Highlights from the British and Irish Hypertension Society Meeting

3 October 2017

This September, the British and Irish Hypertension Society annual meeting in Glasgow brought together the leading experts in high blood pressure. A lively series of seminars, debates and exhibitions took place at the three-day event where scientists and health professionals shared their new discoveries and ideas.

We reached out to health professionals

We were delighted to be invited to speak at the event and our CEO Katharine gave a talk about our successes so far and our aspirations for the future. As well as our awareness-raising work to lower the nation’s blood pressure, Katharine explained that we’re also here to help health professionals give the best care to patients. We have resources to help identify people with high blood pressure and develop treatment plans to suit each individual.

We are very happy to welcome our new health professional members who discovered our work as a result of the talk.

Trends in resistant hypertension

Dr Sarah-Jo Sinnott, Assistant Professor at the London School of Hygiene & Tropical Medicine, presented her research identifying trends in the numbers of people developing and living with resistant hypertension - blood pressure that remains above 140/90mmHg despite being treated with optimal doses of three or more antihypertensive drugs, including a diuretic.

Medical records for more than 1.3 million people dating between 1995-2015 revealed a steep rise in the number with resistant hypertension from the 1990s to the mid-2000s, peaking at almost 8% of all treated hypertensive patients in 2007, before it levelled off and began to fall in recent years. The rise may have been due to a better awareness of high blood pressure and more aggressive treatment in the medical community, and the fall could have been due to incentives to doctors to get blood pressure under control, although this was not explicitly studied.

Dr Sinnott explained: "In 2015, 6.5% of all people with hypertension had resistant hypertension. This means resistant hypertension is fairly common. This is worth highlighting as it’s an important risk factor for heart disease and stroke. The rise and fall in the numbers is probably not due to any changes in physiology, but perhaps because of change in the detection and treatment of high blood pressure over time. Interventions to lower the numbers with resistant hypertension would be best focused on adherence to blood pressure medications."

Read more about this research. 

Blood pressure in older adults

Dr Nigel Beckett from Imperial College London discussed how blood pressure changes with age. A number of changes in our bodies cause our systolic blood pressure to rise as we age, while diastolic blood pressure tends to rise up until the age of around 50 then levels off. It's the systolic blood pressure that's key in reducing the risk of illness. 

He quoted epidemiologist Geoffrey Rose – “Hypertension is defined as that level at which treatment does more good than harm” – to highlight some of the challenges in deciding who to treat and to what level. Doctors will want to lower the risk of heart disease and stroke wherever possible, while avoiding the risks of bringing blood pressure down too low or simply adding to a long list of medications and side effects in people who already have various health issues."

High blood pressure in adolescents 

Dr Manish Sinha is a consultant children’s kidney specialist from Evelina London Children’s Hospital, London. He explained that high blood pressure is common in children and adolescents who are carrying excess weight – up to a third of obese children have blood pressure that’s above the normal range – and they often have a high salt intake. There is also evidence that excess weight and raised blood pressure in adolescence will often carry on into adulthood, raising the risk of high blood pressure and the problems it causes.

Dr Sinha explained “Often the parents we see in clinic don’t realise that their child is overweight, and both children and their parents are unaware of their high salt intake, as they don’t add salt to their food. We’re surrounded by salt but we don’t see it, it’s hidden in the foods we buy and they often don’t taste salty, and most children eat more than the recommended daily maximum. Clear labelling highlighting salt content is really important in helping young people and their families reduce their salt intake.”

Pharmacogenetics of blood pressure response 

Dr Helen Warren, BIHS Young Investigator Representative and Lecturer in Statistical Genetics at Queen Mary University of London, gave an update on the exciting new field of pharmacogenetics. This is the study of how our genes affect the way we respond to blood pressure medications, and aims to explain why different people respond differently to the same medications.

Dr Warren explained “This is quite a novel area of research. We have already found a number of genes which affect blood pressure, now we’re aiming to find out whether our genes affect the way we respond to blood pressure medications and which genes these are. The ultimate aim is personalized medicine, where we can prescribe the right drug for each person based on their genes.”

Introducing: a new mentoring scheme for young investigators

Last year BIHS introduced their Young Investigators Network, making sure the young scientists working in blood pressure research are given the representation they need to promote their work. This year’s meeting saw the launch of a new mentoring scheme where young members are supported by a senior scientist - helping young researchers with career advice, professional development and networking.

Young Investigator Representative, Dr Helen Warren, explained “This will not only help to attract young scientists into the Society, but support them through their career as they build the future of blood pressure research.”

There was also a poster storm: a very lively session where young researchers had just 90 seconds each to introduce themselves and their poster, explaining as much of their work as possible and encouraging the attendees to find out more. 

Three Young Investigators won awards for best talks

William Hunt from University of Leicester: Relationship between Aortic Stiffness and Cardiac Remodelling in Younger Adults with Type 2 Diabetes

Luca Faconti from King’s College London: Selective Reduction of Central Blood Pressure by Reducing Cardiac Pre-Load

Giacomo Rossitto from University of Glasgow: Sodium Accumulation in The Myocardium of Hypertensive Rats

While two Young Investigators won awards for best posters

Jason Appleton from University of Nottingham: Transdermal glyceryl trinitrate does not cause precipitous changes in blood pressure in dehydrated acute stroke patients

Susana Rivera-Mancía from the National Institute of Cardiology Ignacio Chávez in Mexico: Utility of anthropometric and lipid indicators to classify people with hypertension or pre-hypertension