The Emerging Pandemic of Heart Disease: Metabolic Syndrome, Diabetes, Hypertension, and Atherosclerosis.
The Association of Black Cardiologists, Inc. (ABC) convened an international educational symposium during a recent tour of China, June 23-July 4, 2007. Program co-chairs Keith C. Ferdinand, MD, and David E. Knox, MD, hosted the event, titled
The program began on Wednesday, June 27, and the first session highlighted special populations and special situations related to the cardiometabolic syndrome. This lead-off session was moderated by ABC Chairman General K. Hilliard, MD, and featured ABC President Gerald DeVaughn, MD, Laurence Watkins, MD, MPH, and Elizabeth Ofili, MD, MPH, as faculty.
Dr DeVaughn highlighted the connections between obesity and lifestyle and increased cardiac risk, especially in women. Next, Dr Watkins reviewed guidelines and current data that can assist clinicians in addressing multiple risk factors. Closing the day's session was Dr Ofili, who highlighted the successful efforts of the Morehouse School of Medicine in developing a symbiotic relationship between academic medicine and community practices for research.
On the following day, Joseph Quash, MD, moderated a session on hypertension and renal disease. Presenters included Dr Knox, Chamberlain Obialo, MD, Ralph Watson, MD, and B. Waine Kong, JD, PhD. Dr Knox noted several important issues when addressing patients with diabetes with multiple medications, confirming that all beta blockers are not created equal. A unique presentation by Dr Obialo suggested that cardiologists should be aware that kidney disease is a cardiac risk equivalent. He noted that clinicians needed to address multiple factors to better identify the increased morbidity and mortality from cardiovascular diseases in patients with renal disease. Next, Dr Watson reviewed in detail new guidelines from the American Heart Association targeting blood pressure to less than 130/80 mm Hg in patients with hypertension and ischemic heart disease, and even less than 120/80 mm Hg if concomitant heart failure (HF) is present. Subsequently, Dr Kong gave practical suggestions on how we can assist patients to understand and adhere to antihypertensive treatments.
The Friday session included an update on the application of modern technology in treating cardiac diseases and featured presentations by Andre Artis, MD, Malcolm Taylor, MD, and Ernest Madu, MD. Dr Artis began the day by giving insights on the present controversy regarding coated versus bare-metal stents and proposed appropriate early and sustained use of clopidogrel to prevent acute thrombosis. Next, Dr Taylor explored why isosorbide dinitrate and hydralazine (I/H) in generic forms are not bioequivalent to fixed-dose I/H. He suggested that patients would be harmed by not making this fixed-dose combination available when added to conventional therapy to decrease HF hospitalizations and mortality. Closing the session, Dr Madu described in detail the need for modern cardiovascular care in developing societies. He described his successful efforts in Jamaica to make diagnostic and therapeutic care accessible and equal to that seen in mainland United States.
The symposium was informative and well received, but the highlight of the international excursion was our visit to Fu Wai Hospital, which included a facility tour and an educational symposium attended by ABC and Chinese physicians. The hospital, which is located in the heart of downtown Beijing, sees more than 10,000 interventional procedures annually, has approximately 800 beds, and totals approximately 18,000 patient admissions per year. The tour and educational program was organized by Hui Rutai, MD, scientific director, Cardiovascular Institute, and medical director of hypertension and vice president of Fu Wai Hospital.
Following the tour, the ABC members participated in a joint symposium on cardiovascular diseases with 2 speakers from ABC and 2 speakers from China. First, Dr Ferdinand addressed the rationale for examining various racial and ethnic groups to find unique opportunities and challenges in reducing cardiovascular diseases. Subsequently, Dr Ofili informed her Chinese colleagues of some of the recent advances in medical and surgical care from the United States. Dr Rutai and Gu Dongfeng, MD, director, department of population genetics and director of the department of evidence-based medicine, National Center for Cardiovascular Diseases, demonstrated that although China is considered a developing society, cardiovascular diseases, especially hypertension and stroke, are serious concerns. Their data noted high rates of cardiovascular disease not only in the urban areas, but also in rural China, where, surprisingly, elevated blood pressure and its sequelae are common. This landmark session was moderated by Dr DeVaughn and Yang Yuejin, MD, vice president and medical director of cardiology, Fu Wai Hospital.
To learn more about the ABC local programs, and ways to assist, call 800-753-9222 and ask for member services or visit online at