Our mission is to become a worldwide reference for education in the field for all professionals involved in the process to disseminate knowledge & skills of Acute Cardiovascular Care.
Our mission is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging in Europe.
Our mission is to promote excellence in research, practice, education and policy in cardiovascular health, primary and secondary prevention.
Our mission is to reduce the burden of cardiovascular disease in Europe through percutaneous cardiovascular interventions.
Our mission is to improve the quality of life of the population by reducing the impact of cardiac rhythm disturbances and reduce sudden cardiac death.
Our mission is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
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OUR MISSION: TO REDUCE THE BURDEN OF CARDIOVASCULAR DISEASE
A drug whose history goes back more than 50 years could revolutionise today’s treatment of resistant hypertension, a Hot Line session heard yesterday. The PATHWAY-2 study showed that spironolactone, first introduced in 1959 as a diuretic, controlled 60% of previously uncontrolled patients with resistant hypertension and was three times more likely than doxazosin or bisoprolol to exert control.
‘Spironolactone is overwhelmingly the most effective drug treatment for resistant hypertension,’ said study presenter Bryan Williams, from University College London. ‘The result in favour of spironolactone is unequivocal and for the first time establishes a clear hierarchy for drug treatment of resistant hypertension which should influence future guidelines and clinical practice worldwide.’
The study, which has the global potential to influence treatment in 100 million people, offers a ‘spectacularly cost-effective’ approach, added Williams, since spironolactone is cheap and patients are at very high risk of cardiovascular events.
International guidelines recommend treating resistant hypertension with three BP-lowering agents - ACE inhibitors or ARBs, plus calcium channel blockers plus thiazide-like diuretics. ‘However,’ said Williams, ‘despite 50 years of research the optimal drug treatment is still undefined.’
The PATHWAY-2 study, funded by the British Heart Foundation, randomised 335 patients with resistant hypertension (already treated according to guidelines) to sequentially receive 12 weeks of spironolactone (25-50 mg), bisoprolol (5-10 mg), doxazosin (4-8 mg modified release) and placebo. The study design allowed drug comparisons in each patient, with 230 completing all cycles.
Results showed that spironolactone reduced home systolic BP by 8.70 mmHg more than placebo (p<0.001), 4.26 mmHg more than bisoprolol/doxazosin (p<0.001), 4.03 mmHg more than doxazosin (p<0.001), and by 4.48 mmHG more than bisoprolol (p<0.001).
By the end of the trial, said Williams, there would only be 15 patients considered eligible for renal denervation trials in uncontrolled hypertension. ‘PATHWAY-2,’ he added, will have significant implications for patient recruitment into other trials.’
About the European Society of CardiologyThe European Society of Cardiology (ESC) represents more than 90 000 cardiology professionals across Europe and worldwide. Its mission is to reduce the burden of cardiovascular disease in Europe. About ESC Congress 2015ESC Congress is the world’s largest and most influential cardiovascular event contributing to global awareness of the latest clinical trials and breakthrough discoveries. ESC Congress 2015 takes place 29 August to 2 September at ExCel London in London, UK. Access the scientific programme. To access all the scientific resources from the sessions during the congress, visit ESC Congress 365.
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