hypertension - The Global Challenge
The Global Burden of Disease study confirmed recently that when 84 behavioural,
environmental, occupational and metabolic risk factors were compared, systolic
blood pressure was found to be the leading risk factor accounting for 10.4 million deaths.
It is therefore paramount that important action steps are taken to address the global challenge
that hypertension poses. This was the task given to the Lancet Commission of Hypertension,
namely to identify 10 high impact action steps to address the global burden of raised blood pressure on current
and future generations. In this action plan we recognised firstly the importance of the lifecourse strategy
and how external conditions – from pre-conception and fetal to exposures during childhood
can have a significant effect on cardiovascular risk.
In this lecture some key actions will be discussed in more detail.
Collectively the burden of hypertension in any country or region remains of high priority to all,
as the consequences of cardiovascular disease and death impact widely.
With the detailed knowledge we have on factors contributing to hypertension,
it is the obligation and responsibility of every single person working in this field to educate,
empower and collaborate to act now and make a difference to current and future generations.
Japanese Society of Hypertension Future Plan: Moon-Shots For Conquering Hypertension in Japan
Japanese Society of Hypertension (JSH) has newly established
“Future Plan” to conquer hypertension (Hypertens Res 41;989–990, 2018) With this plan,
we will explore/perform the best clinical practices for hypertension management
and develop positive initiatives for realizing a lively and happy society nationwide.
The Slogan is “Good Blood Pressure for Lively 100 Years”
and the goal is to decrease the number of hypertensive individuals by seven million over the next decade,
thereby extending the healthy life expectancy. We have three directions; 1.Medical system:
establishment of a lifetime-care system for individuals with hypertension.
2. Academic research: promotion of research in hypertension and embodiment of “Future Medicine”
3. Social edification: development of a social model for self-controlled blood pressure. Recognizing that conquering
hypertension should be based on “convergence science”, we especially focus on “Digital Hypertension”
by using artificial intelligence, big-data, and telemedicine via the IoT and on the formation of a multidisciplinary
network that involves the cooperation of specialists, primary care physicians, medical teams, academic societies,
administrative agencies, and insurance providers (Population Health Management).
University of British Columbia, BC Children’s Hospital
Blood Pressure Management in Children and Adolescents: Important Updates
Several prominent hypertension workgroups have developed recent guidelines for the diagnosis,
investigation and management of hypertension in children and adolescents.
Most importantly, the American Academy of Pediatrics Subcommittee on Screening and Management of High Blood Pressure
in Children developed guideline recommendations which are an update to the previously
widely used Fourth Report. Included in this guideline are tools
for improving recognition of elevated blood pressure in children,
updated normative blood pressure tables, and revision of the blood pressure classification for children and adolescents.
These important updates will be discussed along with the potential impact of the new recommendations on clinical practice.
Javier Eduardo Stern
Neuroscience Institute, Georgia State University
Thinking Outside The Cleft: Regulation of CNS Presympathetic Neuronal Activity in Health and Cardiovascular Disease States
Accumulating evidence supports a key contribution of hypothalamic presympathetic and neurosecretory neurons
to the exacerbated neurohumoral drive characteristic of cardiovascular disease states,
including hypertension. Still, the precise mechanisms that regulate their level of activity,
both under physiological and pathological conditions, remain unknown.
In recent years, we and other laboratories have shown that glial cells, particularly astrocytes and microglia,
regulate hypothalamic neuronal activity targeting unconventional non-synaptic mechanisms,
including extrasynaptic glutamate/GABA signaling. In my presentation,
I will summarize recent work from our laboratory highlighting the critical
contribution of both astrocytes and microglia to the regulation of
hypothalamic neuronal function both in health and cardiovascular disease states.
Keio University, School of Medicine
Protective role of adenosine in the renal corticomedullary boundary zone against acute ischemia-finding
from mass imaging analysis
Adenosine plays an essential role in maintenance of renal function by regulating glomerular filtration,
tubular reabsorption and renal vascular tone via activation of adenosine receptors (A1, A2a and A2b receptors).
However, the spatial distribution of adenosine in the kidney and the region-specific
function is unknown. Mass imaging is a technique to visualize small molecules quantified by mass-spectrometry.
By using this technique, we have found that adenosine showed very unique accumulation in the boundary zone.
To analyze the roles for accumulated adenosine in the regulation of vascular tone,
we performed western blot analysis of the phosphorylation of smooth muscle myosin light chain (MLC),
which indicates the degree of vaso-constriction, in each region of the kidney (the cortex, boundary zone and medulla),
with or without pretreatment of adenosine receptor antagonists. In summary, the local accumulation
of adenosine was suggested to have a role in A2b receptor-dependent vasodilation in the boundary zone.
In addition, the A2b-dependent vasodilation by higher concentration of adenosine contributed
to reno-protection under acute ischemia.
Teikyo University School of Medicine
Japan National Health and Nutrition Survey -
blood pressure measurement standard protocol and replacement of mercury device for non-mercury era
The Japan National Health and Nutrition Survey has been conducted annually by the Ministry of Health,
Labour, and Welfare. The Survey enables us to capture the essential status of health,
nutritional intake and lifestyle habits among residents nationwide Japan for comprehensive health promotion.
Use of a mercury sphygmomanometer has been mandatory in the Survey until recently;
however, we decided not to use a mercury device anymore because the United Nations Minamata Convention
on Mercury will come into effect on 2021 and mercury devices shall be eventually banned
in clinical practice in the near future. For the epidemiological settings including the Survey,
we promote a mercury-less electric sphygmomanometer in which semiconductor pressure sensor is embedded.
In this lecture, I will introduce the current situation on the Survey with a detailed background
and perspective in the future blood pressure measurement.
The Future of Renal Denervation in Hypertension Management
President, Hypertension Canada
What is the best medical treatment for resistant hypertension?
Resistant hypertension affects up to 10% of the hypertensive population
and is associated with increased cardiovascular events.
This lecture will discuss recent advances in resistant hypertension medical therapy.
President Elect, APSH
Blood Pressure Variability and Its Clinical Implications
Physicians and scientists have been distracted from consideration of variability of blood pressure by giving
obsession attention to mean BP (MBP).
The hypertension guidelines insist on reduction of Mean Arterial blood pressure (MBP)
per se and remove BP variability from consideration.
Now growing evidences indicate that blood pressure variability (BVP)
is an independent predictor of hypertensive target organ damage and cardiovascular events.
This can be short term or Long term variability.
Several mechanisms have been considered to unravel BPV mystery like impairment of autonomic or hormonal regulation,
renal dysfunction and increased arterial stiffness.
New studies shows that Asians show greater morning surges in blood pressure and a steeper slope illustrating
the link between higher blood pressure and the risk of CVD events. All three components of perfect 24 hr.
BP control, the 24 hr. BP level, nocturnal BP dipping and BPV need to be addressed to tackle CVD risk.
Targeting BPV by antihypertensive agents in addition to controlling mean blood pressure values,
to achieve maximum cardiovascular protection is an exciting area of research.
Vice President, Laos luxamberge and Commitee of Laos Cardilogy Society
Yook Chin Chia
Immediate Past President, Malaysian Society of Hypertension
Blood pressure target of less than 140/90 mmHg: Is that good enough for Asia?
Hypertension is the leading cause of mortality worldwide.
Prevalence and unawareness of hypertension continue to be high in Asia.
Control of blood pressure in Asia is far from optimal.
While cardiovascular mortality in the western world since the epidemic of cardiovascular
death in the early 1940s-1950s is falling, that is not the case in most countries in Asia.
Several factors are responsible for this. Rapid increase in obesity and
other unhealthy life-style practices still plague many countries in Asia causing an increase
in background cardiovascular risk. Furthermore, many other differences both genetic and epigenetic
between Asians and Caucasians exist. Because of these differences, contributing to the high mortality rates
from cardiovascular disease, perhaps we need to re-examine what BP target is more appropriate for Asians
Recent Advances in Hypertension Research
In this lecture, several recent exciting scientific findings in hypertension research will be reviewed and highlighted.
Immediate Past President, Indonesian Society of Hypertension
Does intensive BP control reduce dementia? : Learned from SPRINT MIND
In the elderly, aggresive blood pressure reduction can be harmful and the side effects may outweigh the advantages,
highlighting the complexities of recommending uniform levels of BP across the life course.
Aggressive lowering of systolic blood pressure in SPRINT MIND cuts the risk for mild cognitive
impairment but not in dementia.
The situation gets complicated since the incidence of MCI and dementia continues
to increase in very late life and adverse events from intensive BP control may also increase.
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