Cardio-metabolic disorders are the most important cause of mortality and morbidity worldwide. Hypertension, obesity, diabetes, metabolic syndrome and hyperlipidaemia, cause 60% of global deaths annually. Hypertension is the main driver of cardiovascular (CV) events and morbidity.
More than 40% of atrial fibrillation (AF) patients have diabetes. Chronic kidney disease (CKD), defined as an estimated glomerular filtration rate (eGFR) below 60mL/min per 1.73 m2 or kidney damage for three or more months, is a common complication of diabetes.2,19
In 2017, the publication of the new American College of Cardiology (ACC)/American Heart Association (AHA) hypertension guideline created considerable controversy. Should the new recommended thresholds for hypertension be incorporated, it would increase the prevalence of hypertension by 43%.
Studies show that the prevalence of AF ranges from 1% to 15% in people between the ages of 35 and 85. Age is a risk factor for AF, which means as life expectancy increases, the number of people with the condition will continue to rise. It is expected that by 2050, the prevalence of AF will increase by 250%.
Worldwide the prevalence of heart failure is rising. Prognosis is poor with symptomatic heart failure with yearly mortality rate of 6-7% in stable heart failure and 25% or more in patients admitted to hospital with acute heart failure.
The International Society of Hypertension (ISH) is currently writing new global hypertension guidelines to be published during the first half of 2020. The Southern African Hypertension Society will soon comment on the impact of lowered blood pressure threshold recommended by some international societies.
This is a new review topic addressing the overall concept of atherosclerosis and where we are at this moment in time in terms of pathogenetic concepts with an emphasis on inflammation and immunity.
The first position paper on the management of patients with patent foramen ovale (PFO) and left circulation embolism explores the available trial evidence and define the principles needed to guide decision-making.
MEDICAL CHRONICLE DECEMBER 2018 CPD 3 of 3: Recently the DECLARE trial was published evaluating in a randomised, double-blind, multinational, placebo- controlled trial, the effect of Dapagliflozin on safety and efficacy for macrovascular and microvascular outcomes.