Title: Hypertension Therapy Devices: In-Home and Patient-Centered

Abstract:

The opportunity to introduce hypertension therapy devices arises from three challenges: 1) the inability of some patients to tolerate current pharmacological therapies for hypertension, or their non-compliance with antihypertensive medications; 2) the development and availability of device-based therapies for patient home-use; and, 3) the use for monitoring as well as for actual treatment, such devices for both modalities can transmit remotely for data storage and evaluation. Increasingly, long-term side effects from pharmacological therapies are recognized as well as simple preference for another regime prompt, another alternative. On the physiological level there always are the alternatives of weight reduction, exercise, and dietary adjustments such as reduced sodium intake. This is especially relevant when the condition is one of three initial stages: prehypertension, mild hypertension, or moderate hypertension. When pharmacological therapies are in use for these stages, there are the downsides to such therapies which can present differently for different patients. Additionally, non-compliance by some patients has its effects. Ease of monitoring by the patient in the home or when mobile has efficacy. Such is the patient-operated device. This can be the traditional upper-arm cuff as well as the hypertension-specific wrist monitor. This latter device may be prone to less accuracy than the arm cuff. In the same vein, a wearable device (fitness-type multi-purpose) can be expected to emerge.

Biography:

Bill Boerum is in his fourth term on the Board of Directors of the Sonoma Valley Health Care District, the governing board for Sonoma Valley Hospital. Currently serving as Board Secretary, he previously served twice as Board Chair and as Treasurer including as Chair of the Audit Committee and as a member of the Finance Committee. Currently, he is Chair of the Governance Committee. He is an advocate for medical tourism as well as for medical cannabis having spoken at state, county, and city hearings including before the Medical Board of the State of California. He was Chairman of the Northern California Health Care Authority, a consortium of five hospital districts. Also, in the healthcare domain, he was a member of the Board of Directors, the Executive Committee and Vice Chairman of the Association of California Healthcare Districts and its related workers compensation insurance affiliate, the ALPHA Fund, both Sacramento-based. Boerum’ s interest in healthcare extends to the international sphere where he has toured hospitals in China, Egypt and India with a special focus on cardiology departments and patient through-put. He is an international conference speaker, having spoken at the “Healthy Life Forum – Toward 80+” held in Sochi, Russia, and has spoken on “Digital Healthcare Transformation Drives Quality of Life.” He is Chairman Emeritus of Sister Cities International, Washington, D.C., a citizen diplomacy organization with 2,200 partners in over 140 countries. Previously in the risk management domain, he had more than 15 years of experience in the decision technology industry and a 20-year career in banking. He holds an MBA degree from Cornell University and a BS degree in Economics.

Title: India Heart Study – IHS

Abstract:

Heart failure is a syndrome with high mortality and morbidity, as well as being the result of many cardiac and non-cardiac diseases. The corner stone of management in these cases is basically medical therapy, which can be very successful in most cases, especially if combined with lifestyle modifications such as control of fluid and salt intake as well as physical activity. At some point the introduction of devices may be required such as ICD and CRT in selective cases. Nevertheless, around 5% of patient will fall in the category of advanced heart failure, where failure of medical therapy is the landmark of such condition and mortality is almost inevitable, this could occur over a long course of the disease with gradual decline or suddenly after a major cardiac injury such as massive MI. In this situation it is required to introduce mechanical circulatory support (MCS) to maintain survival of the patient as well as perfusion of all organs, which will either become a permanent solution or a bridge to heart transplantation whenever an organ is available. In this lecture, I stress on the importance of pinpointing the proper time to initiate MCS therapy, since both timing and patient selection are crucial in decision making to insure best clinical outcome.

Biography:

Director of the advanced heart failure and transplantation program in Kuwait.Long experience in internal medicine and diagnostic acumen in cardiovascular diseases. Good in communication and interpersonal skills. Management of Advanced heart failure, LVADS, Heart transplantation, pulmonary hypertension, performing right heart cath and biopsy, as well as management of coronary artery disease, hypertension and leading Coronary Care Units. Having a great passion for clinical and academic medicine and providing innovative teaching methods to fellow colleagues and medical students. Consultant Cardiologist at the Ministry of Health in Kuwait working at Salman Aldabbous cardiac center - Aladan Hospital Earned a "Heart failure fellowship" from University of Ottawa Heart Institute, Ontario Canada

Title: Why South-East Asia does not need statins

Abstract:

Today, statins, also known as HMG-CoA reductase inhibitors, are a class of lipid-lowering medications, and one of the most commonly prescribed class of drugs to lower cholesterol - with sales estimated to approach $1 trillion by 2020.¹ Despite the widespread use of statins to lower cholesterol and reduce cardiovascular morbidity and mortality, half of the patients prescribed statins in primary care fail to reach healthy cholesterol levels after two years of treatment with these drugs.  Drugs like Atorvastatin (Lipitor) and Fluvastatin (Lescol) provide little value to people without heart disease.² Used in this way, statins are not only of low value care, but in many cases, represent a waste of health care resources and may even have undesirable side effects. Worryingly, heart-healthy users represent a sizable number of statin users. Changes in clinical guidelines have increased the number of people eligible to take statins. In many countries, the majority of people taking the drugs do so for primary prevention. A 2019 study from Ireland found that the proportion of adults older than 50 years eligible for statins rose from 8% under 1987 guidelines to 61% under 2016 guidelines.³ That means a far greater number of lower-risk people became eligible for statin treatment. The number of people who would need to be treated with statins to prevent a major cardiovascular event also increased substantially, from 40 at the lowest risk under 1987 guidelines, to 400 at the lowest risk under 2016 guidelines. As part of the study, the investigators also analyzed primary prevention data for people with an average age of 62 to 69, who were taking statins for one to five years. Overall, there were significant reductions in death from any cause, cardiovascular deaths, and major coronary or cardiovascular events. However, when the baseline risk of developing heart disease was taken into account, most outcomes were not statistically significant, raising uncertainty about the benefits of statins for primary prevention. The findings showed that none of the people classified as low or moderate risk in primary prevention would achieve acceptable levels of risk reduction to justify taking a daily statin.

Biography:

Karl J Nesser is one of Switzerland’s leading anti-aging research scientists, and author of several anti-aging books. He has been a Professor at Lausanne University/Switzerland for more than 20 years. Today he is a worldwide appreciated health consultant, key speaker, board member, and senior lecturer at the American Academy of Anti-Aging Medicine A4M. He lives in Switzerland and Bangkok/Thailand where he is currently a Professor at the Chulalongkorn University Bangkok, College of Public Health Science. Karl works with scientists from Canada in the field of Molecular Resonance Effect Technology and its influence on human physiology. He earned Master degrees in Exercise Physiology and Physical Education at Eidgenössische Technische Hochschule Zürich as well as a Doctor degree in Philosophy & Health Science at Columbus State University.

Title: Rhythmic Inversion Exercise Techniques :Healthier Approach To Beat Hypertension

Abstract:

Until very recently, there has been little interest in objectively documenting  the effects on health, especially for the more advanced or esoteric practices, such as inversions. Inversion Therapy has been around a long time  –  & talked about Since 400 BC When “Hippocrates The Father Of  Modern  Medicine,” monitored patients being hung from a ladder in the interests of their health. We spend most of our life sitting, standing or walking i.e.  in antigravity postures. Blood is pulled down in to our lower body and our circulation grows progressively sluggish. Those that swear by inversion and its benefits say that inversion therapy helps correct the imbalances affected by antigravity postures. Rhythmic Inversions with muscular exercises reverse the blood flow temporarily & strengthen the Lymhatic drainage, which help regulate the  blood pressure. Applied techniques and mechanisms will be discussed.

Biography:

Dr M B Jani educated from Medical College Baroda , affiliated to M S University of Baroda, Gujarat, India. He was awarded M Sc ( Medial ) and Ph D in Medical Physiology by M S University of Baroda. He worked at the same institute and department as a teacher in various academic caders. He has teaching experience of 34 years to UG and PG students. He retired as Professor & Head of Department of Physiology, Faculty of Medicine, M S University Of Baroda.. His fields of research interest are Application of Medical therapeutic exercises in COPD, Hypertension, Obesity and PAD. He has been as a Guest speaker at National and International Conferences.

Title: guidelines represent updates of previous guidelines and reinforce previous concepts of prevention regarding elevated blood pressure

Biography:

Amal Nehmeh was senor cardiology fellow in Lebanon University. 

Title: India Heart Study – IHS

Abstract:

Background: Measurement of BP is essential for diagnosis of hypertension. There is limited information in India on the type of instrument (mercury, aneroid and oscillometric) used to measure BP. In a newly diagnosed treatment-naive hypertensives the prevalence of white coat hypertension (WCH), masked hypertension (MH), and atrial fibrillation (AF), when both office and home BP measurements are measure is not known. 
Objective: The study the prevalence of WCH and MH by comparing Office BP Measurement (OBPM) with Home BP Measurement (HBPM) in an Indian primary care setting in real world treatment naive subjects with and without hypertension.
Methods: An observational study comprising 18,918 treatment naive subjects with and without hypertension from 1233 primary care clinics across India were included between June 2018 and April 2019. OBPM (Visit 1) was performed by practioner’s.  In addition patients also underwent 7 days HBPM using the oscillometric BP measurement by “Microlife Watch BP Home device” and then another OBPM (Visit 2) was performed. This device also has a validated AF screening algorithm.
Results: The age range was 42.6+11.7 years and male: female 63:37%. hypertension diagnosis based on OBPM visit 1 is inadequate because 2nd OBPM reading showed a discrepancy in 32% cases. The evening BP was higher than the morning Systolic BP (127.8 ± 14.7 vs 129.8 ± 15.3, p<0.001) mm Hg and Diastolic BP (81.9 ± 10.1 vs 82.4 ± 10.2, p<0.001) mmHg. Considering visit 1 and HBPM, the prevalence of WCH was 24%. On the other hand, 18% of the participants had masked hypertension. More than half of the participants,had an elevated resting heart rate (79.8 ± 9.6 bpm . Elevated heart rate was more frequent in WCH. AF was found in 1027 subjects (5.7%) based on CHA2DS2 score. Of the type of instruments used for OBPM, 69% were mercury sphygmomanometers, 22% aneroid and only 9% were oscillometric ones.
Conclusion: The prevalence of WCH and MH in India is higher in comparison with global data which has therapeutic implications. The diagnosis of hypertension based on office blood pressure measurements alone can be fallacious. The evening BP was higher than the morning. Elevated resting heart rate may mean a reconsideration of the use of heart rate lowering anti-hypertensive drugs among Indian hypertensives. HBPM with a validated oscillometric BP measuring device should be preferred over mercury instruments which are still being used in 69% cases for OBPM, despite being banned in India since December 2017.

Biography:

Senior Consultant Cardiologist – Apollo Hospitals, Hyderguda, Hyderabad. Director Cathlab – Apollo Hospitals, Hyderguda, Hyderabad. Rich experience in Complex Coronary Interventions, Chronic Total Occlusions, Left Main & Bifurcation interventions and Cardiac Device therapy. Special Interest in Coronary Imaging and Complex Coronary Interventions. Special Work in Cardiac Stem cell therapy.

Title: Psychosomatic reactions and hypertension In Stress Conditions

Abstract:

Psychosomatic diseases are diseases of the organ in which they arise Psychic and somatic reactions to prolonged stress are involved. It is considered that for the emergence of psychosomatic diseases plays a crucial role in the emotional factor.The Aim of the paper :  Determine if there is a difference in behavior and expressing psychosomatic stress responses between healthy and diseased of hypertension, and to prove or reject the hypothesis that HTA is associated with psychosomatic diseases.

Method:  The study was performed with patients who were given the original Questionnaire with closed-ended questions about how to respond to stressful situations. Of emotions, fear - withdrawal is mostly involved. The Results: The statistical survey was conducted on a sample of 100 respondents, which are divided into two groups: the group of patients in whom registered hypertension and control group. Research hypotheses have also been formulated: H0 : NTA is not associated with psychosomatic disease; HI : HTA is associated with psychosomatic diseases. As the realized value of χ 2 = 44.72 is greater than the boundary tablevalues ​​of χ 2 = 24,996 for degree of freedom 15 and significance threshold p = 0.05, we reject the null and accept the alternative hypothesis for the error levelp > 0.05, and we conclude that HTA is associated with psychosomatic disease.The following hypothesis was also tested:H0 : there is no correlation between HTA and withdrawal reaction;H1 : There is an association between HTA and the withdrawal reaction. As the realized value of χ 2 = 29.99 is greater than the boundary table values ​​of χ 2 = 3.841 for degree of freedom 1 and significance threshold p = 0.05, we reject zero and accept the alternative hypothesis with error p <0.05 and a P > 95% safety , and we conclude that there is an association between HTA and withdrawal reactions.

Conclusion : Modern psychosomatics suggests one of the integrative models for explaining the psychophysiological mechanisms of arterial formation hypertension. This model contains all the knowledge so far and classic and psychosomatic medicine in an attempt to explain the chain of change they bring about to the end result - elevated blood pressure.

Biography:

PROFESSIONAL PRACTICE -February 2017-Present: Health Center "Dr. Milenko Marin" Loznica; Head of the Lešnica health station, -October 2006- February 2017: Zvornik Health Center; Chief of the General Emergency Medicine and Home Care Service -September 2004- July 2006: Health Center: "Milivoje Stojkovic" Grocka, Beograd; -April 2003- April 2004: Health Center Novi Beograd; internship EDUCATION: -University of Belgrade, School of Medicine, 2003 -University of Belgrade Specialisation: GENERAL MEDICINE; 2013 -University of Kragujevac, Kragujevac School of Medicine, Doctoral studies in neuroscience ( final year) -T.A. Center - Association of transactional analysts of Serbia, psychotherapy education. HONORS AND AWARDS PROFESSIONAL SOCIETIES - Assessor of Serbian health institutions within the Agency for Accreditation of Health Institutions of Serbia at the Ministry of Health (AZUS) since 2017. - Certificate of completed training in Abdominal Ultrasonography, KCS 2012 (as well as daily practice in the same from 2013 to the present.) -Psychotherapist in Supervision, T.A. Center-Association of transactional analyst of Serbia MEMBERSHIPS (Mensa) - Member of MENSA Serbia (International Association of Above-average Intelligent Persons) since 2012 - organizer of testing for Mensa in Loznica in 2014 and 2015 - Member of the Presidency of the Branch Office of Loznica of the Serbian Medical Society from 2015 to 2017 -Author of the project "Psychosocial support for talented children" sponsored by Mensa Serbia 2017. - Associate of the magazine "MozaIQ" which is the official publication of Mensa Serbia, with several published texts since 2016. -Author of the project "Writing, Research, Publishing" sponsored by Mensa Serbia, 2018.

Title: PREOPERATIVE INTERNIST THERAPY

Abstract:

Preoperative risk factors and corrective medication thereof for the success of operations and the reduction of postoperative complications in middle-aged and senior patients Since the Sarajevo University Clinical Centre admits patients from the whole of the Bosnia and Herzegovina, it can be said that in the country, just as is the case globally, there is an upward trend in the number of patients subjected to surgical operations of various kinds. This research encompasses patients from 50 to 85 years of age. While old age poses a less operation-related risk, the problem lies in risk factors that rise with age, such as stress, smoking, genetic predisposition and unhealthy lifestyle that lead to certain diseases and conditions such as hypertension, diabetes and heart rhythm disorders. In general, cardiovascular diseases were the most common cause of postoperative complications and even mortality in old age, however, this boundary seems to have has moved closer to middle age. The evaluation of senior patients with cardiovascular diseases is hampered by cardiac changes associated with aging, and types of risk factors and atypical appearance of the disease. Premedication is an integral part of the patient’s preparation for the surgical procedure. It involves administration of the drug at least 2 hours before the application of anesthesia. The aim of pharmacological premedication is primarily to reduce the risk by correcting all the parameters to the acceptable physiological boundaries, such as blood pressure, HP; minerals, respiratory parameters, and possibly rhythm and heart rate, followed by. Premedication should not deteriorate the patient’s current condition, and the choice of the drug, dose, time, and frequency must be tailored for each particular patient

Biography:

I am currently working as a Head of the Internal Medicine Department that serves multiple surgical clinics of the University Clinical Center "Kosevo" in Sarajevo, Bosnia. In organization hierarchy my Department belongs to the Clinic for Anesthesiology and Reanimation. I worked in KCUSarajevo, as the head of a medical part internist at the Surgical Clinic. Specialist in Internal Medicine and Master of Medical Sciences. Specifically, the description of my job is to prepare patients for surgery, or give consent for surgical operations.

Title: Hypertension prevalence dynamics in United states, a closer look

Abstract:

Hypertension is an increasing risk in USA. According to CDC During 2015–2016, the prevalence of hypertension was 29.0% and increased with age. The prevalence is higher among the non-Hispanic black (40.3%) compared to non-Hispanic white (27.8%), non-Hispanic Asian (25.0%), or Hispanic (27.8%) adults. Prevalence of controlled hypertension was 48.3% and increased with age for men but not women. Hypertension control was higher among non-Hispanic white (50.8%) than non-Hispanic black (44.6%) or non- Hispanic Asian (37.4%) adults. According to this study race contributed significantly to the variation observed between groups1 .Immigrants and immigration policies are very dynamic field in USA. The health of immigrants has been reported as negative. Absence of health insurance and acculturation have been contributing to this negative health status 2 . A study and as the researchers stated was the first to investigate social determinant of health and systolic blood pressure. The study found a significant relationship between socioeconomic status, being a male and high blood pressure2. The presentation will be based on the spatial analysis using ArcMap version 10.6. RStudio for significance testing Variables foreign born, Race, poverty, health insurance and High blood pressure in USA. In addition, the presentation will discuss hypothesis driven by the findings and recommendations for the way forward.

Biography:

Maysa M. Ahmed is an Epidemiologist by profession and works with Johnson county public health a local government institution in Iowa. She holds a MBBS and Doctor of Medicine degree in community medicine, with MBA, Master of science in international health from Charite-Berlin, and Master of Applied Science in spatial analysis in public health from Johns Hopkins University. Maysa has more than 13 years of public practice. He has also been involved in wide range of public health activities from establishing surveillance systems to planning and monitoring HIV prevention and control, to the fields of human resources for health development outbreak investigations of infectious diseases in Ghana. She has presented in different local platforms academic and professional. Maysa is very passionate about spatial analysis in public health.