International Conference on Hypertension & Healthcare August 11-12, 2016 Toronto, Canada

Biography:

Hossein Tabriziani obtained his Medical degree with honor at the age of 25. He completed his Internal Medicine residency at St. Barnabas Hospital, Weill Cornell Medical College in New York. With the passion for Transplant, he accepted a clinical Nephrology and Hypertension fellowship at Georgetown University in Washington, DC and continued his education at University of California San Francisco (UCSF) with a Transplant Nephrology fellowship. He was appointed at the Medical director of Pancreas Transplantation at Westchester Medical Center, New York Medical college before moving to Loma Linda Univeristy in California to accept the position as an Assistant Professor of Medicine in Transplant Nephrology division. He is an active member of American Society of Nephrology (ASN) and American Society of Tranplantation (AST). He has multiple publications and has been involved in many clinical researches. His interests are in Hypertension and oxidative stress in patintes with chronic kidney disease and transplantaion.

Abstract:

One quarter of Americans will be older than 65 by 2030 and more than half of this popultaion will be older than 80 years old and hypertension in this group will be ubiquitous. Most studies of hypertension exclude octogenarians and are not able to be generalized because of differences in physiologic and social phenomena. This presentaion will review and evaluate the existing literature in an effort to identify unresolved issues and guide future areas of investigation. Hypertension has been well characterized in adults and the young elderly, and the focus is on optimizing treatment regimens. However, research specifically involving this rapidly growing minority is sparse. Most studies are still trying to characterize blood pressure goals, and only one major series has begun to evaluate treatment options. Based on available evidence, it appears that an appropriate blood pressure goal may be somewhat higher in octogenarians and that thiazide diuretics may be the initial treatment of choice.

Biography:

Abdou Elhendy is a cardiologist at Marshfield Clinic and Clinical Associate Professor of Medicine, University of WI, Madison WI. He has completed his PhD at Erasmus University, Rotterdam, NL in 1996. He has published 250 papers in peer review journals including 70 original studies as first author in the field of cardiovascular imaging. He has contributed to CME publications by the American College of Cardiology and Society of Nuclear Medicine. He served on the editorial board of Journal of American Society of Echocardiography and Euro Echo.

Abstract:

Hypertension is a major risk factor for coronary artery disease (CAD) and its complications. Accurate non-invasive diagnosis of CAD allows identification of patients in whom aggressive medical therapy and intervention may improve outcome. Challenges in the diagnosis of CAD in hypertensive patients include baseline EKG abnormalities which impair accuracy of exercise EKG interpretation. Left ventricular hypertrophy may be associated with demand ischemia in absence of obstructive CAD. Stress echocardiography using exercise or dobutamine was shown to have good accuracy. The technique is widely available and does not entail irradiation. In addition to ischemia, left ventricular mass index predicts cardiac events. Hypertensive response during stress has been related to false positive results. Stress myocardial perfusion imaging provides good sensitivity and specificity. Some studies showed reduced specificity in patients with left ventricular hypertrophy. However, many studies demonstrated similar accuracy in patients with and without hypertension. A normal stress echocardiogram or radionuclide study is associated with low risk of cardiac death and myocardial infarction during intermediate and long term follow up. Coronary CT angiography is increasingly used in patients with intermediate probability of CAD and in those with equivocal stress test. The test has high negative predictive value to rule out CAD. Disadvantages include artifacts, irradiation and risk of contrast nephropathy. Obesity is a significant comorbid condition that may impair imaging quality of different techniques. Proper selection of imaging modality depends on various clinical parameters, availability and expertise of the center with each type of imaging.

Biography:

Sasidharan is Vice President of Hypertension Society of India, Formerly Professor of Medicine& Head, Department of Medicine Calicut Medical College. Research Guide University of Calicut, Scientific Advisory committee Member- National Institute of Immuno Hematology, Mumbai, Dean Faculty of Medicine, University of Calicut. Best outgoing student for MBBS, MD from Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. Awards and fellowships- 7; Teaching experience of – 32 years, Papers Published 73, Published 4 books and authored chapters in textbooks of Medicine and Hematology. Two land mark studies on Vitamin D and SLE. Papers presented: More than 500 guest speaker/Paper presentations in National & International conferences.

Abstract:

Hypovitaminosis D is widely prevalent in the Indian populations despite good sunlight exposure. Our landmark study has proven this first in 2000 in patients with tuberculosis and in the apparently normal individuals (Ref1). The role of vitamin D in several diseases is now becoming clearer and its role in hypertension and cardiovascular disease has been proven and studied in some western populations. There are little data on Vitamin D status in hypertensive patients in the Indian context. Aims and Objectives: a) to assess the vitamin D status in patients with essential hypertension and to compare the vitamin D status, dietary intake of vitamin D, physical activity and sunlight exposure among hypertensives and age and gender matched normotensive controls. b) To correlate vitamin D levels with dietary intake, physical activity, BMI and daily sunlight exposure. Materials and Methods: 55 subjects and 32 controls were studied over a period of nine months from December 2011 to August 2012. Their 25 Hydroxy Vitamin D levels, daily sunlight exposure, dietary intake, physical activity were assessed and subjected to statistical analysis. Results: The mean 25(OH) D levels for hypertensives were found to be 17.07 ± 9.72 ng/ml while in the normotensive controls were 22 ± 10 ng/ml (p=0.027). Only 20 % of the total population ie cases and controls had sufficient levels above 30 ng/ml. Higher dietary intake ie >200 IU/day were found to have lesser incidence of hypertension.

Biography:

Stephanie Tjen-A-Looi completed her Ph.D from University of Wisconsin, Madison and is currently Project Scientist in University of California, Irvine. She has published over 47 peer reviewed articles and chapters and is currently serving as an editorial board member for American Journal of Physiology - Heart and Circulation, Evidence-Based Complementary and Alternative Medicine, and BioMed Central (BMC) - Complementary and Alternative Medicine.

Abstract:

There is a growing interest in integrative medical treatments such as acupuncture on hypertension although therapy to control high blood pressure (BP) is available. We have demonstrated in a series of experimental investigations the mechanisms and actions of acupuncture and electroacupuncture (EA) in models of elevated BP associated with reflex induced sympathoexcitation. These studies suggest that bilateral EA at select acupoints PC5-6 and ST36-37, in contrast to EA at LI6-7 and GB37-39, inhibits sympathetically-mediated reflex responses lowering BP through cardiovascular regions in the brain and specific neurotransmitter systems. The experimental findings provided guidance in designing the clinical study to proof the overall hypothesis that weekly EA at PC5-6+ST36-37 but not LI6-7+GB37-39 acupoints for 8 weeks decreases BP for a prolonged period of time in patients with mild to moderate hypertension. We have used 24-hr ambulatory blood pressure measurements to monitor EA-inhibition of peak and average systolic and diastolic BP (SBP and DBP) and to identify high and low responders to EA. In a cross-over and double blinded design, we have shown that EA application to acupoints PC5-6+ST36-37 for 8 weeks reduces peak and average SBP by 8 and 6 mmHg in the overall group. Of interest, in high responders EA decreases peak and average SBP by 16 and 11 mmHg. Following 8 weeks of EA treatment, sympathetic activity reduces and therefore ultimately norepinephrine, renin-aldosterone-system. In subgroup of patients, we observed a long-lasting blood pressure lowering acupuncture effect for at least an additional four weeks after the end of EA treatment.

Biography:

Habibollah Saadat is a Professor of Cardiology at Shahid Beheshti University of Medical Sciences. He has Cardiology fellowship from Shahid Beheshti University of Medical Sciences and is in clinical and academic research activities for 25 years.

Abstract:

The most common cardiovascular diseases are systemic hypertension, ischemic heart disease and heart failure. The earliest pathophysiology in these disorders is left ventricular (LV) diastolic dysfunction. Left atrial (LA) enlargement is the first reaction in LV diastolic dysfunction. As witness to chronically elevated LV filling pressures, LA enlargement is a reliable marker of diastolic dysfunction. At least 50% of hypertensive patients are asymptomatic and 25% of myocardial infarction happens silently. Early recognition of LA enlargement would help physicians to detect primary silent disorders at earlier stages. Most practitioners consider the P wave on electrocardiogram (ECG) as a diagnostic clue for the presence or absence of arrhythmias. However, P wave on ECG is an indicator of ventricular diastolic function. This fact needs to be emphasized by the cardiology community. Next to ECG, LA size and volume measured by 2D echocardiography are excellent parameters to assess diastolic function in a long-term fashion. LA size has an important role in LV diastolic dysfunction similar to the role that glycosylated hemoglobin (HbA1c) plays in clinical assessment of diabetes mellitus. Sophisticated but error prone, momentary Doppler parameters are getting too much attention at the cost of simple, shrewd ECG and 2D echo.

Biography:

Dr. Seeger is Professor of Internal Medicine at the Justus-Liebig University Giessen, Germany and Director of the Department of Lung Development and Remodeling at the Max Planck Institute for Heart and Lung Research Bad Nauheim, Germany. He chairs the Universities of Giessen and Marburg Lung Center (UGMLC), the Excellence Cluster Cardio-Pulmonary System (ECCPS) and the German Center for Lung Research (DZL). Focusing on the pathogenesis of pulmonary hypertension (PH) in partnership with the scientists of these centers, he revealed disturbances of the NO synthase - soluble guanylate cyclase – cGMP – phosphodiesterase V pathway on several levels, adding to the lack of prostaglandin I2 to promote prolonged pulmonary vasoconstriction in PH. Moreover, growth factor abnormalities (in particular PDGF upregulation) and epigenetic mechanisms (in particular micro-RNA signaling alterations and epigenetic silencing of BMPR2) were identified as major contributors to the abnormal inward remodeling processes underlying PH. Translating these finding into novel treatment concepts, the Giessen team initiated and carried through preclinical and clinical trials the development of inhaled iloprost (worldwide approval 2004), sildenafil (approval 2005), inhaled treprostinil (approval 2010) and riociguat (approval 2014) for treatment of pulmonary arterial hypertension (PAH). Along the same line, riociguat was approved for chronic thromboembolic pulmonary hypertension (CTEPH; first drug in this class). Moreover, this team forwarded the concept that “reverse remodeling” is the novel treatment goal in PH and proved in preclinical up to phase III trials that the tyrosine kinase inhibitor imatinib meets this goal, though it was not approved for PH treatment due to serious side effects.

Abstract:

The lecture will summarize the progress that has been made in the treatment of pulmonary hypertension (PH) over the past two decades. Here, it will address pulmonary vasodilatory treatment concepts, with particular focus on the prostaglandin I2 – cAMP and the NO synthase - soluble guanylate cyclase – cGMP – phosphodiesterase V pathways. It will, however, point out that the abnormal inward remodeling processes underlying PH go far beyond vasomotor abnormalities, and that the development of vascular “reverse remodeling” and “regenerative” strategies represents the future challenge of PH therapy. Open issues that will be addressed in this lecture are: - The role of various growth factors and transcription factors - The role of inflammatory and immunological sequelae - The role changes in the epigenetic landscape / “epigenetic memory” underlying the vascular phenotypic switch and maintenance in PH Being challenged with increased afterload in PH, the right ventricle (RV) initially responds with “adaptive” hypertrophy, which is, however, often rapidly followed by “maladaptive” changes leading to right heart failure. Though research here is still in its infancy, topics of major future relevance to be addressed in the lecture are: - RV morphogenesis and recapitulation of morphogenetic pathways in right ventricular hypertrophy - Hypoxia and ischemia in right ventricular hypertrophy - Metabolic “switch”, mitochondrial dysfunction, and enhanced formation of reactive oxygen species in RV hypertrophy - Epigenetic changes underlying the hypertrophic response profile (adaptive, maladaptive) of the right ventricle to mechanical load

Biography:

Costas Tsioufis was born in Greece in 1963. He graduated in Medicine from the Medical School of the University of Athens in 1987 and obtained his PhD from the same university in 1997. His postgraduate medical training in Cardiology and Hypertension was first at the University of Athens, Greece and later at the Veterans Affairs Medical Center, Georgetown University, Washington DC, USA. Currently, he is Associate Prof. of Cardiology, University of Athens, Hippocratio Hospital, Athens, Greece and Head of the Hypertension Unit of the same institute. In the clinical field, the topics of his competence are hypertensive disease and interventional cardiology. The last 5 years he has a special interest for the novel interventional therapies of hypertension and he is involved in major clinical trials regarding renal sympathetic denervation. He is also Secretary of ESH and Elected President of Hellenic Cardiology Society. He has published 229 papers in peer-review journals mainly in the areas of hypertension, atherosclerosis, and interventional cardiovascular disease.

Abstract:

Resistant hypertension (RHTN) represents a very mixed group of patients with target organ damage and cardiovascular and renal disease but the causes of resistant hypertension (RHTN) are complex and multifactorial. Older age, diabetes, chronic kidney disease and obesity are the most common factors associated. Clinical assessment requires close follow-up and adherence to medication is of great importance but its clinical assessment in routine practice is challenging. Available evidence that some blood pressure (BP) lowering effect by Increase in the dose of existing drug treatments (especially diuretics) and addition of spironolactone in some cases. We have learned from renal denervation (RDN) clinical trials that BP response to RDN is characterized by huge variability and heterogeneity. Possible causes for that variability have been recognized procedural aspects (related to incomplete denervation), the studied population and the design of the study. In order to move forward, there is a need for conducting an appropriately designed trial to definitely resolve the uncertainties regarding the BP effects of RDN. So, according to a recently released paper in Eur Heart Journal, the following considerations for future RDN studies should be taken into account. • For the procedure: to use multi-electrode ablation system targeting the circumferential ablation • For the Study population : to include patients with moderate rather than resistant hypertension and to exclude patients with stiff large arteries (e.g. isolated systolic hypertension • For the study design : to perform wash out period only in highly experienced centers (safety concerns) and to consider sham procedure with renal angiography as potentially unethical ; to standardize concomitant antihypertensive therapy and to monitor drug adherence as potential confounder of BP response • For study outcomes : to use the change in ambulatory BP as a primary efficacy parameter

Biography:

Deepika Narasimha is a Cardiology fellow at the Loma Linda University Medical Center and her research interests include clinical trials in cardiovascular disease especially coronary artery disease, atrial fibrillation and cardiomyopathies. She have been actively involved in two single center randomized controlled trials as a resident including writing the IRB proposal, enrolling patients, data analysis and manuscript preparation. She is also currently involved in retrospective studies evaluating systolic dysfunction in post liver transplant patients, and pre-operative work-up of renal transplant patients. She was the Chief resident at Internal Medicine residency program and received the 2014-2015 Thomas Frawley research fellowship awarded to upcoming young investigators. She have published several peer reviewed articles, one book chapter, and presented abstracts at various national and regional conferences including the ACC, ISHLT, HRS and ACP meetings.

Abstract:

Hypertension is a major risk factor for cardiovascular morbidity and mortality. The risk for coronary artery disease is doubled, and the risk for congestive heart failure and stroke is tripled in patients with hypertension. In addition to this, hypertensive heart disease itself encompasses a very wide range of disorders including left ventricular hypertrophy, systolic and diastolic dysfunction which can down the line lead to symptomatic heart failure and precipitate arrhythmias. There are several structural and functional changes in hypertensive heart disease which first lead to concentric left ventricular hypertrophy which if left untreated leads to dilated cardiomyopathy or the ‘burned-out’ left ventricle. Cardiac complications from hypertension cause significant morbidity and mortality and also influence the choice of appropriate therapy and diagnostic tests. My talk will focus on the clinical manifestations and natural history of hypertensive heart disease as well as the various diagnostic and therapeutic modalities available to diagnose and treat the same. In addition to these we will also discuss some of the common cardiovascular co-morbidities associated with hypertension including atrial fibrillation, coronary artery disease and concomitant aortic stenosis with hypertension.

Biography:

MU has completed his PhD at the age of 65 years from medical college of Xian Jiaotong University. He is the director of dept. cardiology, First Affiliated Hospital of Xian Jiaotong University. He is a member of ISH and ESH . and he has published more than 100 papers in reputed journals and has been serving as an editorial board member of repute.

Abstract:

The objectives of this study were to investigate the impact of a high salt diet on the PRMT/ADMA/DDAH (protein arginine methyltransferases; dimethylarginine dimethylaminohydrolase) pathway in Dahl salt-sensitive (DS) rats and SS-13BN consomic (DR) rats, and to explore the mechanisms that regulate ADMA metabolism independent of blood pressure reduction. 8-weeks-old male Dahl salt-sensitive (SS) rats and SS-13BN (13BN) rats were randomly divided into five groups: SS normal diet group (NaCl 0.3%, SN group), SS high-salt diet group (NaCl 8%, SH group), high salt diet (8% NaCl) and hydralazine (10 mg/kg/d) intragastric administration (SH + HYD group), 13BN normal diet group (containing NaCl 0.3%, BN group), 13BN high-salt diet group (containing NaCl 8%, BH group). The plasma concentration of ADMA and NOx were determined, mRNA and protein expression of PRMT-1, mRNA expression and activity of DDAH, mRNA and protein expression of eNOS in aortic tissue were detected with RT-qPCR and Western blot Plasma levels of nitric oxide (NO) in DS rats given a high salt diet and subjected to intragastric administration of hydralazine (SH + HYD group) were lower than those given a normal salt diet (SN group). There were significant decreases in expression and activity of dimethylarginine dimethylaminohydrolase (DDAH) and endothelial NO synthase (eNOS) in DS rats given a high diet (SH group) in comparison to the SN group. The activity of DDAH and expression of eNOS in the SH + HYD group decreased more significantly than SN group. The mRNA expression of DDAH-1 and DDAH-2 were lowest in the SH group. It suggest that salt, independent of blood pressure, can affect the PRMT-1/ADMA/DDAH system to a certain degree and lead to endothelial dysfunction in Dahl salt-sensitive rats.

Biography:

MU has completed his PhD at the age of 65 years from medical college of Xian Jiaotong University. He is the director of dept. cardiology, First Affiliated Hospital of Xian Jiaotong University. He is a member of ISH and ESH . and he has published more than 100 papers in reputed journals and has been serving as an editorial board member of repute.

Abstract:

The objectives of this study were to investigate the impact of a high salt diet on the PRMT/ADMA/DDAH (protein arginine methyltransferases; dimethylarginine dimethylaminohydrolase) pathway in Dahl salt-sensitive (DS) rats and SS-13BN consomic (DR) rats, and to explore the mechanisms that regulate ADMA metabolism independent of blood pressure reduction. 8-weeks-old male Dahl salt-sensitive (SS) rats and SS-13BN (13BN) rats were randomly divided into five groups: SS normal diet group (NaCl 0.3%, SN group), SS high-salt diet group (NaCl 8%, SH group), high salt diet (8% NaCl) and hydralazine (10 mg/kg/d) intragastric administration (SH + HYD group), 13BN normal diet group (containing NaCl 0.3%, BN group), 13BN high-salt diet group (containing NaCl 8%, BH group). The plasma concentration of ADMA and NOx were determined, mRNA and protein expression of PRMT-1, mRNA expression and activity of DDAH, mRNA and protein expression of eNOS in aortic tissue were detected with RT-qPCR and Western blot Plasma levels of nitric oxide (NO) in DS rats given a high salt diet and subjected to intragastric administration of hydralazine (SH + HYD group) were lower than those given a normal salt diet (SN group). There were significant decreases in expression and activity of dimethylarginine dimethylaminohydrolase (DDAH) and endothelial NO synthase (eNOS) in DS rats given a high diet (SH group) in comparison to the SN group. The activity of DDAH and expression of eNOS in the SH + HYD group decreased more significantly than SN group. The mRNA expression of DDAH-1 and DDAH-2 were lowest in the SH group. It suggest that salt, independent of blood pressure, can affect the PRMT-1/ADMA/DDAH system to a certain degree and lead to endothelial dysfunction in Dahl salt-sensitive rats.

Biography:

Ms. Imei Tiongco , 5th year student of BS Pharmacy Major in Clinical Pharmacy in University of Santo Tomas, Manila, Philippines.

Abstract:

Hypertension is a condition in which the arteries have persistently elevated blood pressure. Diuretic based therapy has been proven effective in reducing morbidity and mortality in hypertensive patients. The goal of this study is to determine whether the methanolic extract of Pachyrhizus erosus tubers has diuretic and blood-pressure lowering effect. Pachyrhizus erosus exhibits a variety of pharmacological use including the utilization of its tubers through decoction which is said to be diuretic based on folkloric use. The study utilized 25 male Sprague-Dawley rats divided into five groups with five rats each. Hypertension was induced to all of the test subjects through the subcutaneous injection of Cyclosporin A with a dose of 25 mg/kgBW. Systolic blood pressure (SBP) was measured using a Non-invasive Blood Pressure apparatus utilizing tail cuffs. Then, two groups were set as positive (Hydrochlorothiazide) and negative (water) controls. The other three were given varying doses of the methanolic extract of the tubers of Pachyrhizus erosus: 50 mg/kg, 100 mg/kg, and 200 mg/kg orally. During the whole course of treatment, the SBP of the subjects were consistently monitored. The urine output was also recorded based on schedule, 8 hours a day, using a metabolic cage. Statistical tests were used to determine significant changes. The methanolic extract of the tubers of Pachyrhizus erosus showed potential blood pressure lowering activity at a dose of 200 mg/kg and possibly on higher doses. The diuretic effect was only exhibited at the 50 mg/kg dose and cannot be suggestive of potential therapeutic activity.

Biography:

Jalal Poorolajal has completed professional medicine from Hamadan University of Medical Sciences and completed PhD in Epidemiology from Tehran University of Medical Sciences. He is the associate professor of epidemiology and managing editor of the Journal of Research in Health Sciences. He has published more than 100 papers in reputed journals and has been serving as an editorial board member of Epidemiology.

Abstract:

A 25% relative reduction in the prevalence of hypertension is a global target for the prevention and control of noncommunicable diseases. We conducted this meta-analysis to estimate the effect of excess weight loss on hypertension. We searched PubMed, Web of Science, Scopus, and reference lists of articles to January 2016. We included prospective cohort studies addressing the association between overweight and obesity and hypertension. We expressed the strength of association between overweight and obesity and hypertension using risk ratio and the excess risk of hypertension attributable to overweight and obesity using attributable risk fraction with 95% confidence intervals (CI) based on the random-effects model. We found a total of 7617 references and included 10 studies with 173,828 participants. Compared to normal weight, the risk ratio of hypertension was 1.52 (95% CI: 1.37, 1.67; 9 studies, I2=82.4%) for overweight and 2.17 (95% CI: 1.84, 2.50; 9 studies, I2=88.9%) for obesity. The excess risk of hypertension attributable to overweight was 32% (95% CI: 24%, 40%; 8 studies, I2=85.5%) and that attributable to obesity was 47% (95% CI: 40%, 54%; 8 studies, I2=88.2%). That means, excess weight loss may reduce the risk of hypertension from 24% to 40% in people who are overweight and from 40% to 54% in people who are obese. No evidence of publication bias was detected. Excess weight loss is effective in a relative reduction in the incidence of hypertension and is sufficient for achieving the global target and requires to be accompanied with other preventive measures.

Biography:

Juliana Mandha has completed his Masters at the age of 27 years from Nelson Mandela African Insitution of Science and Technology. She has published 4 papers in reputed journals and loves learning.

Abstract:

Non-communicable diseases are rising in low income countries. Information on the risk factors at the community level is of paramount importance to enable strategic preventive programs. This study was conducted within a rural pastoral community of Maasai in Simanjiro District of Tanzania to determine prevalence of hypertension and its determinants.This population based cross-sectional study included 561 Maasai participants. Consenting adults (≥ 25 years) were interviewed using the World Health Organization STEPWISE survey instrument.The average age (years) of the participants was 39±13.9. The prevalence for hypertension was 21.3%, 95% CI [18,25]. Systolic blood pressure was significantly (p<0.05) associated with diastolic blood pressure, heart rate, weight, height, body mass index, waist circumference, abdominal obesity, fruit servings per day, and vigorous work done. The majority (96.26%) of Maasai participants were physically active, with those in the 24-34 year age group having higher metabolic equivalents (10563.92±7552) than the 65+ group (4852.09±5835.272) (p< 0.0001). Hypertensive participants showed lower metabolic equivalents (179.2±107.7) than their non- hypertensive counterparts (297.6±53.1). The majority of participants were within normal weights, but body mass index differed according to age groupings (p = 0.0454) and hypertensive status (p=0.0063). Hypertensive participants had significantly (p=0.0136) higher blood glucose levels. Fruits and vegetable intake was similar among hypertensive and non- hypertensive participants; however, there was a significant difference across age groups (p=0.0085). Hypertension prevalence among the rural Maasai community was found to be high. It is imperative to put strategies in place for primary prevention and targeted treatment of hypertension.

Biography:

Enkhtuya Palam received the M.D (Pediatrician) and PhD (Public Health) from Medical University, Irkutsk, Russia in 1994 and 2003, respectively. She works as leading Researcher in Public Health Institute of Mongolia. Her research fields are NCD surveillance system and Tobacco Control Programme.

Abstract:

Mean systolic blood pressure (SBP) was 125.6 mmHg (95% CI 124.3-127.0) in the study population in general, and 129.8 mmHg (95% CI 128.4-131.1) in men and 121.4 mmHg (95% CI 120.0-122.9) in women. Mean SBP was higher in men compared to women. Mean diastolic blood pressure (DBP) was 78.9 mmHg (95% CI 78.1-79.6) in the study population in general, and 79.6 mmHg (95% CI 78.7-80.5) in men and 78.1 mmHg (95% CI 77.3-78.9) in women. No significant difference was detected between genders. SBP ≥140 and/or DBP ≥ 90 mmHg or currently on medication for raised blood pressure: Prevalence of hypertension was 27.3% (95% CI 24.9-29.8) in the study population, 31.5% (95% CI 28.3-34.7) in men and 23.2% (95% CI 20.7-25.7) in women (Annex 1.40-43). Prevalence of hypertension in men was higher than in women. Prevalence of hypertension was 25.3% (95% CI 21.8-28.8) in urban and 29.3% (95% CI 26.1-32.6) in rural settings with no significant differences between genders when stratified by locality. Of those with hypertension, 63.7% (95% CI 59.8-67.6) were diagnosed newly. Men accounted for 74.3% (95% CI 69.7-78.9) and women – for 48.7% (95% CI 44.0-53.4) of newly diagnosed cases. Almost half (40.9%) of the newly diagnosed cases had never had their blood pressure measured, 37.3% had not been diagnosed with hypertension although had blood pressure measurements in the past, and 21.8% discovered they had hypertension in the past 12 months, but did not take anti-hypertensive drugs. The above finding demonstrated that self-monitoring of blood pressure in the population was not sufficient.

Biography:

Surya Prasad is from BP Koirala Institue of Health Sciences, Nepal

Abstract:

Magnesium sulfate is the drug of choice for prevention of seizures in the pre-eclamptic woman. There is no agreement in the published randomized trials regarding the optimal time to initiate magnesium sulfate, the dose to use (both loading and maintenance) as well as the duration of therapy. The objective of this study is to determine whether magnesium sulfate (MgSO4) prophylaxis is needed for up to 24 hours postpartum in all patients with severe pre-eclampsia for the prevention of seizure. The primary outcome measures were occurrence of seizure in each group. Secondary outcome measures were maternal and neonatal outcome.

Biography:

Fizza Hassan is a student of Karachi Medical and Dental College. She is also a research associate and has helped in the intellectual contribution, data collection, and data entry, summarization of results and presentation of research papers. She is a medical student researcher and has contributed in a couple of papers in international medical journals. Her medical rotations include, Department of Medicine, Gynecology and Obstetrics, and Dermatology at Karachi Medical and Dental College, Abbasi Shaheed Hospital. During her electives she worked in outdoor patient department, wards, clinics and operation room. In the patient setting Fizza Hassan worked with the medical team in caring for the needs of pregnant women and continued to care for them on the postpartum floor and also at the department of Medicine.

Abstract:

Preeclampsia affects 5% of all pregnancies and is a significant cause of maternal and neonatal morbidity and mortality. Early risk stratification may improve the identification of women at highest risk for preeclampsia and provide an opportunity for intervention. Studies have evaluated serum angiogenic markers in gestation for the commencement of preeclampsia.

Biography:

Irene A. Kretchy is from the department of Pharmacy Practice and Clinical Pharmacy, University of Ghana School of Pharmacy, College of Health Sciences

Abstract:

Patients with chronic conditions like hypertension may experience negative emotions which increase their risk for the development of mental health disorders particularly anxiety and depression. For many patients with hypertension, the interaction between medication adherence and symptoms of anxiety, depression and stress remains largely unexplored. To fill this knowledge gap, the study sought to ascertain the prevalence and role of these negative symptoms on anti-hypertensive medication adherence while taking into account patients’ belief systems.

Biography:

Pollen Yeung completed his Ph.D at the age of 30 years from University of Saskatchewan (Saskatoon, SK, Canada) and is currently Professor of Pharmacy and Medicine at Dalhousie University in Halifax, NS, Canada. He has published more than 90 peer reviewed articles in reputed journals and is currently serving as an editorial board member for Recent Review of Clinical Trials, Drug Metabolism Open Journal, Medical Sciences Monitor, Metabolites, Cardiovascular Pharmacology Open Access, and Natural Products Chemistry and Research Open Access.

Abstract:

The importance of adenosine and ATP in regulating many biological functions has long been recognized, especially for their effects on the cardiovascular homeostasis which may be used for management of hypertension and cardiovascular diseases. In response to ischemia, ATP is broken down to release adenosine. The activity of adenosine is very short lived because it is rapidly taken up by myocardial and endothelial cells, erythrocytes (RBC), and also rapidly metabolized to oxypurine metabolites and other adenine nucleotides. Extracellular and intracellular ATP is broken down rapidly to ADP and AMP and finally to adenosine by 5’-nucleotidase. These metabolic events are known to occur in the myocardium as well as in RBC. We investigate in this study the feasibility of exploiting ATP metabolism in the RBC as systemic biomarker for post exercise hypotension and cardiovascular protection. An experimental exercise rat model was used to probe the relationship between post exercise hypotension and ATP metabolism in the RBC. The cardiovascular protective effect of exercise preconditioning was further investigated in an acute myocardial infarction model using mortality and ATP metabolism in the RBC as endpoints. We have shown post-exercise hypotension correlated significantly with RBC concentrations of ATP, and that exercise pre-conditioning reduced cardiovascular mortality and breakdown of ATP in the RBC. The post exercise effect was greater in hypertensive than in normotensive rats. The presentation will also discuss the opportunities, challenges and obstacles of exploiting ATP metabolism as targets for drug development and personalized medicine. Suppored in part by CIHR, NSHRF and DPEF.

Biography:

Tafadzwa Goverwa is a public health specialist who has served in the public health sector in Zimbabwe since she completed her MBChB from the University of Zimbabwe in 2006. Since she completed her MPH from the University of Zimbabwe in 2012 she has worked as a provincial maternal and child health officer in one of the 8 rural provinces in Zimbabwe. She is a provincial health executive in the Ministry of Health and also has a strong inclination towards epidemiological disease control. The work she is presented was her thesis for her MPH degree and this was her first publication.

Abstract:

More than half of hypertensive patients reviewed at Lupane District Hospital during the first half of 2011 had uncontrolled hypertension. This prompted an investigation on the prevalence of uncontrolled hypertension and associated factors among hypertensives on treatment. Analytical cross-sectional study was conducted. Three hundred fifty-four consenting participants were consecutively selected from eligible hypertensive patients on treatment attending the outpatients department at Lupane District Hospital for their reviews. An interviewer administered questionnaire adapted from the World Health Organization was used to collect data on risk factors. Blood pressure and anthropometric measurements were taken as per World Health Organization guidelines. Uncontrolled hypertension was defined as systolic blood pressure of ≥140mmHg and/or diastolic blood pressure of ≥90mmHg in a patient taking anti-hypertensive medication. The mean systolic BP was 151.0mmHg and mean diastolic BP was 92.6mmHg. Prevalence of uncontrolled hypertension was (238) 67.2%. Independent risk factors for uncontrolled hypertension were obesity (AOR 3.28, 95% CI 1.39-7.75) and adding salt to food at the table (AOR 2.77, 95% CI 1.41-5.43) whilst being compliant with the drug treatment regimen (AOR 0.34, 95% CI 0.16-0.72) and having received health education on hypertension (AOR 0.49, 95% CI 0.25- 0.97) were protective against uncontrolled hypertension. There prevalence of uncontrolled hypertension is high despite all the participants being on treatment. The findings suggest that interventions at the patient, the provider and the health delivery system are needed to improve hypertension control in Lupane.

Biography:

Márcio Galindo Kiuchi is a Brazilian, 36 years old doctor, master in basic sciences and a PhD in medical sciences, qualifications awarded by the Federal University of Rio de Janeiro and Fluminense Federal University, respectively. Also, he is cardiologist, this title granted by the Federal Fluminense University. He is also electrophysiologist, specialist in pacemakers, implantable cardiac defibrillators and cardiac resynchronization therapy. His doctoral thesis was on percutaneous renal sympathetic denervation

Abstract:

Forty-five patients were included and treated with an ablation catheter with open irrigated tip. RSD was performed by a single operator following the standard technique. Patients included with CKD were on stages 2 (n=22), 3 (n=16), and 4 (n=7). Data were obtained at baseline and monthly until 6th month of follow-up. Twenty-six out of the 45 patients had LVH and nineteen did not present LVH. The LV mass index decreased from 123.70±38.44g/m2 at baseline to 106.50±31.88g/m2 at the 6th month after RSD, P<0.0001. The end-diastolic left ventricular internal dimension (LVIDd) reduced from 53.02±6.59mm at baseline to 51.11±5.85mm 6 months post procedure, P<0.0001. The left ventricular end-diastolic posterior wall thickness (PWTd) showed a reduction from 10.58±1.39mm at baseline to 9.82±1.15mm at 6th month of follow-up, P<0.0001. The end-diastolic interventricular septum thickness (IVSTd) also decreased from 10.58±1.39mm at baseline to 9.82±1.15mm 6 months post procedure, P<0.0001. The left ventricular ejection fraction (LVEF) improved from 58.90±10.48% at baseline to 62.24±10.50% at 6th month of follow-up, P<0.0001. When the ∆ between baseline and the 6th month post RSD in LVH patients and non LVH patients were compared to the same parameters no significant difference was found.

Biography:

Baliga Juliet Bassiome is from the Department of Chemical Pathology, Nkwen Medical Center (PMI)

Abstract:

Associations between hyperuricemia, metabolic syndrome, cardiovascular disease and diabetes have been reported. Limited information, however, is available concerning the prevalence and correlates of hyperuricemia among adults in Tiko subdivision. This study sought to estimate the prevalence of hyperuricemia and to evaluate its relationship with metabolic syndrome (MetS). A total of 202 participants were enrolled in this study between the May and April 2010 from patients who came for health examination at the CDC Central Clinic Tiko and Regina Pacis Health Centre Mutengene. Hyperuricemia was defined as ≥7mg/dl (in men) and ≥6mg/dl (in women). Metabolic syndrome was defined according to World Health Organization, National Cholesterol Education Program-Adult Training Panel III and International Diabetes Federation. The overall prevalence of hyperuricemia was 45% and the condition was more prevalent in females than in males (47.7% Vs 41.9 %) and more in the people between the ages of 20 40 years than in those above 40 years (47%Vs 38.9%). The metabolic syndrome had a general prevalence of 28.2%.The IDF definition recorded the highest prevalence of the metabolic syndrome (32.17%) while the WHO definition recorded the lowest (8.42%). Hyperuricemia was related to IDF metabolic syndrome (r = 0.22, p = 0.001), NCEP-ATPIII metabolic syndrome (r = 0.12, p = 0.077), WHO metabolic syndrome (r = 0.16, p = 0.027). Hyperuricemia was most correlated with cholesterol (r=0.236) and HDL (r= - 0.151) Hyperuricemia and metabolic syndrome are prevalent among the adult population of Tiko.

Biography:

Márcio Galindo Kiuchi is a Brazilian, 36 years old doctor, master in basic sciences and a PhD in medical sciences, qualifications awarded by the Federal University of Rio de Janeiro and Fluminense Federal University, respectively. Also, he is cardiologist, this title granted by the Federal Fluminense University. He is also electrophysiologist, specialist in pacemakers, implantable cardiac defibrillators and cardiac resynchronization therapy. His doctoral thesis was on percutaneous renal sympathetic denervation

Abstract:

Forty-five patients were included and treated with an ablation catheter with open irrigated tip. RSD was performed by a single operator following the standard technique. Patients included with CKD were on stages 2 (n=22), 3 (n=16), and 4 (n=7). Data were obtained at baseline and monthly until 6th month of follow-up. Twenty-six out of the 45 patients had LVH and nineteen did not present LVH. The LV mass index decreased from 123.70±38.44g/m2 at baseline to 106.50±31.88g/m2 at the 6th month after RSD, P<0.0001. The end-diastolic left ventricular internal dimension (LVIDd) reduced from 53.02±6.59mm at baseline to 51.11±5.85mm 6 months post procedure, P<0.0001. The left ventricular end-diastolic posterior wall thickness (PWTd) showed a reduction from 10.58±1.39mm at baseline to 9.82±1.15mm at 6th month of follow-up, P<0.0001. The end-diastolic interventricular septum thickness (IVSTd) also decreased from 10.58±1.39mm at baseline to 9.82±1.15mm 6 months post procedure, P<0.0001. The left ventricular ejection fraction (LVEF) improved from 58.90±10.48% at baseline to 62.24±10.50% at 6th month of follow-up, P<0.0001. When the ∆ between baseline and the 6th month post RSD in LVH patients and non LVH patients were compared to the same parameters no significant difference was found.

Biography:

Kelly Garrity has received her Doctor of Medicine from Pennsylvania State College of Medicine. She is currently working as an Obstetrics and Gynecology resident at Northwell Health in New York.

Abstract:

The American College of Obstetricians and Gynecologists (ACOG) recommends against the use of butorphanol in patients diagnosed with preeclampsia or chronic hypertension secondary to a theoretical concern that the drug will further elevate blood pressures. No study has examined the drug’s potential to elevate blood pressures in laboring patients. In this retrospective cohort study, all chronic hypertensive and preeclamptic patients who underwent an induction of labor and delivered a viable, singleton pregnancy between the dates of 1/1/2013-12/31/2014 at a Single Academic Hospital were included. The use of butorphanol in chronically hypertensive patients during labor was not associated with the presence of severe range blood pressures during labor [OR=0.92, 95% CI: (0.04-19.34) P=0.96]. In preeclamptic patients, there was similarly no change in the frequency of severe range blood pressures with the use of the drug [OR=0.59, 95% CI: (0.19-1.83) P=0.36]. In laboring patients with chronic hypertension or preeclampsia, butorphanol is not associated with severe range blood pressures and therefore it is a reasonable option for providing pain relief in these populations.

Biography:

Dr. Mashhud Zia Chowdhury, completed his MBBS in 1987, joined BIRDEM hospital, Dhaka. He completed his Diploma in Chest Diseases in 1990 and MD (Cardiology) in 2003. In 2007, he joined Ibrahim Cardiac Hospital & Research Institute- a specialized cardiac hospital, as Assistant Professor, later promoted to Associate Professor. During his nine year carrier as interventional cardiologist, he was trained in Japan and Germany and participated in various cardiac conferences also as faculty. He has 24 publications and is serving as editorial board member of the journal of his hospital. Dr. Chowdhury is a Fellow of the American College of Cardiology.

Abstract:

Bangladesh has been elevated from the low income status to lower middle income nation last year. According to the Bangladesh Bureau of Statistics, the per-capita income will increase by 11.39% from $1316 in 2014-15 to $1,466 this financial year. Communicable diseases have also been reasonably in good control. Both of these lead to epidemiological transition from communicable to non-communicable disease (NCD). Hypertension (HTN) is one of the ‘fatal four’ NCD i.e. Cardiovascular, Cancer, Chronic Respiratory Disease and Diabetes. The prevalence of HTN in Bangladesh is showing an increasing trend. A meta-analysis showed pooled HTN prevalence in Bangladesh within each 5 year time period was, 11% in 1995-2000, 12.8% in 2001-2005, and 15.3% in 2006-2010. According to a recent multilevel analytic survey, overall age standardized prevalence of pre-hypertension and HTN were 27.1% and 24.4%, respectively. HTN was found more common in elderly (ranging 40-65%) and urban population. Low awareness of disease is common in low-income and low educated population. According to NCD risk factors survey, only half of the hypertensive patients were aware of their illness and 33% had never measured their blood pressure in life time. Moreover, hypertension is largely untreated especially in rural area and only 41% were undergoing treatment. Non-adherence to treatment was very high, only 31.4% had their hypertension controlled. On the contrary of present guide line, Beta-blocker was found to be the highest prescribed drug. Strategies for early detection, awareness buildup and adherence to treatment are urgently necessary to halt the growing disease burden of hypertension.

Biography:

Abstract:

The simple and rather rapid traditional method for assessing pulse rate has remained as a common method for monitoring pulse rate. It seems that most people cannot detect and assess their pulse rhythm correctly. In this prospective study, 300 patients admitted due to cardiovascular diseases were included and then were randomly divided into two groups. One group received individual face-to-face training. The other group received group training via displaying an animation movie (using a three minute animation about taking radial pulse rate and assessing its regularity). Immediately after the training and then after 48 hours, the patients were tested by the nurse to find out whether they have learned the correct technique of taking radial pulse rate or not. Immediately after the interventions, 84.9% in face-to-face group and 81.8% in training group were able to correctly count their radial pulse rate (P=0.536). After 48 hours, 71.7% in face-to-face group and 60.8% in training group were able to correctly count their radial pulse rate with a marginal significant difference (P=0.051). Both methods were effective in enhancing the skill of the patients in counting their radial pulse rate. No significant difference was observed between the two groups. Though after 48 hours, it seemed that face-to-face method was marginally superior. We suggest face-to-face educational method in future relevant studies as a potential method in this regard.

Biography:

Yosef Segman is the CEO & CTO of Cnoga Medical Ltd. Prior to founding Cnoga Medical Ltd., he founded Oplus Technologies Ltd., where he served as CEO and Chief Scientist until 2005 when Oplus was acquired by Intel. Dr. Segman holds a PhD degree in applied mathematics from the Israeli Institute of Technology and was a guest researcher at Harvard University and Siegen University, Germany. He is the author of fundamental papers and patents on signal processing, neural computation and brain modelling

Abstract:

Hypertension is a major risk indicator for coronary heart diseases, renal failure, stroke and other various illnesses, and it is the primary global risk for mortality. Blood pressure measurements are essential for managing the risks resulting from hypertension. Today, the most common technique used for monitoring blood pressure is the oscillometric technique based on the sphygmomanometer arm cuff pressure. In this paper we will present a new device, the TensorTip MTX, which computes hemodynamic blood pressure noninvasively and without the need of air pumping. This technique uses the color imaging resulting from a set of monochrome light source that traverse the tissue under consideration and is projected onto the color image sensor. We have found that the variation in the pressure flow can be determined from the changes in the height of the temporal color histograms and additional temporal volume information. A new extended solution of the Windkessel model is being displayed in the paper and provides additional insight on various functional resistance rather than a constant resistance. The TensorTip MTX was clinically evaluated in two medical centers and was found to perform well at standard blood pressure measurements and also in monitoring patients who suffered from alterations of blood pressure due to cardiac surgery. The device successfully fulfilled the ISO 81060-2 recognized standard requirements for various notified bodies.

Biography:

Waqas Hussain is an internationally awarded computer scientist and project developer. He is working on different international research based projects and presenting is research work all over the world. Waqas was named by Time as one of the most influential people and one of the top innovators in the world. Waqas, who is also an ACM and IEEE fellow, worked for World Wide Fund which is the world's largest conservation organization. He organized international research conferences using IEEE platform, an annual conference for scientists and researchers. After many years of research in computer science he has turned his attention to medical science, particularly bacteria attacking the white blood cells, Alzheimer’s disease which is the fourth leading cause of death in the world causing about 32.6 million deaths a year and automated morphological analysis of human sperms, according to World Health Organization 1/5 families have problems in conception worldwide.

Abstract:

High blood pressure (hypertension) puts extra strain in our heart and blood vessels. This can cause them to become weaker or damaged. If we have other health conditions, such as diabetes or high cholesterol, this increases the risk of health problems even more. It is then even more important to lower our high blood pressure. Nattokinase decreases the ability of blood to clot. This "thins the blood" and might protect against conditions caused by blood clots such as stroke, heart attack, and others. A recent 8-week, randomized double-blind study examined the effects of nattokinase supplementation on 86 untreated adults with high blood pressure. The participants ranged from 20 to 80 years old, and had a systolic blood pressure of 130 to 159. Systolic pressure is the number on top, (i.e. 120/80) which measures the pressure inside the blood vessels at the moment our heart beats. These findings suggest that increased intake of nattokinase may play an important role in preventing and treating hypertension.

Biography:

Deepika Narasimha is a Cardiology fellow at the Loma Linda University Medical Center and her research interests include clinical trials in cardiovascular disease especially coronary artery disease, atrial fibrillation and cardiomyopathies. She have been actively involved in two single center randomized controlled trials as a resident including writing the IRB proposal, enrolling patients, data analysis and manuscript preparation. She is also currently involved in retrospective studies evaluating systolic dysfunction in post liver transplant patients, and pre-operative work-up of renal transplant patients. She was the Chief resident at Internal Medicine residency program and received the 2014-2015 Thomas Frawley research fellowship awarded to upcoming young investigators. She have published several peer reviewed articles, one book chapter, and presented abstracts at various national and regional conferences including the ACC, ISHLT, HRS and ACP meetings.

Abstract:

Hypertension is a major risk factor for cardiovascular morbidity and mortality. The risk for coronary artery disease is doubled, and the risk for congestive heart failure and stroke is tripled in patients with hypertension. In addition to this, hypertensive heart disease itself encompasses a very wide range of disorders including left ventricular hypertrophy, systolic and diastolic dysfunction which can down the line lead to symptomatic heart failure and precipitate arrhythmias. There are several structural and functional changes in hypertensive heart disease which first lead to concentric left ventricular hypertrophy which if left untreated leads to dilated cardiomyopathy or the ‘burned-out’ left ventricle. Cardiac complications from hypertension cause significant morbidity and mortality and also influence the choice of appropriate therapy and diagnostic tests. My talk will focus on the clinical manifestations and natural history of hypertensive heart disease as well as the various diagnostic and therapeutic modalities available to diagnose and treat the same. In addition to these we will also discuss some of the common cardiovascular co-morbidities associated with hypertension including atrial fibrillation, coronary artery disease and concomitant aortic stenosis with hypertension.

Biography:

Tecla Namusonge, has completed her masters from Africa Nazarene University. She is the Monitoring and Evaluation Assistant, AMREF Health Africa. She has authored an abstract on Behavioral Factors Inhibiting Data Quality among Health Care Workers in Kenya that was presented in the 1st Annual monitoring and evaluation best practice conference.

Abstract:

Background: Hypertension is the leading cause of NCD related morbidity and mortality in Kenya with the prevalence of elevated BP in Kenya at 23.8%. In a bid to address this burden, the Ministry of Health developed a protocol for management of hypertension which states that an elevated BP reading should be confirmed on three separate occasions. The objective of this study is to evaluate hypertension diagnosis following initial BP screening in Kibera Informal Settlement. Methodology: This is a retrospective cohort study where clients reached with hypertension screening through the Healthy Heart Africa Project between October 2015 and March 2016 were followed for diagnosis. Data was recorded in manual linkage registers and analysis done for individuals with initially elevated BP who came for subsequent readings until final diagnosis. Results: A total of 34,779 people were screened, out of whom 6,150 (17.7%) an initially high BP. Only 1,270 (20.7%) with an elevated BP returned for a second reading and only 220 individuals retuned for the third reading. Overall, 23% (1421) of clients with elevated BP were diagnosed. Due to the use of manual records, some of the clients returning for follow-up were captured as new clients’ further delaying diagnosis. Discussion: There was a high attrition rate along the hypertension diagnosis process. The long diagnostic process posed a challenge for hypertension management in this highly mobile population. There is need for strategies to strengthening the diagnosis process within this population and adoption of an electronic medical records system to facilitate follow-up.

Biography:

Hossein Tabriziani obtained his Medical degree with honor at the age of 25. He compleleted his Internal Medicine residency at St. Barnabas Hospital, Weill Cornell Medical College in New York. With the passion for Transplant, he accedted a clincial Nephrology and Hypertension fellowship at Georgetown University in Washington, DC and conitnued his eduction at University of California San Francisco (UCSF) with a Transplant Nephrology fellowship. He was appointed at the Medical director of Pancreas Transplantation at Westchester Medical Center, New York Medical college before moving to Loma Linda Univeristy in California to accept the position as an Assistant Professor of Medicinie in Transplant Nephrology division. He is an active member of American Society of Nephrology (ASN) and American Society of Tranplantation (AST). He has mutiple publications and has been involved in many clinical researches. His interests are in Hypertension and oxidative stress in patintes with chronic kidney disease and transplantaion.

Abstract:

"Incidence of End Stage Renal Failure is rising in US. By the year 2030, the number of patients with end-stage renal disease (ESRD) is projected to exceed 2.2 million. This is more than five times the current prevalence. Increasing in Kidney disease and subsequently ESRD is related to ageing of the society and high morbidity due to lifestyle diseases such as diabetes, atherosclerosis, and hypertension. During the past decade, kidney transplantation has increasingly been recognized as the treatment of choice for medically suitable patients with ESRD. As well as improving quality of life, successful transplantation accords major benefits by improving mortality and morbidity of ESRD patients who receive kidney transplant over those who undergo Renal Replacement Therapy (RRT). Although reducing Cardiovascular (CV) risk in these patients remains the leading cause of this improvement but still CV diseases remain the leading cause of morbidity and mortality in kidney transplant recipients.