Dr. Terlinsky Attends the European Society on Hypertension and Cardiovascular Protection Meeting

One of my areas of medical expertise is hypertension having been certified as a specialist in clinical hypertension in 2002 by the American Society of Hypertension (ASH). As I do each year, I just attended the annual meeting of the European Society on  Hypertension and Cardiovascular Protection (ESH) which occurred in Barcelona Spain, June 8-11.

It was a very exciting event as ESH 2018 introduced its newest guidelines for the diagnosis and treatment of hypertension. Furthermore, Dr. Paul Whelton, the lead author of the American guidelines for the diagnosis and treatment of hypertension released in September 2017, was a guest speaker and he participated in a discussion comparing the American and the European Guidelines.

We tend to lose sight of the fact that poorly controlled blood pressure (hypertension) is the root cause of heart failure, atrial fibrillation, sudden death, kidney failure, heart attacks, stroke and atherosclerotic vascular disease. In fact, deaths from hypertension and related complications exceed all of the causes of death combined. Think about that, hypertension and hypertensive co-morbidities kill more people than all deaths caused by cancer, smoking, alcohol, influenza, AIDS, West Nile Virus, pneumonia, influenza, drug overdoses, car accidents and everything else imaginable!

We know from the landmark studies that started in the 1960s and 1970s and which have continued for the past 60 years that treating the “Silent Killer” dramatically reduces hypertension-related deaths.

Dr. Terlinsky’s Thoughts at the Annual Meeting of the Obesity Medical Association

Good morning, Dr. Terlinsky here in San Antonio, TX at the annual meeting of the Obesity Medicine Association. I will be attending lectures and other educational sessions on the latest developments in the fields of nutrition and weight management.

This morning I had breakfast with Dr. Eric Westman from Duke University who is an international expert on weight loss and ketogenic diets He told me about his program at Duke and how patients are treated with low carb diets. Dr. Westman is a firm believer in teaching patients how to follow low-carb diets to cure their sugar addiction, improve insulin sensitivity and lose excess body fat. He shared data with me relating to the likelihood of a patient getting into ketosis based on the total amount of carbs ingested. His initial favorite is to start at 20 grams per day.

I heard the results from an interesting, novel strategy to lose weight by following an alternate date fasting (ADF) vs. a calorie reduction diet (CR) of 25 % per day.

Basically, a person eats about 500 calories on one day and gets to eat whatever they want on the other.

After one year there was not much difference between the two. There may be an advantage to the alternate-day fasting for pre-diabetics as insulin sensitivity may improve with the alternate-day fasting.

Explosion of New Medications to Combat Obesity

Our “toolbox” of medication for obesity as been empty since several previously FDA approved drugs were removed from the market. Sibutramine was removed becasue of controversial information suggesting Sibutramine caused heart attacks. Nevertheless, we now have two new agents, Qsymia and Locaserin, approved as well as Contrave (yet to be approved) which are expanding options to treat obesity. Full discusssion to follow.

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