简介：Hypertensionisaleadingriskfactorforcardiovasculardisease,theleadingcauseofdeathandmorbidityinoursocietyandonaglobalscale.Majorcomponentsofcardiovasculardiseaseincludestroke,coronaryarterydisease,heartfailure,andchronickidneydisease,inallofwhichhypertensionplaysamajorrole.Theriskofthesecomplicationsincreasesdirectlyandlinearlywithsystolicbloodpressurestartingat115mmHg.Althoughusuallyasymptomatic,hypertensionisreadilydetectableonphysicalexaminationandisamenabletobothlifestylemodificationandpharmacologictreatmentinmostpatients.However,largeproportionsofthehypertensivepopulationremainundetectedandundertreated.Numerousguidelineshavebeenissuedduringthepastfewdecadestopromotedetectionandoptimaltherapy.Despitetheincreaseinriskwithsystolicbloodpressuregreaterthan115mmHg,thegenerallyacceptedthresholdfordiagnosisandtreatmenthasbeensystolicbloodpressuregreaterthan139mmHganddiastolicbloodpressuregreaterthan80mmHgbecauseuntilrecentlytreatmenttolowerlevelshasbeenassociatedwithanunfavorablerelationbetweenclinicalbenefitandharm.Inthepastseveralyears,newguidelines,advisories,commentaries,andclinicaltrialshaveprovidedevidenceforapotentialchangeincurrentrecommendationsforthemanagementofhypertension.Inthisregard,thelong-awaitedeighthreportoftheJointNationalCommitteeonthePrevention,Detection,Evaluation,andTreatmentofHighBloodPressurerecommendedpatientsolderthan60yearsbetreatedtoasystolicbloodpressureoflessthan150mmHg,whichhasgeneratedconsiderablecontroversyandcaution.ThestrikingfindingsoftheSystolicBloodPressureInterventionTrial(SPRINT)havereceivedconsiderableattentionbecauseofthedemonstrationthatintensivetherapytoatargetsystolicbloodpressurebelow120mmHgdecreasescardiovascularmortalityandmorbiditymorethanlessintensivetreatmenttoatargetsystolicbloodpressurebelow140mmHg

简介：Surgicaloptionsdevelopedtotreatcarotidarterystenosishaveevolvedinthelastsixdecades,andstudieshaveshownthesuperiorityofcarotidendarterectomy(CEA)comparedtomedicaltherapy.Similarly,asendovasculartherapyhasevolvedoverthelasttwodecades,studiesreflectingsafety,feasibility,andequivalenceofcarotidarterystenting(CAS)toCEAhavebeenreplicatedinseveralstudiesforintermediatetohighsurgicalriskpatients.However,sinceitsinception,thefieldofCAShasbeenmiredinseveralcontroversiesandhasbeensubjecttointensescrutinyfrommultiplestakeholderswithinthefieldofmedicine.ThisreviewdiscussesspecificissuesconcerningCASthatarerelevantinthecurrentera.

简介：Heartfailureisacomplexclinicalsyndromethatcanresultfromanystructuralorfunctionalcardiacdisorderthatimpairstheabilityoftheventricletofillwithorejectblood.Theechocardiogramisthesinglemostperformedandusefulstudyinthesepatients.Thisarticlereviewstheroleoftheechocardiogramintheevaluationoftheheartfailurepatient,withoutfocusingontheleftventricle.Thediscussionincludestheuseoftheechocardiogramintheassessmentoftherightventricleanddiastolicfunctionandindetectinghemodynamicandmorphologicchangesinheartfailureoveraperiodoftime.Inaddition,wehighlightsomeofthelimitationsofechocardiographyintheassessmentofthesepatients.