Author
Roland E. Schmieder
Other affiliations: Complutense University of Madrid, University of Regensburg
Bio: Roland E. Schmieder is an academic researcher from University of Erlangen-Nuremberg. The author has contributed to research in topics: Blood pressure & Essential hypertension. The author has an hindex of 97, co-authored 717 publications receiving 78138 citations. Previous affiliations of Roland E. Schmieder include Complutense University of Madrid & University of Regensburg.
Papers published on a yearly basis
Papers
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01 May 2022
TL;DR: In this paper , a Markov model was used to compare projected 10-year clinical events for radiofrequency renal denervation (RDN) patients vs. a hypothetical control for age <65 (n=1,551; 53±9 years) and age ≥65 years (n =1,101; 72±5 years) subgroups.
Abstract: BackgroundClinical event rates through 3 years have been published for patients with uncontrolled hypertension treated with radiofrequency renal denervation (RDN) in the Global SYMPLICITY Registry (GSR). We estimated 10-year clinical event reductions by age.MethodsA Markov model was used to compare projected 10-year clinical events for RDN patients vs. a hypothetical control for age <65 (n=1,551; 53±9 years) and age ≥65 years (n=1,101; 72±5 years) subgroups. The simulated control assumed maintenance of baseline office systolic blood pressure (oSBP) over time and maintained RDN effect over the analysis horizon. The model was calibrated to 3-year stroke and MI events reported in the GSR and used published meta-regression data to calculate risk reduction based on cohort-specific changes in oSBP from baseline. Relative risks (RRs), events avoided, and numbers needed to treat (NNTs) were calculated at 3 and 10 years, along with the ratio of 10- vs. 3-year projected events avoided.ResultsProjected 10-year MACE events were 33.4% vs. 44.9% (-11.6%, RR=0.74) for RDN vs. control for age <65, and 39.8% vs. 54.2% (-14.4%, RR=0.73) for age ≥65. 10-year events avoided were highest for stroke and lowest for MI, and 10-year NNTs for MACE were below 10 in both age cohorts. The ratio of model-projected MACE at 10- vs. 3-years was 4.35 and 4.61, respectively. See Table 1.ConclusionsDisclosuresD. E. Kandzari: Medtronic: Advisory Board/Board Member, Consulting and Principal Investigator for a Research Study; Ablative Solutions: Consulting and Principal Investigator for a Research Study; Boston Scientific Corp.: Principal Investigator for a Research Study; Cardiovascular Systems, Inc.: Consulting and Principal Investigator for a Research Study; Teleflex: Principal Investigator for a Research Study; Orbus Neich: Principal Investigator for a Research Study; K. Cao: Medtronic: Consulting; M. Esler: Medtronic: Advisory Board/Board Member; SyMap: Advisory Board/Board Member; R. Schmieder: Medtronic: Consulting; Recor: Consulting; Ablative Solutions: Consulting; M. Lobo: Medtronic: Consulting and educational grant funding; ReCor Medical: Consulting and educational grant funding; Ablative Solutions: Consulting; Vascular Dynamics: Consulting; Aktiia: Consulting; A. Sharp: Medtronic: Consulting; Recor Medical: Consulting; Boston Scientific Corp.: Consulting; Philips: Consulting; G. Mancia: Böhringer Ingelheim: Speaker Bureau; Medtronic: Speaker Bureau; Ferrer: Speaker Bureau; Gedeon Richter: Speaker Bureau; Menarini Int.: Speaker Bureau; Merck Healthcare KGaA: Speaker Bureau; Neopharmed-Gentili: Speaker Bureau; Novartis Pharma: Speaker Bureau; Recordati: Speaker Bureau; Sanofi: Speaker Bureau; Servier: Speaker Bureau; M. Böhm: Abbott: Consulting; Bayer AG: Consulting; Amgen: Consulting; AstraZeneca: Consulting; Servier: Consulting; Medtronic: Consulting; Vifor: Consulting; is supported by Deutsche Forschungsgemeinschaft (SFB TRR219): Principal Investigator for a Research Study; J. B. Pietzsch: Medtronic: Consulting; Aktiia SA: Consulting. BackgroundClinical event rates through 3 years have been published for patients with uncontrolled hypertension treated with radiofrequency renal denervation (RDN) in the Global SYMPLICITY Registry (GSR). We estimated 10-year clinical event reductions by age. Clinical event rates through 3 years have been published for patients with uncontrolled hypertension treated with radiofrequency renal denervation (RDN) in the Global SYMPLICITY Registry (GSR). We estimated 10-year clinical event reductions by age. MethodsA Markov model was used to compare projected 10-year clinical events for RDN patients vs. a hypothetical control for age <65 (n=1,551; 53±9 years) and age ≥65 years (n=1,101; 72±5 years) subgroups. The simulated control assumed maintenance of baseline office systolic blood pressure (oSBP) over time and maintained RDN effect over the analysis horizon. The model was calibrated to 3-year stroke and MI events reported in the GSR and used published meta-regression data to calculate risk reduction based on cohort-specific changes in oSBP from baseline. Relative risks (RRs), events avoided, and numbers needed to treat (NNTs) were calculated at 3 and 10 years, along with the ratio of 10- vs. 3-year projected events avoided. A Markov model was used to compare projected 10-year clinical events for RDN patients vs. a hypothetical control for age <65 (n=1,551; 53±9 years) and age ≥65 years (n=1,101; 72±5 years) subgroups. The simulated control assumed maintenance of baseline office systolic blood pressure (oSBP) over time and maintained RDN effect over the analysis horizon. The model was calibrated to 3-year stroke and MI events reported in the GSR and used published meta-regression data to calculate risk reduction based on cohort-specific changes in oSBP from baseline. Relative risks (RRs), events avoided, and numbers needed to treat (NNTs) were calculated at 3 and 10 years, along with the ratio of 10- vs. 3-year projected events avoided. ResultsProjected 10-year MACE events were 33.4% vs. 44.9% (-11.6%, RR=0.74) for RDN vs. control for age <65, and 39.8% vs. 54.2% (-14.4%, RR=0.73) for age ≥65. 10-year events avoided were highest for stroke and lowest for MI, and 10-year NNTs for MACE were below 10 in both age cohorts. The ratio of model-projected MACE at 10- vs. 3-years was 4.35 and 4.61, respectively. See Table 1. Projected 10-year MACE events were 33.4% vs. 44.9% (-11.6%, RR=0.74) for RDN vs. control for age <65, and 39.8% vs. 54.2% (-14.4%, RR=0.73) for age ≥65. 10-year events avoided were highest for stroke and lowest for MI, and 10-year NNTs for MACE were below 10 in both age cohorts. The ratio of model-projected MACE at 10- vs. 3-years was 4.35 and 4.61, respectively. See Table 1. Conclusions DisclosuresD. E. Kandzari: Medtronic: Advisory Board/Board Member, Consulting and Principal Investigator for a Research Study; Ablative Solutions: Consulting and Principal Investigator for a Research Study; Boston Scientific Corp.: Principal Investigator for a Research Study; Cardiovascular Systems, Inc.: Consulting and Principal Investigator for a Research Study; Teleflex: Principal Investigator for a Research Study; Orbus Neich: Principal Investigator for a Research Study; K. Cao: Medtronic: Consulting; M. Esler: Medtronic: Advisory Board/Board Member; SyMap: Advisory Board/Board Member; R. Schmieder: Medtronic: Consulting; Recor: Consulting; Ablative Solutions: Consulting; M. Lobo: Medtronic: Consulting and educational grant funding; ReCor Medical: Consulting and educational grant funding; Ablative Solutions: Consulting; Vascular Dynamics: Consulting; Aktiia: Consulting; A. Sharp: Medtronic: Consulting; Recor Medical: Consulting; Boston Scientific Corp.: Consulting; Philips: Consulting; G. Mancia: Böhringer Ingelheim: Speaker Bureau; Medtronic: Speaker Bureau; Ferrer: Speaker Bureau; Gedeon Richter: Speaker Bureau; Menarini Int.: Speaker Bureau; Merck Healthcare KGaA: Speaker Bureau; Neopharmed-Gentili: Speaker Bureau; Novartis Pharma: Speaker Bureau; Recordati: Speaker Bureau; Sanofi: Speaker Bureau; Servier: Speaker Bureau; M. Böhm: Abbott: Consulting; Bayer AG: Consulting; Amgen: Consulting; AstraZeneca: Consulting; Servier: Consulting; Medtronic: Consulting; Vifor: Consulting; is supported by Deutsche Forschungsgemeinschaft (SFB TRR219): Principal Investigator for a Research Study; J. B. Pietzsch: Medtronic: Consulting; Aktiia SA: Consulting. D. E. Kandzari: Medtronic: Advisory Board/Board Member, Consulting and Principal Investigator for a Research Study; Ablative Solutions: Consulting and Principal Investigator for a Research Study; Boston Scientific Corp.: Principal Investigator for a Research Study; Cardiovascular Systems, Inc.: Consulting and Principal Investigator for a Research Study; Teleflex: Principal Investigator for a Research Study; Orbus Neich: Principal Investigator for a Research Study; K. Cao: Medtronic: Consulting; M. Esler: Medtronic: Advisory Board/Board Member; SyMap: Advisory Board/Board Member; R. Schmieder: Medtronic: Consulting; Recor: Consulting; Ablative Solutions: Consulting; M. Lobo: Medtronic: Consulting and educational grant funding; ReCor Medical: Consulting and educational grant funding; Ablative Solutions: Consulting; Vascular Dynamics: Consulting; Aktiia: Consulting; A. Sharp: Medtronic: Consulting; Recor Medical: Consulting; Boston Scientific Corp.: Consulting; Philips: Consulting; G. Mancia: Böhringer Ingelheim: Speaker Bureau; Medtronic: Speaker Bureau; Ferrer: Speaker Bureau; Gedeon Richter: Speaker Bureau; Menarini Int.: Speaker Bureau; Merck Healthcare KGaA: Speaker Bureau; Neopharmed-Gentili: Speaker Bureau; Novartis Pharma: Speaker Bureau; Recordati: Speaker Bureau; Sanofi: Speaker Bureau; Servier: Speaker Bureau; M. Böhm: Abbott: Consulting; Bayer AG: Consulting; Amgen: Consulting; AstraZeneca: Consulting; Servier: Consulting; Medtronic: Consulting; Vifor: Consulting; is supported by Deutsche Forschungsgemeinschaft (SFB TRR219): Principal Investigator for a Research Study; J. B. Pietzsch: Medtronic: Consulting; Aktiia SA: Consulting.
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01 Jan 2012TL;DR: In the last decades, much research effort has been focused on the improvement of imaging technologies that can detect early vascular changes in patients with arterial hypertension in the retinal vascular bed and to assess the prognostic role of these early retinalascular changes in arterials hypertension.
Abstract: Retinal changes in patients with arterial hypertension have been described since the middle of the 19th century. From the famous work by Keith, Wagener, and Barker in 1939 until today, advanced retinal changes assessed by ophthalmoscopy, i.e., grades 3 and 4 of hypertensive retinopathy, as defined according to the traditional classification system established by the aforementioned authors, are indicative of adverse cardiovascular prognosis in patients with arterial hypertension. However, ophthalmoscopy has been repeatedly criticized over the last decades as it was found to be unreliable in mild and moderate arterial hypertension. Therefore, in the last decades, much research effort has been focused on the improvement of imaging technologies that can detect early vascular changes, i.e., arteriolar narrowing, microvascular rarefaction, arteriolar remodeling, and vascular dysfunction among others, in the retinal vascular bed and to assess the prognostic role of these early retinal vascular changes in arterial hypertension.
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TL;DR: In those older than age 50, systolic blood pressure of greater than 140 mm Hg is a more important cardiovascular disease (CVD) risk factor than diastolic BP, and hypertension will be controlled only if patients are motivated to stay on their treatment plan.
Abstract: The National High Blood Pressure Education Program presents the complete Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Like its predecessors, the purpose is to provide an evidence-based approach to the prevention and management of hypertension. The key messages of this report are these: in those older than age 50, systolic blood pressure (BP) of greater than 140 mm Hg is a more important cardiovascular disease (CVD) risk factor than diastolic BP; beginning at 115/75 mm Hg, CVD risk doubles for each increment of 20/10 mm Hg; those who are normotensive at 55 years of age will have a 90% lifetime risk of developing hypertension; prehypertensive individuals (systolic BP 120-139 mm Hg or diastolic BP 80-89 mm Hg) require health-promoting lifestyle modifications to prevent the progressive rise in blood pressure and CVD; for uncomplicated hypertension, thiazide diuretic should be used in drug treatment for most, either alone or combined with drugs from other classes; this report delineates specific high-risk conditions that are compelling indications for the use of other antihypertensive drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, calcium channel blockers); two or more antihypertensive medications will be required to achieve goal BP (<140/90 mm Hg, or <130/80 mm Hg) for patients with diabetes and chronic kidney disease; for patients whose BP is more than 20 mm Hg above the systolic BP goal or more than 10 mm Hg above the diastolic BP goal, initiation of therapy using two agents, one of which usually will be a thiazide diuretic, should be considered; regardless of therapy or care, hypertension will be controlled only if patients are motivated to stay on their treatment plan. Positive experiences, trust in the clinician, and empathy improve patient motivation and satisfaction. This report serves as a guide, and the committee continues to recognize that the responsible physician's judgment remains paramount.
14,975 citations
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TL;DR: In this article, a randomized controlled trial of Aliskiren in the Prevention of Major Cardiovascular Events in Elderly people was presented. But the authors did not discuss the effect of the combination therapy in patients living with systolic hypertension.
Abstract: ABCD
: Appropriate Blood pressure Control in Diabetes
ABI
: ankle–brachial index
ABPM
: ambulatory blood pressure monitoring
ACCESS
: Acute Candesartan Cilexetil Therapy in Stroke Survival
ACCOMPLISH
: Avoiding Cardiovascular Events in Combination Therapy in Patients Living with Systolic Hypertension
ACCORD
: Action to Control Cardiovascular Risk in Diabetes
ACE
: angiotensin-converting enzyme
ACTIVE I
: Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events
ADVANCE
: Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation
AHEAD
: Action for HEAlth in Diabetes
ALLHAT
: Antihypertensive and Lipid-Lowering Treatment to Prevent Heart ATtack
ALTITUDE
: ALiskiren Trial In Type 2 Diabetes Using Cardio-renal Endpoints
ANTIPAF
: ANgioTensin II Antagonist In Paroxysmal Atrial Fibrillation
APOLLO
: A Randomized Controlled Trial of Aliskiren in the Prevention of Major Cardiovascular Events in Elderly People
ARB
: angiotensin receptor blocker
ARIC
: Atherosclerosis Risk In Communities
ARR
: aldosterone renin ratio
ASCOT
: Anglo-Scandinavian Cardiac Outcomes Trial
ASCOT-LLA
: Anglo-Scandinavian Cardiac Outcomes Trial—Lipid Lowering Arm
ASTRAL
: Angioplasty and STenting for Renal Artery Lesions
A-V
: atrioventricular
BB
: beta-blocker
BMI
: body mass index
BP
: blood pressure
BSA
: body surface area
CA
: calcium antagonist
CABG
: coronary artery bypass graft
CAPPP
: CAPtopril Prevention Project
CAPRAF
: CAndesartan in the Prevention of Relapsing Atrial Fibrillation
CHD
: coronary heart disease
CHHIPS
: Controlling Hypertension and Hypertension Immediately Post-Stroke
CKD
: chronic kidney disease
CKD-EPI
: Chronic Kidney Disease—EPIdemiology collaboration
CONVINCE
: Controlled ONset Verapamil INvestigation of CV Endpoints
CT
: computed tomography
CV
: cardiovascular
CVD
: cardiovascular disease
D
: diuretic
DASH
: Dietary Approaches to Stop Hypertension
DBP
: diastolic blood pressure
DCCT
: Diabetes Control and Complications Study
DIRECT
: DIabetic REtinopathy Candesartan Trials
DM
: diabetes mellitus
DPP-4
: dipeptidyl peptidase 4
EAS
: European Atherosclerosis Society
EASD
: European Association for the Study of Diabetes
ECG
: electrocardiogram
EF
: ejection fraction
eGFR
: estimated glomerular filtration rate
ELSA
: European Lacidipine Study on Atherosclerosis
ESC
: European Society of Cardiology
ESH
: European Society of Hypertension
ESRD
: end-stage renal disease
EXPLOR
: Amlodipine–Valsartan Combination Decreases Central Systolic Blood Pressure more Effectively than the Amlodipine–Atenolol Combination
FDA
: U.S. Food and Drug Administration
FEVER
: Felodipine EVent Reduction study
GISSI-AF
: Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation
HbA1c
: glycated haemoglobin
HBPM
: home blood pressure monitoring
HOPE
: Heart Outcomes Prevention Evaluation
HOT
: Hypertension Optimal Treatment
HRT
: hormone replacement therapy
HT
: hypertension
HYVET
: HYpertension in the Very Elderly Trial
IMT
: intima-media thickness
I-PRESERVE
: Irbesartan in Heart Failure with Preserved Systolic Function
INTERHEART
: Effect of Potentially Modifiable Risk Factors associated with Myocardial Infarction in 52 Countries
INVEST
: INternational VErapamil SR/T Trandolapril
ISH
: Isolated systolic hypertension
JNC
: Joint National Committee
JUPITER
: Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin
LAVi
: left atrial volume index
LIFE
: Losartan Intervention For Endpoint Reduction in Hypertensives
LV
: left ventricle/left ventricular
LVH
: left ventricular hypertrophy
LVM
: left ventricular mass
MDRD
: Modification of Diet in Renal Disease
MRFIT
: Multiple Risk Factor Intervention Trial
MRI
: magnetic resonance imaging
NORDIL
: The Nordic Diltiazem Intervention study
OC
: oral contraceptive
OD
: organ damage
ONTARGET
: ONgoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial
PAD
: peripheral artery disease
PATHS
: Prevention And Treatment of Hypertension Study
PCI
: percutaneous coronary intervention
PPAR
: peroxisome proliferator-activated receptor
PREVEND
: Prevention of REnal and Vascular ENdstage Disease
PROFESS
: Prevention Regimen for Effectively Avoiding Secondary Strokes
PROGRESS
: Perindopril Protection Against Recurrent Stroke Study
PWV
: pulse wave velocity
QALY
: Quality adjusted life years
RAA
: renin-angiotensin-aldosterone
RAS
: renin-angiotensin system
RCT
: randomized controlled trials
RF
: risk factor
ROADMAP
: Randomized Olmesartan And Diabetes MicroAlbuminuria Prevention
SBP
: systolic blood pressure
SCAST
: Angiotensin-Receptor Blocker Candesartan for Treatment of Acute STroke
SCOPE
: Study on COgnition and Prognosis in the Elderly
SCORE
: Systematic COronary Risk Evaluation
SHEP
: Systolic Hypertension in the Elderly Program
STOP
: Swedish Trials in Old Patients with Hypertension
STOP-2
: The second Swedish Trial in Old Patients with Hypertension
SYSTCHINA
: SYSTolic Hypertension in the Elderly: Chinese trial
SYSTEUR
: SYSTolic Hypertension in Europe
TIA
: transient ischaemic attack
TOHP
: Trials Of Hypertension Prevention
TRANSCEND
: Telmisartan Randomised AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease
UKPDS
: United Kingdom Prospective Diabetes Study
VADT
: Veterans' Affairs Diabetes Trial
VALUE
: Valsartan Antihypertensive Long-term Use Evaluation
WHO
: World Health Organization
### 1.1 Principles
The 2013 guidelines on hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology …
14,173 citations
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TL;DR: Authors/Task Force Members: Piotr Ponikowski* (Chairperson) (Poland), Adriaan A. Voors* (Co-Chair person) (The Netherlands), Stefan D. Anker (Germany), Héctor Bueno (Spain), John G. F. Cleland (UK), Andrew J. S. Coats (UK)
13,400 citations
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TL;DR: In this article, Anderson et al. proposed a new FAHA Chair, Jeffrey L. Anderson, MD, FACC, FAHA, Chair-Elect, Alice K. Jacobs et al., this article and Biykem Bozkurt.
11,386 citations
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TL;DR: 2007 Guidelines for the Management of Arterial Hypertension : The Task Force for the management of Arterspertension of the European Society ofhypertension (ESH) and of theEuropean Society of Cardiology (ESC).
Abstract: 2007 Guidelines for the Management of Arterial Hypertension : The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).
9,932 citations