1535_Secemsky.pdf

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1、Eric A.Secemsky,MD,MSc,RPVI,FACC,FAHA,FSCAI,FSVM Director|Vascular Intervention|Beth Israel Deaconess Medical CenterSection Head|Interventional Cardiology and Vascular Research|Richard A.and Susan F.Smith Center for Outcomes Research Associate Professor of Medicine|Harvard Medical SchoolBETH ISRAEL

2、EXPERIENCE OF RENAL DENERVATIONNYEVS 20252Funding:NIH/NHLBI K23HL150290,Food&Drug AdministrationGrants to Institution:BD,Boston Scientific,Cook,Medtronic,PhilipsSpeaking/Consulting:Abbott/CSI,BD,BMS,Boston Scientific,Cagent,Conavi,Cook,Cordis,Endovascular Engineering,Evident Vascular,Gore,InfraRedx,

3、Medtronic,Philips,RapidAI,Rampart,Recor,SoniVie,Shockwave,Terumo,Thrombolex,VentureMed and ZollDisclosures3 55 yo female with prior CVA and longstanding history of essential hypertension Referred to me by PCP as had tried 6 blood pressure medications,all with intolerable side effects Office BP 164/9

4、2 mmHg;mean ABPM 158/89 mmHg Started on Minoxidil and Lasix Titrated Minoxidil to highest tolerated dose,limited by hirsutism Office BP remains 150/90mmHgMy Patient Ms.W4High systolic blood pressure accounted for 10.8 million deaths or 19.2%of all deaths globally in 2019PollutionHypertension is the

5、Largest Global Risk Factor for Death*Measured across all age groups and both sexes,2019Adapted from:GBD 2019 Risk Factors Collaborators;Lancet 2020;396:122349 5US Blood Pressure Control Rates Are DECREASINGOver 56%of US hypertensive patients are not controlled to below 140 mmHgOver 35%of US treatedh

6、ypertensive patients are uncontrolled*from 2013-2014 through 2017-2018,P=0.003 for trend Muntner P,et al.JAMA.2020.doi:10.1001/jama.2020.145456Relative Risk Reduction Proportional to Decrease in OSBPIrrespective of Baseline BP or CVD History in 2 Meta-Analyses-10%-13%-13%-8%-5%-20%-27%-28%-17%-13%Ma