ACC 16: REPORTING FROM CHICAGO - PART I
Ignite Innovation and Spark Transformation
The Annual Scientific Sessions of American College of Cardiology (ACC) – the showcase presentation of all the latest advances in cardiology – was held in Chicago from April 2-4. Thousands of cardiovascular specialists and medical professionals presented their research findings and engaged in the innovative, interactive and informative educational sessions. It was indeed the learning and networking opportunity of the year. “Ignite innovation and spark transformation” was the main theme. Indeed, new information coming down the pipeline promises to improve the life of cardiac patients even better.
The convention kicked off with the presidential address by Dr. Kim Williams, who highlighted the significant gains in cardiovascular mortality and prevention and treatment of the disease. However, CV mortality continues to be the No. 1 cause of death around the world and he reminded everybody that, “It’s time to finally move to No. 2 position and the goal is well within our grasp, more so than ever before.” For this to happen, “We must expand our focus on primary prevention and health promotion.”
Dr. David B Nash, founding dean of the Jefferson Medical school Population Health, gave the prestigious Simon Dack lecture that focused on “Population Health: Is it the Secret Sauce?” He pointed out some of the challenges in our current health care environment, including the considerable wasteful spending. Of major concern is that “40 percent of the public are still at risk of heart disease as a result of smoking, unhealthy eating, lack of exercise and alcohol consumption.” Hopefully, the new initiatives that include evidence-based practice, value-based payment and population health management will address these challenges.
Lifestyle factors affecting heart health has been the subject of intensive discussion led by Pamela Morris, MD FACC, chair of the prevention council of ACC. The focus was on “implementation of nutrition counseling and education of important issues in heart healthy nutrition, and updates on smoking cessation counseling including the use of E-cigarettes.” Considerable emphasis was given on “plant-based diet” in maintaining heart health. It’s to be noted that the ACC President Dr. Williams is a practicing vegan!
The “Results of Hope 3 Trial” presentation by Salim Yusuf, MD, and colleagues created quite a buzz. As per Dr. Yusuf, “Our approach, which used a combination of moderate doses of two BP lowering drugs plus statin (candesartan 16 mg, Hydrochlorothiazide 12.5 mg and Rosuvastatin 10 mg daily vs. placebo or placebo with some combination of these drugs) in intermediate risk group of patients appears to produce the biggest bang in reducing events with few side effects.” In other words, Hope 3 Trial supports broader use of statins in intermediate–risk populations. And majority of the public are in this category. Dr. Yusuf also stressed the importance of treating patients who have hypertension with statins since high BP and hypercholesterolemia go hand in hand. You may remember Dr. Yusuf developed the concept of “poly pill” for mass treatment of the vulnerable segment of the population to reduce the risk of heart attack and stroke – perhaps the best way to reach more people effectively.
CV disease is still the leading non-communicable disease (NCD) and remains the No. 1 cause of death globally. Coronary atherosclerosis is the chief culprit in heart disease and identifying the high risk coronary plaque remains the big challenge. In his lecture, Dr. Jagat Narula, DM, PhD, MACC, focused on the use of cardiovascular imaging strategies in understanding the atherosclerotic process. “Interestingly, anthropological studies done in ‘mummies’ and special populations have shown that even 4,000 years ago atherosclerosis occurred from the same risk factors as seen in the current population,” he said. He also spoke about the interplay between genes and environment in the development of CAD and how to promote global cardiovascular wellness with strategies to address modifiable risk factors, public health screening and general education.
To be continued …
M.P. Ravindra Nathan, M.D., is a cardiologist and Emeritus Editor of AAPI Journal. His book “Stories from My Heart” was recently released. (www.amazon.com or www.bn.com).
