Health professionals for a new century: Ttransforming education to strengthen health systems in an interdependent world

Julio Frenk, Lincoln Chen, Zulfiqar A. Bhutta, Jordan Cohen, Nigel Crisp, Timothy Evans, Harvey Fineberg, Patricia Garcia, Yang Ke, Patrick Kelley, Barry Kistnasamy, Afaf Meleis, David Naylor, Ariel Pablos-Mendez, Srinath Reddy, Susan Scrimshaw, Jaime Sepulveda, David Serwadda, Huda Zurayk

Research output: Contribution to journalArticle

2074 Citations (Scopus)

Abstract

Background Activation of renal sympathetic nerves is key to pathogenesis of essential hypertension. We aimed to assess eff ectiveness and safety of catheter-based renal denervation for reduction of blood pressure in patients with treatment-resistant hypertension. Methods In this multicentre, prospective, randomised trial, patients who had a baseline systolic blood pressure of 160 mm Hg or more (?150 mm Hg for patients with type 2 diabetes), despite taking three or more antihypertensive drugs, were randomly allocated in a one-to-one ratio to undergo renal denervation with previous treatment or to maintain previous treatment alone (control group) at 24 participating centres. Randomisation was done with sealed envelopes. Data analysers were not masked to treatment assignment. The primary eff ectiveness endpoint was change in seated offi ce-based measurement of systolic blood pressure at 6 months. Primary analysis included all patients remaining in follow-up at 6 months. This trial is registered with ClinicalTrials.gov, number NCT00888433. Findings 106 (56%) of 190 patients screened for eligibility were randomly allocated to renal denervation (n=52) or control (n=54) groups between June 9, 2009, and Jan 15, 2010. 49 (94%) of 52 patients who underwent renal denervation and 51 (94%) of 54 controls were assessed for the primary endpoint at 6 months. Offi ce-based blood pressure measurements in the renal denervation group reduced by 32/12 mm Hg (SD 23/11, baseline of 178/96 mm Hg, p

Original languageEnglish (US)
Pages (from-to)1923-1958
Number of pages36
JournalThe Lancet
Volume376
Issue number9756
DOIs
StatePublished - Dec 4 2010
Externally publishedYes

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Denervation
Blood Pressure
Kidney
Education
Health
Therapeutics
Random Allocation
Type 2 Diabetes Mellitus
Antihypertensive Agents
Catheters
Hypertension
Safety
Control Groups

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Health professionals for a new century : Ttransforming education to strengthen health systems in an interdependent world. / Frenk, Julio; Chen, Lincoln; Bhutta, Zulfiqar A.; Cohen, Jordan; Crisp, Nigel; Evans, Timothy; Fineberg, Harvey; Garcia, Patricia; Ke, Yang; Kelley, Patrick; Kistnasamy, Barry; Meleis, Afaf; Naylor, David; Pablos-Mendez, Ariel; Reddy, Srinath; Scrimshaw, Susan; Sepulveda, Jaime; Serwadda, David; Zurayk, Huda.

In: The Lancet, Vol. 376, No. 9756, 04.12.2010, p. 1923-1958.

Research output: Contribution to journalArticle

Frenk, J, Chen, L, Bhutta, ZA, Cohen, J, Crisp, N, Evans, T, Fineberg, H, Garcia, P, Ke, Y, Kelley, P, Kistnasamy, B, Meleis, A, Naylor, D, Pablos-Mendez, A, Reddy, S, Scrimshaw, S, Sepulveda, J, Serwadda, D & Zurayk, H 2010, 'Health professionals for a new century: Ttransforming education to strengthen health systems in an interdependent world', The Lancet, vol. 376, no. 9756, pp. 1923-1958. https://doi.org/10.1016/S0140-6736(10)61854-5
Frenk, Julio ; Chen, Lincoln ; Bhutta, Zulfiqar A. ; Cohen, Jordan ; Crisp, Nigel ; Evans, Timothy ; Fineberg, Harvey ; Garcia, Patricia ; Ke, Yang ; Kelley, Patrick ; Kistnasamy, Barry ; Meleis, Afaf ; Naylor, David ; Pablos-Mendez, Ariel ; Reddy, Srinath ; Scrimshaw, Susan ; Sepulveda, Jaime ; Serwadda, David ; Zurayk, Huda. / Health professionals for a new century : Ttransforming education to strengthen health systems in an interdependent world. In: The Lancet. 2010 ; Vol. 376, No. 9756. pp. 1923-1958.
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