The eects of high blood pressure on the structure and function of all arteries lead to subclinical damage in most organs of the human body. Of particular importance are abnormalities in the heart, brain, kidneys and the large elastic arteries which, after years of silent disease, may erupt as clinical fatal or non-fatal events such as stroke, coronary artery disease, heart failure, chronic kidney disease and peripheral artery disease. These complications remain the most frequent cause of death and morbidity worldwide, including developed Countries, and underdeveloped and developing Countries. The high prevalence of hypertension and other associated traditional cardiovascular risk factors, such as central obesity, dyslipidemia, hyperglycemia, sedentarism and metabolic syndrome, may be explained by the interaction of environmental factors with a specic and complex genetic predisposition. Epigenetics are probably more important than genes in emerging Countries, where the incidence of these traditional cardiovascular risk factors is increasing dramatically. Hopefully, the burden of these factors can be reduced and corrected by optimizing available treatments, possibly with the exception of obesity, thus permitting a signicant reduction in cardiovascular events. As a rst step, silent structural and functional alterations of small and large arteries may be prevented and reversed by appropriate treatments. Therefore, the introduction of life style measures focused on reducing weight gain over time, reducing salt and alcohol intake, and reducing excess carbohydrate and saturated fat intake in the general population are crucial rst steps in avoiding the transition from health to disease. In addition, the correct use of the vast arsenal of pharmacological antihypertensive treatments is the most eective way of reducing cardiovascular mortality and morbidity worldwide. The best results in terms of the ecacy of therapy can only be obtained with correct stratication of the global cardiovascular risk, the early detection of cardiovascular risk factors, early diagnosis of the process and early treatment. This is a very complex task as reected by the title of this Symposium: “The complexity of the management of hypertension and its comorbidities”. The aim of this International Symposium is to update general practitioners and specialists (cardiologists, internists, nephrologists, endocrinologists, neurologists) on the most recent advances in the eects and mechanisms by which cardiometabolic risk factors induce organ damage: early vascular aging, the transition from hypertension to heart failure, how the brain is aected, the interaction of cardiovascular risk factors in kidney damage, the best treatments for preventing organ damage and cardiovascular events and, nally, how to tackle hypertension and comorbidities in low-resource Countries.
Prof. Antonio Coca President of the Meeting