A preliminary paper warned about the dangers of therapeutic inertia, i.e. doctors finding a hypertensive patient to have blood pressure above the target value, but instead of prescribing increased or different hypertensive treatment the doctor does not act, but instead tells the patient that they will check it later.  Therefore an opportunity to act is lost.

The importance of using statins in both hypertensive and diabetic patients was stressed.  In the UK there have been dramatic improvements in ischaemic heart disease and stroke because of increased use of statins in these patients.  In the UK 80% of diabetics and 50% of hypertensives are taking statins with dramatic health benefits.

In fact, the UK male lives longer than the USA male, despite spending half the money on the national health budget.

Home blood pressure monitoring was universally recommended as the best method for BP monitoring in hypertensive patients.  White coat hypertension was seen as a significant problem when the BP was measured by a doctor.  The average BP reading when measured by a doctor was 10mm mercury above the true value and 5mm mercury above the true value when measured by a nurse!

The use of ACE inhibitors and ARBs in combination was discouraged.  This was because the incidence of side effects, particularly renal side effects, outweighed the benefits.  It was also considered that beta blockers should no longer be considered as first line agents for hypertension.

A common regime suggested was to use ACE inhibitors or ARBs as first line.  If another agent was later required then consider adding calcium channel blocker or a diuretic.

If a further agent is required, then use ACE inhibitor or ARB plus a calcium channel blocker plus a diuretic.

Overall I found the conference a very valuable learning experience.