Of course every year we try to include in our meeting reviews of the most relevant information that we have in mechanisms， diagnosis， and therapies for hypertension. We also try to bring to this meeting all the novel things and to try and envisage the future. At this meeting， there is one thing in particular that has emerged: renal denervation. I think this is the start of something big. This is a new procedure that has been introduced in the last two to three years and is coming of age rapidly. It is an invasive procedure which appears to be effective in treating patients who would otherwise be difficult to control. There is a lot of interest in it because of its novelty and because it comes at a time when there are not many new drugs coming on the market.
　　Of course， there are always new elements that can influence blood pressure， such as vitamin D. It looks like giving vitamin D in countries where there is not too much sun exposure can be effective in lowering blood pressure a little. They are preliminary data， but this is one of the topics that is interesting.
　　There are presentations related to the mechanisms that link obesity and hypertension. There is recent information that some bariatric surgeries are capable of reducing blood pressure. Maybe one of the mechanisms involved is that， after bariatric surgery， inflammation in adipose tissue is reduced and consequently there is less impact on blood vessels and endothelial function. The reasons for that are not clear， but maybe the incretin system is involved. Incretins were initially related to diabetes， but we are getting more information that the incretins can also control other systems and there may be some link with the renin-angiotensin system. This may be an interesting topic to follow in the future.
　　Another interesting aspect is the development of the new guidelines for 2013. We have been working on them for several months now， together with the European Society of Cardiology. We are going to update all the information we have available and release advice for general practitioners and other specialists who are not deeply involved in hypertension on what they can do and what is best for the patient.
　　While there are not too many new drugs on the horizon， we still have a lot of questions to answer in the future. One of them is the topic I am going to address in the Presidential Lecture: ambulatory blood pressure monitoring. Particularly， I will talk about what more we need to know to be able to more precisely choose a procedure and perform that procedure to achieve the best result. We need to be aware of what is the state-of-the-art. We also need to work in conjunction with the National Health Service here in the UK. In their guidelines they have mandated that， before starting anti-hypertensive treatment， you need to use ambulatory blood pressure monitoring. But we have a lot of gaps in the knowledge that we have. The main gap is that we do not know whether we are doing a better job by targeting ambulatory blood pressure as opposed to office measurements and whether we can reduce morbidity and mortality. We have never tested this and we need to.
　　会上有多个令人感兴趣的话题：①高血压治疗新进展：其中值得一提的是高血压治疗新方法——肾脏交感神经消融术。尽管出现时间短，但发展迅速。肾脏交感神经消融术是一种有创的新型高血压治疗手段，能够有效治疗药物难以控制的高血压，为高血压治疗带来新的希望。另外，此次大会还会介绍其他一些新的高血压治疗方法，如在阳光照射不足的国家应用维生素D可以降低血压，当然，这只是初步数据，但是也是有趣话题之一。②高血压发病机制新进展：会上介绍了肥胖参与高血压发病的机制。近期一些研究表明，胃绕道手术能降低患者血压，同时降低糖尿病发生风险，甚至使某些糖尿病患者能够得到治愈。其可能的机制是抑制脂肪组织释放炎性因子，减弱对血管内皮功能的影响。这其中可能涉及肠促胰素系统与肾素血管紧张素系统之间的相互作用。③新的高血压治疗指南的公布：2013年即将在米兰召开的ESH年会上公布数个新的高血压治疗指南。目前我们正和欧洲心脏病学学会（ESC）一起进行指南制定工作。新指南将纳入目前高血压领域的新进展，为临床医生提供最佳治疗方案。④动态血压监测：在开始降压治疗之前，需要对患者进行动态血压监测，但是以动态血压作为治疗目标是否优于诊室血压尚不明确，需要对此进一步研究。