William B. White, MD (Chair)

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1 Dear CME Planner: Despite the availability of a number of approved medications to control high blood pressure, only half of patients with hypertension who are under treatment meet their blood pressure goal. This represents a significant gap in preventive medicine and cardiology. It is a gap that is not just clinically relevant but one that may be financially relevant for your organization and physicians as more health plans and accrediting organizations base reimbursement and accreditation on the quality of blood pressure management provided. It is evident that there is a need for continuing medical education (CME) that will enable physicians and other healthcare professionals to adhere to evidence-based approaches that help patients meet their blood pressure goal. We have designed a national CME initiative for your healthcare professionals entitled Getting to Goal: How Thiazide-Type Diuretics, Following the Guidelines, and Improving Patient Adherence Can Help. In doing so, we invite you to consider participating in this informative program. The content of this educational activity has been designed with the goal of enhancing the competence of physicians and other healthcare professionals in managing hypertension in their patients, including improving patient adherence to recommended therapy. CME credit will be offered to those who participate in this activity, which is targeted toward cardiologists, primary care physicians, nurse practitioners, and physician assistants. This educational activity, which has been reviewed for balance and scientific rigor, will consist of a 1-hour Grand Rounds program. It will provide an overview of key clinical trials in the clinical management of hypertension; the use of thiazide-type diuretics in clinical outcome trials and general treatment of high blood pressure; treatment considerations for African Americans with hypertension with and without kidney disease; and patient adherence to recommended treatments. This educational initiative is jointly sponsored by the Postgraduate Institute for Medicine (PIM) and Spire Learning and is supported by an educational grant from Takeda Pharmaceuticals U.S.A., Inc. Please note that there is no cost to your institution to host this activity, and the program can be scheduled at your convenience. You will be provided with materials to publicize the program, along with a participant handout, an educational tool, a pre- and posttest, and an evaluation. I have enjoyed planning this activity with the esteemed faculty, and I am sure that you and your clinicians will find the presentation useful and informative. Sincerely, William B. White, MD (Chair)

2 Target Audience Cardiologists Primary care physicians Nurse practitioners Physician assistants Agenda 1-hour Grand Rounds program consisting of patient case examples, didactic presentations, and a Q&A session Learning Objectives Upon completion of this educational activity, participants should be able to: 1. Discuss key clinical trials on the role of medication in hypertension and their influence on current sequencing algorithms for the pharmacologic treatment of hypertension 2. Improve adherence to current sequencing algorithms for the management of hypertension 3. Describe pharmacokinetic/ pharmacodynamic differences between the thiazide-type diuretics chlorthalidone and hydrochlorothiazide, outcomes of clinical trials with the two drugs, and the relevance of these two drugs in the contemporary management of hypertension 4. Describe the outcomes of ALLHAT in African Americans and its implications for clinical practice 5. Discuss the potential benefits of fixeddose combination antihypertensive therapy and home blood pressure monitoring to improve patient adherence to antihypertensive therapy

3 Faculty William B. White, MD (Chair) Professor of Medicine University of Connecticut School of Medicine Chief, Division of Hypertension and Clinical Pharmacology University of Connecticut Health Center Farmington, CT George L. Bakris, MD Professor of Medicine Director, ASH The University of Chicago Medicine Chicago, IL Henry R. Black, MD Clinical Professor of Internal Medicine NYU Center for the Prevention of Cardiovascular Disease New York University School of Medicine New York, NY Angela L. Brown, MD Assistant Professor of Medicine Department of Internal Medicine Washington University School of Medicine Washington University Cardiology Consultants St. Louis, MO William C. Cushman, MD Professor of Preventive Medicine, Medicine, and Physiology University of Tennessee College of Medicine Chief, Preventive Medicine Section Veterans Affairs Medical Center Memphis, TN Keith C. Ferdinand, MD Professor of Clinical Medicine Tulane University School of Medicine New Orleans, LA Louis Kuritzky, MD Clinical Assistant Professor Department of Community Health and Family Medicine University of Florida Gainesville, FL Domenic Sica, MD Professor, Department of Internal Medicine Division of Nephrology Head, Clinical Pharmacology and Hypertension Virginia Commonwealth University Richmond, VA Jackson T. Wright Jr, MD, PhD Professor of Medicine Case Western Reserve University Director of Clinical Hypertension Program University Hospitals Case Medical Center Cleveland, OH

4 Accreditation Statements This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Spire Learning. PIM is accredited by the ACCME to provide CME for physicians. Credit Designation Postgraduate Institute for Medicine (PIM) designates this live activity for a maximum of 1 AMA PRA Category 1 Credit. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This educational activity is jointly sponsored by PIM and Spire Learning. SP RE LEARNING This activity is supported by an independent educational grant from Takeda Pharmaceuticals U.S.A., Inc. Disclosure Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by PIM for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

5 Scheduling a Grand Rounds Activity Upon receipt of your request form, Spire Learning will contact you to arrange the Grand Rounds activity. Services provided by PIM and Spire Learning include: 1. Speaker confirmation and arrangements including travel, accommodations, and honoraria 2. Program publicity materials including posters, a press release, and a pdf flyer 3. CME syllabus including accreditation information and a speaker biographical sketch 4. Slides, educational tool, evaluation form, pre- and posttest 5. Reprints of recent JFP supplement distributed to all participants 6. Onsite CME forms including participant sign-in sheet, housekeeping notes, and instructions Register Today! Fax the form on the adjacent page to or go online to and click on the Request a Program button.

6 Getting to Goal: How Thiazide-Type Diuretics, Following the Guidelines, and Improving Patient Adherence Can Help Once you have completed this form, please fax it to INSTITUTION OR ORGANIZATION ADDRESS CITY STATE ZIP CONTACT NAME TITLE ADDRESS PHONE NUMBER FAX NUMBER DATE OF ACTIVITY (FIRST CHOICE) DATE OF ACTIVITY (SECOND CHOICE) TIME OF ACTIVITY (FIRST CHOICE) TIME OF ACTIVITY (SECOND CHOICE) LOCATION OF ACTIVITY (INCLUDE BUILDING, ROOM NUMBER, FLOOR, ETC) EXPECTED NUMBER OF ATTENDEES (APPROXIMATE) Other ATTENDEE TITLES (APPROXIMATE NUMBER) Cardiologists Nurse practitioners Other (Please specify title and number) Primary care physicians Physician assistants Please check which method(s) you will use to publicize this program. We will provide you with the materials per your request. (Check all that apply) Poster promotion Press release Calendar of events Other Do you plan on inviting local community physicians? Yes No If yes, how will you invite them? Permission for representative from supporter to attend? Yes No In order to ensure that this educational activity meets the needs of your institution or organization, please identify the current professional practice gap(s) of your staff that you would like to see improved as a result of their participation in this activity. What barriers exist to addressing the professional practice gap(s) identified above? What practice changes do you expect to see as a result of your staff s participation in this educational activity? Please check here if you agree to be contacted to complete a brief outcomes survey 2-4 months after this activity. CME Grand Rounds Presentation I understand that this activity is accredited for continuing medical education by the Postgraduate Institute for Medicine and will not be accredited by another entity. Please check here to indicate that you have read and understand this statement If you have any questions, please contact us: Nancy Dolan Spire Learning 4 Gatehall Drive Parsippany, NJ Phone: Fax: ndolan@spirelearning.com

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