Hotline update of clinical trials and registries presented at the at the European Society of Cardiology Congress in Paris 2011.

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions during the Late Breaking Clinical Trial Sessions European Society of Cardiology Congress, held in Paris, France, from 27th to 31st August 2011. This article gives an overview on a number of novel clinical trials in the field of cardiovascular medicine, which were presented. The data have been presented by leading experts in the accordant field with relevant positions in the trials. Unpublished reports should be considered as preliminary data as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology, similar as previously reported (Lenski et al. in Clin Res Cardiol Off J Ger Card Soc 99: 679-692, 2010) and should provide the readers with the most comprehensive information of relevant publications. The data were presented by leading experts in the field with relevant positions in the trials.

Hotline update of clinical trials and registries presented at the 77th spring meeting of the German Society of Cardiology 2011.

This article provides information and commentaries on trials, which were presented during the Hotline Sessions at the 77th annual spring meeting of the German Society of Cardiology in Mannheim, Germany, from April 27 to 30, 2011. This article summarizes a number of important, novel clinical trials in the field of cardiovascular medicine. The comprehensive summaries have been generated from the oral presentation from the authors as previously reported [1] and should provide the readers with the most comprehensive information of relevant publications. The data were presented by leading experts in the field with relevant positions in the trials.

Hotline update of clinical trials and registries presented at the American College of Cardiology Congress 2011.

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions during the Late Breaking Clinical Trial Sessions at the 60th annual meeting of the American College of Cardiology in New Orleans, USA, from 2nd April to 5th April 2011. This article gives an overview on a number of novel clinical trials in the field of cardiovascular medicine, which were presented. The comprehensive summaries have been generated from the oral presentation and the webcasts of the American College of Cardiology, similar as previously reported (Gensch et al. Clin Res Cardiol 100:1-9, 2011; Lenski et al. Clin Res Cardiol 99:679-692, 2010) and should provide the readers with the most comprehensive information of relevant publications. The data were presented by leading experts in the field with relevant positions in the trials.

Hotline update of clinical trials and registries presented at the German Cardiac Society Meeting 2009.

This review article gives an overview on a number of novel clinical trials and registries in the field of cardiovascular medicine. Key presentations made at the 75th annual meeting of the German Cardiac Society, held in Mannheim, Germany, in April 2009 are reported. The data were presented by leading experts in the field with relevant positions in the trials and registries. These comprehensive summaries should provide the readers with the most recent data on diagnostic and therapeutic developments in cardiovascular medicine similar as previously reported (Rosenkranz et al. in Clin Res Cardiol 96:457-468, 9; Maier et al. in Clin Res Cardiol 97:356-363, 3).

[Treatment of peri- and postoperative hypertensive emergencies]. / Therapie des peri- und postoperativen hypertensiven Notfalls.

Acute hypertensive emergencies occur in 5 to 35 % of the patients in perioperative care. This is associated with an increase in perioperative complications: the rate of bleedings, myocardial infarctions, cerebral ischemia and overall mortality is increased 4-fold. Before an operation, it is of utmost importance to recognize predictors for hypertensive emergencies and to achieve an adequate blood pressure control. There has so far been no agreement on a blood pressure threshold at which blood pressure needs to be reduced. Antihypertensive therapy is a bedside decision of the responsible physician. It aims at a rapid decrease of hypertensive peaks without risking a reduced organ perfusion. The optimal drug for the treating hypertensive emergencies should have a rapid and safe action. Antihypertensives of first choice are esmolol, metoprolol, urapidil or clonidin. The oral therapy with nifedipine or nitrendipine has the risk of abrupt hypotensive episodes and should therefore only be administered after exclusion of an acute coronary syndrome or cardiac failure Because of its toxicity sodium nitroprusside is an antihypertensive drug of second choice. Nitrates or diuretics are supplementary drugs for patients with angina pectoris, cardiac failure or renal insufficiency. Newer substances (fenoldopam, nicardipine, clevidipine) have promising kinetic properties but are not as yet been approved for antihypertensive treatment in Germany.

[Hypertensive emergencies]. / Der hypertensive Notfall.

Critical cases of high blood pressure are common clinical occurrences that may account for as many as 25% of all medical emergencies. About 75% of these increases in blood pressure can be judged as hypertensive urgencies, 25% are even hypertensive emergency situations. Nevertheless, only less than 1% of the hypertensive population experiences hypertensive urgency or emergency situations. Hypertensive emergencies are defined as acute cardiac, vascular or cerebral target organ damages. In these cases an acute lowering of blood pressure is inevitable. The rate and intensity of blood pressure depression is dependent on the localization of organ damages. For cardiac and vascular damages it is absolutely necessary to lower the blood pressure rapidly to near normal values. On the contrary, cerebral organ damages are better treated by a moderate lowering of blood pressure peaks to slightly increased blood pressure levels. In hypertensive urgencies no target organ damages occur. For these patients a slow lowering of blood pressure values to normal levels is adequate.

[Hypertensive coronary angiopathy]. / Hypertensive Koronaropathie.

HISTORY AND ADMISSION FINDINGS: A 66-year old woman reported non-radiating anginal symptoms, at first only on physical stress and without dyspnea. A raised blood pressure of 180/95 mmHg was the only significant abnormality on admission. INVESTIGATIONS: Coronary angiography merely showed slight plaque formation and marked twisting of the coronary arteries. TREATMENT AND COURSE: The patient became symptoms-free on optimal antihypertensive medication. CONCLUSION: This case demonstrates that a coronary microangiopathy may be associated with hypertensive heart disease, perhaps as a separate entity.