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Dr. R. Diaz
Dr. Georg Ertl,
Presenter: R. Diaz | see Discussant report
Discussant: Georg Ertl | see Presenter abstract
IntroductionToday a subanalysis was presented on hypertension in the Prospective Urban Rural Epidemiology (PURE) studyContentThe Prospective Urban Rural Epidemiology (PURE) has some unique features:• It is a very large community based cohort study on 153,996 individuals.• It very international including 5 continents, 17 countries, 41 centres and 628 communities.• It offers a wide spectrum of socio-cultural background and medical care including high, middle, and low income countries, and individuals from rural and urban areas.PURE has some minor limitations:• The diagnosis of hypertension relies on two blood pressure measurements or self-reporting which carries some risk of false judgment. However, the large number of individuals included in the study may well balance this uncertainty.• The definition of pre-hypertension: 120-139/80-89 may include many patients with “normal” blood pressure.• The effect of different health care systems vs. the economic status remains unknown.• Biological effects of ethnicities remain unclear (see Zimbabwe vs. Asian low income countries).The major results of the study were:• Hypertension (and other cardiovascular risk factors) represent a global epidemic• Globally, awareness, treatment and control of HT is low.• In rural communities in lower income countries HT control is virtually absent.• So far, we have focused in rural communities in lower income countries mostly on infectious diseases. However, these communities require specific care also for non-communicable disease and risk factors.• Transition from a low to a medium income country appears to broaden the complexity and spectrum of heart disease.• Lessons learned from CVRC in high income countries may help in low income countries.ConclusionConclusions for further development of research and patient care• The diseases of high income countries become more and more important in low income countries.• On the other hand, diseases so far rare and therefore not sufficiently studied in high income countries may become more frequent in high income countries along with globalization of disease.• The study of such diseases in low income countries may improve patient care in high income countries.
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Clinical Trial & Registry Update I: Updates on Prevention and Markers
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