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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article discusses the latest guidelines for the treatment of hypertension in patients with dyslipidemia, diabetes, atrial fibrillation, and chronic kidney disease.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EHypertensive Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Kidney Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EArrhythmias\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ELipid Disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Guidelines\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ERenal Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology \u0026amp; Cardiovascular Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHypertensive Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Kidney Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EArrhythmias\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ELipid Disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Guidelines\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ERenal Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EThis session focused on the latest guidelines for the treatment of hypertension in patients with dyslipidemia, diabetes, atrial fibrillation (AF), and chronic kidney disease (CKD).\u003C\/p\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003E2013 AMERICAN COLLEGE OF CARDIOLOGY \/AMERICAN HEART ASSOCIATION GUIDELINES ON THE TREATMENT OF BLOOD CHOLESTEROL\u003C\/h2\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EGenovefa Kolovou, PhD, Onassis Cardiac Surgery Center, Athens, Greece, provided an overview of the American College of Cardiology\/American Heart Association 2013 guidelines on the treatment of blood cholesterol [Stone NJ et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2013], highlighting changes in the recommendations since the previous version.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EDr. Kolovou stressed that these guidelines address treatments proved to reduce atherosclerotic cardiovascular disease (ASCVD) events and are not intended to be a comprehensive approach to lipid management. The updates in the new guidelines focus on identifying individuals most likely to benefit from statin therapy and clarify treatment goals for lowering low-density lipoprotein cholesterol (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E).\u003C\/p\u003E\n         \u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/14625\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/14625\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14625\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-5\u0022 class=\u0022first-child\u0022\u003EACC\/AHA 2013 Guideline Updatesa\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EThe new guidelines identify high-, moderate-, and low-intensity statins for use in the secondary and the primary prevention of ASCVD (\u003Ca id=\u0022xref-table-wrap-2-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T2\u0022\u003ETable 2\u003C\/a\u003E).\u003C\/p\u003E\n         \u003Cdiv id=\u0022T2\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/14626\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/14626\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14626\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 2.\u003C\/span\u003E \n               \u003Cp id=\u0022p-9\u0022 class=\u0022first-child\u0022\u003EHigh-, Moderate-, and Low-Intensity Statin Therapy\u003Csup\u003E\u003Csup\u003Ea\u003C\/sup\u003E\u003C\/sup\u003E\n               \u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-14\u0022\u003EDr. Kolovou concluded that ASCVD is the most important public health problem of our time. Achieving consistency of clinical care, incorporating new evidence, and its synthesis into practical recommendations for clinicians is the task of various guideline committees throughout the world. According to Dr. Kolovou, the guidelines could be enhanced by refining the use of lipid goals rather than by removing them.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-2\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EHYPERTENSION MANAGEMENT AND GLYCEMIC CONTROL IN DIABETES\u003C\/h2\u003E\n         \u003Cp id=\u0022p-15\u0022\u003EPeter M. Nillson, MD, PhD, Skane University Hospital, Malmo, Sweden, discussed guidelines for blood pressure (BP) and glycemic control in patients with diabetes. The goals of antihypertensive therapy in patients with diabetes are to lower BP and reduce cardiovascular risk and mortality.\u003C\/p\u003E\n         \u003Cp id=\u0022p-16\u0022\u003EBoth the European guidelines on cardiovascular disease prevention [Perk J et al. \u003Cem\u003EEur Heart J\u003C\/em\u003E 2012] and the American Diabetes Association (ADA) Standards of Medical Care in Diabetes 2014 [ADA. \u003Cem\u003EDiabetes Care\u003C\/em\u003E 2014] recommend a hypertension treatment target in patients with diabetes of \u0026lt;140\/80 mm Hg. The 2013 European Society of Hypertension (ESH)\/European Society of Cardiology (ESC) recommendations [Mancia et al. \u003Cem\u003EEur Heart J\u003C\/em\u003E 2013] are shown in \u003Ca id=\u0022xref-table-wrap-3-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T3\u0022\u003ETable 3\u003C\/a\u003E.\u003C\/p\u003E\n         \u003Cdiv id=\u0022T3\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/14627\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/14627\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14627\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 3.\u003C\/span\u003E \n               \u003Cp id=\u0022p-17\u0022 class=\u0022first-child\u0022\u003EESH\/ESC Guidelines for the Treatment of Hypertension in Diabetes and Metabolic Syndrome\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-19\u0022\u003EThe ESC\/European Association for the Study of Diabetes and ESH\/ESC guidelines both suggest that combination therapy is often necessary for patients with diabetes and hypertension. When combination therapy is needed, an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), calcium antagonist, and thiazide diuretic are recommended. The guideline cautions against using an ACE inhibitor plus an ARB or a direct renin inhibitor because of the adverse effects of acute kidney injury and hyperkalemia. Beta-blockers should be used in patients with concomitant symptomatic coronary heart disease. Thiazides and beta-blockers may increase the risk for new-onset diabetes.\u003C\/p\u003E\n         \u003Cp id=\u0022p-20\u0022\u003EThe ADA\/European Association for the Study of Diabetes (EASD) 2012 guidelines for glycemic control [Inzucchi SE et al. \u003Cem\u003EDiabetologia\u003C\/em\u003E 2012] in patients with diabetes recommend initial drug monotherapy with metformin in addition to lifestyle changes. More advanced regimens should use multiple glucose-lowering drugs, possibly insulin (including greater than once daily injections; \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). Glycated hemoglobin (HbA1C) targets may need to be adjusted to avoid hypoglycemia.\u003C\/p\u003E\n         \u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/18\/20\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022ADA\/EASD Guidelines for Glycemic Control in Patients With Type 2 Diabetes\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1034438189\u0022 data-figure-caption=\u0022ADA\/EASD Guidelines for Glycemic Control in Patients With Type 2 Diabetes\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/18\/20\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/18\/20\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/18\/20\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14624\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-21\u0022 class=\u0022first-child\u0022\u003EADA\/EASD Guidelines for Glycemic Control in Patients With Type 2 Diabetes\u003C\/p\u003E\n            \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EADA=American Diabetes Association; DPP=dipeptidyl peptidase; EASD=European Association for the Study of Diabetes; GI=gastrointestinal; GLP=glucagon-like peptide; HbA1C= glycated hemoglobin; SU=sulfonylurea; TZD=thiazolidinedione.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EReproduced with permission from Springer Verlag from Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycaemia in type 2 diabetes: a patient-centered approach. Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). \u003Cem\u003EDiabetologia\u003C\/em\u003E 2012;55(6):1577\u20131596.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-22\u0022\u003EFlexible goals for controlling hypertension (\u0026lt;140\/85 mm Hg) and hyperglycemia (\u0026lt;7% HbA1C) are now recommended to avoid adverse effects, especially in the frail elderly (\u0026lt;8%\u20139% HbA1C). The ADA\u0027s BP goal for patients with diabetes, now \u0026lt;140\/80 mm Hg, has gradually changed to become more like the European goal. The ESH\/ESC and ESC\/EASD 2013 guidelines both recommend a BP goal of \u0026lt;140\/85 mm Hg, but the International Society of Hypertension\/American Society of Hypertension recommend a goal of \u0026lt;140\/90 mm Hg.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-3\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003ETHERAPY FOR PATIENTS WITH ATRIAL FIBRILLATION AND HYPERTENSION\u003C\/h2\u003E\n         \u003Cp id=\u0022p-23\u0022\u003EPatients with hypertension have an increased risk for AF, which leads to reduced cardiac function and increased risk for thromboembolism. Enrico Agabiti Rosei, MD, University of Brescia, Italy, discussed the various guidelines for antihypertensive, antiarrhythmic, and antithrombotic therapy for patients with AF.\u003C\/p\u003E\n         \u003Cp id=\u0022p-24\u0022\u003EThe 2013 ESH\/ESC guidelines for the management of arterial hypertension recommend considering treatment with an ARB, an ACE inhibitor, a beta-blocker, or a mineralocorticoid receptor antagonist to prevent AF and a beta-blocker or nondihydropyridine calcium antagonist for ventricular rate control in hypertensive patients with AF [Mancia et al. \u003Cem\u003EEur Heart J\u003C\/em\u003E 2013]. The 2012 focused update of the ESC guidelines [Camm AJ et al. \u003Cem\u003EEur Heart J\u003C\/em\u003E 2012] recommends antiarrhythmic therapy according to underlying pathology. Patients with AF have a nearly 5-fold increased risk for stroke [Wolf PA et al. \u003Cem\u003EStroke\u003C\/em\u003E 1991]. A meta-analysis found that two-thirds of strokes due to AF are preventable with appropriate anticoagulant therapy; in 29 trials of 28,044 patients, adjusted-dose warfarin reduced ischemic stroke by 67% and all-cause mortality by 26% [Hart RG et al. \u003Cem\u003EAnn Intern Med\u003C\/em\u003E 2007]. The new oral anticoagulants (NOACs), dabigatran, rivaroxaban, apixaban, and edoxaban have been evaluated for stroke prevention in several trials. A meta-analysis of randomized clinical trials comparing NOACs with warfarin reported a 19% overall reduction in stroke risk and a 14% overall reduction in major bleeding risk with NOACs versus warfarin [Ruff CT et al. \u003Cem\u003ELancet\u003C\/em\u003E 2014].\u003C\/p\u003E\n         \u003Cp id=\u0022p-25\u0022\u003EThe ESC AF 2012 [Camm AJ et al. \u003Cem\u003EEur Heart J\u003C\/em\u003E 2012] and AHA\/ACC\/Heart Rhythm Society 2014 [January CT et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2014] guidelines for the treatment of AF recommend warfarin, dabigatran, rivaroxaban, or apixaban in patients with CHA\u003Csub\u003E2\u003C\/sub\u003EDS\u003Csub\u003E2\u003C\/sub\u003EVASc scores \u22652. The American College of Chest Physicians 2012 guidelines [Guyatt GH et al. \u003Cem\u003EChest\u003C\/em\u003E 2012] recommend dabigatran 150 mg twice daily rather than vitamin K antagonist therapy, while the Canadian Cardiovascular Society AF guidelines [Skanes AC et al. \u003Cem\u003ECan J Cardiol\u003C\/em\u003E 2012] recommend dabigatran, rivaroxaban, or apixaban over warfarin (\u003Ca id=\u0022xref-table-wrap-4-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T4\u0022\u003ETable 4\u003C\/a\u003E).\u003C\/p\u003E\n         \u003Cdiv id=\u0022T4\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/14628\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/14628\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14628\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 4.\u003C\/span\u003E \n               \u003Cp id=\u0022p-26\u0022 class=\u0022first-child\u0022\u003EUS, European, and Canadian Guidelines for the Management of Patients With Atrial Hypertension\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-29\u0022\u003EAccording to Prof. Agabiti Rosei, prevention of AF and new treatment regimens are needed, considering the increasing elderly population, high percentage of uncontrolled hypertension, risk for stroke, and worsening of other comorbidities. Management of AF includes antihypertensive, antiarrhythmic, and antithrombotic drugs. Prof. Agabiti Rosei also emphasized that most patients with hypertension and AF do not control BP adequately, and this might represent a risk for cerebral hemorrhage, particularly during anticoagulant therapy.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-4\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003ETREATMENT OF HYPERTENSION IN PATIENTS WITH KIDNEY DISEASE\u003C\/h2\u003E\n         \u003Cp id=\u0022p-30\u0022\u003EThe latest guidelines for the treatment of hypertension in patients with CKD were discussed by Demetrios V. Vlahakos, MD, Attikon University Hospital, Athens, Greece. According to the 2013 ESH\/ESC guidelines for the management of arterial hypertension, patients with CKD and hypertension have a high to very high risk for cardiovascular disease [Mancia et al. \u003Cem\u003EEur Heart J\u003C\/em\u003E 2013]. For patients with CKD stage 3 or \u22654, the guidelines recommend lifestyle changes for those with high normal BP (systolic BP [SBP] 130\u2013139 mm Hg or diastolic BP [DBP] 85\u201389 mm Hg) and lifestyle changes plus antihypertensive therapy targeting a BP \u0026lt;140\/90 mm Hg for patients with hypertension (SBP \u2265140 mm Hg or DBP \u226590 mm Hg).\u003C\/p\u003E\n         \u003Cp id=\u0022p-31\u0022\u003EA meta-analysis studying the effects of intensive BP lowering on the progression of kidney disease reported that intensive BP therapy improved outcomes and reduced the risk for end-stage kidney disease [Lv J et al. \u003Cem\u003ECMAJ\u003C\/em\u003E 2013]. Subgroup analysis showed that intensive BP lowering reduced the risk for kidney failure for patients with baseline proteinuria but not for those without proteinuria.\u003C\/p\u003E\n         \u003Cp id=\u0022p-32\u0022\u003EBP-lowering therapies recommended by the 2013 ESH\/ESC guidelines are shown in \u003Ca id=\u0022xref-table-wrap-5-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T5\u0022\u003ETable 5\u003C\/a\u003E.\u003C\/p\u003E\n         \u003Cdiv id=\u0022T5\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/14629\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/14629\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14629\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 5.\u003C\/span\u003E \n               \u003Cp id=\u0022p-33\u0022 class=\u0022first-child\u0022\u003EHypertension Treatment for Patients With Nephropathy\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-36\u0022\u003EThe 2014 evidence-based guideline for the management of high blood pressure in adults recommends that antihypertensive therapy in adults with CKD include an ACE inhibitor or ARB to improve kidney outcomes [James PA et al. \u003Cem\u003EJAMA\u003C\/em\u003E 2014].\u003C\/p\u003E\n         \u003Cp id=\u0022p-37\u0022\u003EProf. Vlahakos concluded that guidelines provide evidence-based recommendations for the thresholds, goals, and drug treatment strategies for the management of hypertension. However, guidelines are not a substitute for clinical judgment, and decisions must carefully consider the specific characteristics of each patient.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/18\/20.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzm3ip\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzm3ip\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzm3ip\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}