Invited Speakers
Professor Paul Whelton
RD Wright Lecture
Dr. Whelton is Show Chwan Chair of Global Public Health at Tulane University and President, World Hypertension League. A University College Cork (UCC) medical graduate, he trained in medicine and nephrology at Johns Hopkins, clinical epidemiology at the University of London (postgraduate degree) and the MRC, and prevention research at UCC (doctoral degree). He founded the Welch Center for Prevention, Epidemiology, and Clinical Research at Johns Hopkins; was Dean, School of Public Health and Tropical Medicine; Dean, School of Medicine; and Sr. VP for Health Sciences at Tulane; and President/CEO, Loyola University Health System/Medical Center.
His research includes BP-related cardiovascular/renal disease epidemiology, prevention, clinical trials, and global health. He chaired many NIH funded studies, including the Trials of Hypertension Prevention (TOHP 1 & 2), Trial of Nonpharmacologic Interventions in the Elderly (TONE), Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), and Systolic Blood Pressure Intervention Trial (SPRINT). He chaired the 2017 ACC)/AHA BP Guideline and was a lead for the 2021 WHO BP Treatment Guideline. A recipient of two honorary degrees, he received the AHA Population Research Prize, Excellence in Hypertension Research Award, and Distinguished Scientist Award; the NKF David Hume Award; and the Irish Government St. Patrick’s Day Academic Science Award. He has published approximately 600 peer reviewed manuscripts (h-index = 142; 137,181 citations; and i10-index = 470), and 100 books, chapters, supplements, or monographs.
During my career, there has been great progress in understanding the prevalence, risks and treatment of high blood pressure (BP). In the major clinical practice guidelines, recommendations for management of hypertension are more similar than different. Despite this, traditional models of healthcare delivery have not yielded the BP reductions being advocated in clinical practice guidelines. In high income countries, control even to a systolic/diastolic BP <140/90 mm Hg is only being achieved in about 30% of adults and in middle- and low-income countries the percentage is <10%. The disconnect between scientific knowledge and practice patterns is alarming and has led to increasing interest in the application of strategies to improve treatment and control of high BP in clinical practice. Elements that have been most successful in meta-analysis include team-based care, health coaching, electronic support systems, and home BP monitoring. Recent randomized, controlled trials have employed a broader array of implementation strategies including team-based care, simple algorithms for lifestyle counseling and application of antihypertensive drug therapy, measures to ensure convenient, patient-centered delivery of care, elimination of barriers for access to effective therapies, patient engagement using home-based BP monitoring, and case management with prompt attention to deviations from the treatment plan. Trials using these types of strategies have resulted in impressive BP reductions and prevention of CVD events. Similar approaches in systems of care have also resulted in substantially improved hypertension control rates. The World Hypertension League (WHL) works closely with the World Health Organization (WHO) and other partners to implement the WHO HEARTS initiative on a worldwide basis. In the Americas alone, 27 countries have embraced the HEARTS model and developed customized clinical pathways for management of hypertension. The initial HEARTS results are promising but additional assessment is required to determine long term effectiveness and sustainability of the HEARTS initiative.
Professor Sophia Zoungas
Colin Johnston Lecture
Professor Sophia Zoungas is the Academic Director of the Monash University Clinical Trials Centre, the Head of the School of Public Health and Preventive Medicine, Monash University, and a Professor of Diabetes, Vascular Health and Ageing. She is also a consultant Endocrinologist and Physician with clinical appointments at both Monash Health, including the Victorian Heart Hospital, and Alfred Health, Melbourne.
Professor Zoungas is internationally recognised for her expertise in the design and conduct of large multicentre, multinational clinical trials and cohort studies which have impacted directly on public health and clinical care. She has assembled international and national teams in diabetes, cardiovascular and kidney health, including investigator lead projects and large-scale community-based clinical trials.
Professor Zoungas has over 300 publications in peer-reviewed journals, including the New England Journal of Medicine, Lancet, Annals of Internal Medicine, British Medical Journal, and Nature Reviews and she is recognised as one of the most cited researcher in the field of diabetes.
Professor Paul Glasziou
Austin Doyle Lecture
Professor Paul Glasziou, PhD, FRACGP, AO, is Director of the Institute for Evidence-Based Healthcare at Bond University and was the Director of the Centre for Evidence-Based Medicine in Oxford from 2003-2010. His key interests include identifying and removing barriers to using high quality research in everyday clinical practice and improving the clinical impact of research by reducing the more than $85 Billion annual loss from unpublished and unusable research (Chalmers, Glasziou, Lancet 2009). His research has influenced numerous guidelines and clinical policies and practice (cardiovascular disease management, screening, clinical monitoring, and antibiotics stewardship) and guidelines for reporting research. He co-founded the International Society for Evidence-based Health Care and the RACGP’s Handbook of Non-Drug Interventions. He has authored over 600 peer-reviewed journal articles and 7 books related to evidence-based practice, including Evidence-Based Medical Monitoring: Principles and Practice.
In the last half century we have seen huge strides in our understanding and management of hypertension, which has contributed to the significant reduction in cardiovascular morbidity and mortality. These advances have also given rise to many everyday questions in General Practice which remain less understood and researched. This talk will address a few of those uncertainties. One simple uncertainty is the practical question of how and when to monitor blood pressure, in both non-hypertensive and hypertensive patients. Common sense and new statistical methods give somewhat different answers. While drug therapies have made great advances, but non drug therapies have seen far less uptake for both practical and marketing reasons. We know that salt reduction reduces blood pressure, but a practical barriers is how to achieve that in community practice: of the methods in trials, what works is not practical, and what is practical doesn’t work. Recent trials of salt substitution offer one solution, but practical challenges remain. Finally, hypertension is not an isolated cardiovascular risk factor. Individual patients management requires the context of other risk factors, such as lipids, glucose, smoking status, etc. Hence the recent National Heart Foundation guidelines recommend a holistic cardiovascular risk assessment. That is an important management advance, but gives rise to several practical questions for the general practitioner. These issues illustrate that advances in basic understanding and therapeutics have flow on research needs for practice.
Ms Chutong Zhong
British and Irish Hypertension Society (BIHS) Lecturer
Chutong Zhong is a PhD student at the London Tubular Centre, Department of Renal Medicine, University College London, supervised by Prof. Stephen Walsh and Dr. Keith Siew. Her research focuses on developing an in vitro 3D cellular model of the human distal convoluted tubule (hDCT) using urine-derived epithelial cells and the ‘Organ-on-a-Chip’ (OOaC) system.
While the DCT plays a crucial role in blood pressure regulation, there is a lack of healthy and diseased cellular models representing the hDCT. Chutong has investigated a non-invasive method to isolate primary hDCT cells from urine, allowing continuous monitoring of renal disease progression. She has optimised a culture protocol using these hDCT cells on a multi-channel microfluidic system to create Tubule-On-a-Chip models that mimic real-life tissue architecture and physiological responses. These models can be grown alongside artificial blood vessels to study kidney tubule-capillary interactions.
The project facilitates personalised hypertension management by enabling clinicians to tailor treatment using a patient’s own urine- and blood-derived cells, enhancing our understanding of tubular physiology, disease characterisation and pharmacological research. Chutong’s work has been showcased at BIHS, ASN Kidney Week, Europhysiology and the MPS World Summit, earning her awards from BIHS, ASN Kidney STARS, Physiology Society and MPS committee.