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Symposium Explores Spectrum of Hypertension Research

By Ann Taubenheim

Although knowledge about treatment of hypertension has advanced, 20 percent of the world's population, or 1.2 billion people, suffer from hypertension and the current control rates are only 2-27 percent. New strategies are needed for improving the prevention and control of hypertension worldwide.

That was the message delivered at a recent National Heart, Lung, and Blood Institute symposium titled "Hypertension: From Gene to Community." Presented in Rockville, the symposium was a satellite session of the International Society of Hypertension's 18th scientific meeting, held in Chicago. The NHLBI event featured a panel of leading experts in hypertension whose specialty areas included epidemiology, genetics, medicine and nursing. The web broadcast of the conference can be viewed at http://videocast.nih.gov/.

In his opening presentation, NHLBI director Dr. Claude Lenfant provided a historical overview of hypertension research and discussed significant lessons learned. Foremost is the evidence that treatment of hypertension reduces morbidity and mortality from coronary heart disease and stroke.

According to Lenfant, 21st century research on hypertension will focus on the genetics of the disease. The potential benefits of a genetic approach to study hypertension are promising and include early detection, targeted prevention and targeted treatment of the disease.

Dr. Donna Arnett, associate professor, School of Public Health, University of Minnesota, presented an overview of the molecular genetics of hypertension and its complications. She said that although prevention of hypertension is a national priority, it is difficult to target preventive measures effectively. Moreover, despite some successes in genetic research, the identity and characteristics of individual genes contributing to blood pressure and the occurrence of hypertension in the population-at-large remain poorly defined.

The afternoon sessions focused on transferring knowledge about hypertension to clinical practice and included presentations on medical treatment and psychosocial factors in the cause, prevention and control of hypertension. Dr. Jacqueline Dunbar-Jacob, director of research at the University of Pittsburgh School of Nursing, presented research findings showing that patient compliance is a major barrier to effective treatment of hypertension. Between 21 and 66 percent of people with high blood pressure discontinue their medication for reasons such as undesired side effects, complexity of regimen, misperception of the disease and lack of motivation to comply.

Dunbar-Jacob told participants that hypertensive patients who do try to comply often have difficulty taking their medications at consistent times each day. She stressed that failure to take medication as prescribed leads to unnecessary disease complications, disease progression, premature death, reduced functional abilities and quality of life, as well as substantial costs.

Other topics covered at the conference included the renin-aldosterone system in hypertension, the influence of social and cultural effects on blood pressure, and blood pressure levels in and across populations.


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