Tamagna Lecture: Optimal Management of Hypertension
From Vienna, Austria, to Washington, D.C., Irene Tamagna’s journey to medicine was a winding and uncertain path.
She began her career in Austria in the 1930s, but after four years of medical school, she was forced to leave her house and abandon her studies to flee the Nazi occupation. She immigrated to Italy and completed another year of medical training, but once again had to move without a full degree when the Pact of Steel between Germany and Italy was signed. Her next stop was the United States, where she had to learn a new language and begin her schooling again at the Women’s Medical College of Pennsylvania.
Despite all the obstacles she faced, Tamagna completed her medical training, going on to a decades-long career that would open doors for other female physicians. Tamagna joined the George Washington University (GW) medical school faculty in 1948, and taught hypertension and clinical medicine to medical students for more than 40 years. In 2002, Tamagna and her family established the Irene Tamagna Lecture on Hypertension.
Tamagna passed away in March 2018, just short of 103 years old. The lecture series continued in June, to honor her name and her passion for medicine.
This year’s lecturer was George L. Bakris, MD, director of the Comprehensive Hypertension Center and professor of medicine at the University of Chicago Medicine.
Bakris’ presentation, “Optimal Management of Hypertension in Diabetes,” looked at the guidelines for blood pressure (BP) in patients with diabetes who are at risk of chronic kidney disease (CKD) and whether lowering BP actually reduces the risk for CKD as well as cardiovascular events.
Looking at various studies, Bakris detailed the impacts, both negative and positive, of lower levels of BP.
He noted that the American Diabetes Association distinguishes between blood pressure thresholds used to diagnose hypertension and thresholds used as treatment targets. “There’s a big difference … so I think you have to make this distinction, because if you don’t, you run into a lot of problems,” he said.
Bakris added that currently, there “really is no clear rationale to change the blood pressure thresholds for less than 130/80, unless you’re at very high cardiovascular risk. If you’re not, you don’t need to be there, 132 is fine.”
“Less is not more. Lowering the pressure until you can’t stand up anymore, doesn’t get you where you need to be,” he said. “In fact, I think … that there really was no greater benefit in being less than 130.”
He also said there’s no strong data that supports a BP of less than 130/80 to slow progression of kidney disease. In addition, when it comes to older patients, especially those over the age of 80, BP levels and care must be individualized, he said.
Members of Tamagna’s family, including her daughters Ellen and Jane, were in attendance at the lecture. The family honored her memory and legacy on Saturday, June 9, with a memorial service.