Blood Pressure Treatment Guidelines for the Southern Patient:
Hypertension is the world's leading risk factor for cardiovascular and stroke mortality. The American College of Cardiology/American Heart Association (ACC/AHA) this year published the first comprehensive hypertension clinical practice guideline since the 2003 Joint National Committee guideline (JNC-7). This session will review the principle recommendations of the ACC/AHA guideline and the evidence backing up these recommendations. Key new information appearing in the literature subsequent to guideline publication will also be reviewed. At the conclusion of the session, learners should be better prepared to:
- Recognize the latest clinical practice guideline recommendations for high blood pressure in adults;
- Discuss the background evidence supporting these guideline recommendations;
- Identify the latest comparative guideline modeling study results.
CKD progression after stage 3/4:
Once Proteinuric CKD reaches stages 3-4 CKD progresses to End Stage Renal Disease despite tight control of HTN. CKD patients have high CVD mortality. Current clinical approaches have a slight mortality benefit but fail to arrest CKD progression. CKD patients desperately need a treatment (currently unavailable) that targets new pathways that will stop or even reverse disease progression. Strategic possibilities for the development of new approaches/treatments based on novel pathophysiological mechanisms will be discussed. At the conclusion of the session, learners should be able to identify:
- Chronic Kidney Disease (CKD)affects 26 million Americans and is a growing public
- Chronic Kidney Disease (CKD)affects 26 million Americans and is a growing public health concern; it is disproportionately elevated in minority populations and those of lower economic status.
- CKD significantly increases the risk of premature death and cardiovascular disease (CVD). CVD is the leading cause of death in all stages of CKD.
- The prevalence of Stage 3 CKD (GFR 45-60) is ~ 30 times greater than the prevalence of End-Stage Kidney Disease (ESKD). Most CKD patients do not proceed to ESRD but die before the onset of ESRD.
The goal of this activity is to review the clinical trial evidence supporting systolic and diastolic blood pressure goals in patients with hypertension and diabetes, and the recent guidelines recommend for blood pressure treatment in patients with diabetes. The benefits of various classes of antihypertensive agents demonstrated in clinical trials and what recent guidelines recommend for selection of various antihypertensive classes in diabetes will also be reviewed. At the conclusion of the session, learners should be better prepared to:
- Describe the evidence from clinical trials supporting blood pressure goals in hypertensive patients with diabetes.
- Discuss recommendations for systolic and diastolic blood pressure goals in patients with diabetes in recent hypertension guidelines.
- Describe the evidence supporting selection of various classes of antihypertensive agents in diabetes.
- Discuss the recommendations for selection of different classes of antihypertensive agents in diabetes.
CME Release Date: January 4, 2019
Valid for credit through: January 4, 2020
Course type: Video lecture
Southern Medical Association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA PRA Category 1 Credits™
Southern Medical Association designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABIM MOC: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.25 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
To receive CME credit and/or MOC points, you MUST complete the activity and the evaluation form. For ABIM MOC points, your information will be shared with the ABIM through the ACCME Program and Activity Reporting System (PARS). Please allow 6-8 weeks for your MOC points to appear on your ABIM records.
AAPA: AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 1.25 hours of Category I credit for completing this activity.
AANPCP: The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board. All healthcare professionals who are not MDs or DOs will receive a certificate of participation.
Instructions for Participation and Credit
To successfully earn credit, participants must complete the activity online during the valid credit period noted, following these steps:
- Read the goals and objectives, accreditation information, and author disclosures.
- View the educational video of the lecture.
- Study the educational references.
- Online, choose the best answer to each test question. Learners must receive a passing score of 80%.
- Complete the activity evaluation and outcomes.
Upon successful completion of the test, evaluation and attestation, your certificate will be processed and emailed from [email protected] within approximately 1 hour. Credits will be archived for 6 years; at any point within this time period you may login to your account to print a duplicate copy of your certificate.
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Disclosure of Relevant Financial Relationships
As an organization accredited by the ACCME, Southern Medical Association requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner that could create a conflict of interest.
Southern Medical Association encourages Speakers/Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.
Robert M. Carey, MD, MACP
Dr. Robert M. Carey is Dean, Emeritus, and Professor of Medicine at the University of Virginia School of Medicine. He is a world renowned cardiovascular endocrinologist and hypertension specialist. His research on hormonal control of blood pressure (BP) and hypertension has resulted in over 400 publications.
He has received numerous awards, including the American Heart Association (AHA) Lifetime Achievement Award and Excellence Award for Hypertension Research (Novartis Award) and the Thomas Jefferson Award (highest honor of the University of Virginia) for transforming medicine during his 16-year deanship.
Dr. Carey has been President of the AHA (Virginia Affiliate), the Endocrine Society, and the American Clinical and Climatological Association. He has chaired the AHA Hypertension Council, Council Operations Committee and Scientific Publishing Committee, co-chaired the 2017 AHA/American College of Cardiology Hypertension Guideline Writing Committee and chaired the 2018 AHA Scientific Statement on Resistant Hypertension Writing Committee. He is a Master of the American College of Physicians and an elected member of the American Society for Clinical Investigation, the Association of American Physicians and the National Academy of Medicine
- Dr. Carey has no relevant financial relationships to disclose:
- Dr. Carey does not intend to discuss off-label or investigational uses of drugs, mechanical devices, biologics, or diagnostics not yet approved by the FDA for use in the United States.
Leopoldo Raij, MD
Dr. Leopoldo Raij is Professor of Medicine, Emeritus - Katz Family Division of Nephrology and Hypertension, Director, the Program for International Research Scholars, International Medicine Institute, the University of Miami Miller School of Medicine.
Dr. Raij previously served as the Director of Hypertension in the Renal-Hypertension Division, as the Director of Hypertension and Nephrology Research of the International Medicine Institute of the University of Miami. These are in addition to his serving as Medical Director and Co-PI of the Miami Field Center of the NIH Hispanic Community Health Study, a longitudinal epidemiological multicenter study to examine health status, chronic disease risk factors and health behaviors in 16,000 Hispanic/Latino participants, 4,000 of whom are being examined in Miami. Dr. Raij also has served as Chief of Nephrology-Hypertension Section of the VAMC, and was as member of the editorial board of several medical journals, including Hypertension and Kidney International, and of JASH, the Journal of the American Society of Hypertension. Additionally, Dr. Raij is the author of more than 180 publications in peer-reviewed journals.
- Dr. Raij has no relevant financial relationships to disclose:
- Dr. Raij does not intend to discuss off-label or investigational uses of drugs, mechanical devices, biologics, or diagnostics not yet approved by the FDA for use in the United States.
William C. Cushman, MD
Dr. William Cushman is Chief of the Preventive Medicine Section at the Veterans Affairs (VA) Medical Center and Professor of Preventive Medicine, Medicine, and Physiology at the University of Tennessee Health Science Center in Memphis, Tennessee. Dr. Cushman graduated from the University of Mississippi School of Medicine in 1974, where he completed his residency training in 1977. He served on the faculty at the University of Mississippi and was on the staff at the VA, both in Jackson, MS, from 1977-1988, when he moved to the University of Tennessee and VA in Memphis, TN.
He was a member of the 2004 and the VA champion for the 2014 VA-Department of Defense Hypertension Clinical Practice Guideline committees, and was on the JNC 7 and JNC 8 U.S. hypertension guideline committees. Read More.
- Dr. Cushman has the following relevant financial relationships to disclose:
- Institutional Grants: Eli Lilly
- Consulting: Sanofi, Takeda (uncompensated)
- Dr. Cushman does not intend to discuss off-label or investigational uses of drugs, mechanical devices, biologics, or diagnostics not yet approved by the FDA for use in the United States.
The following planning committee members have no relevant financial relationships to declare:
Donald DiPette, MD
Daniel T. Lackland, MD
Jennifer Price, MA, SMA CME Program Manager
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