Current problems in cardiology
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Hypertension is the leading cause of mortality worldwide. Effective therapies are needed for resistant hypertension, a common condition characterized by inadequate blood pressure control despite 3 or more medications, which is associated with increased cardiovascular mortality. ⋯ Initial studies have demonstrated procedural safety and effectiveness in blood pressure reduction up to 2 years after procedure. Large randomized control trials are necessary and currently underway to define further the role of renal denervation and long-term consequences in the treatment of resistant hypertension.
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Hypertrophic cardiomyopathy is a fascinating disease of marked heterogeneity. Hypertrophic cardiomyopathy was originally characterized by massive myocardial hypertrophy in the absence of known etiology, a dynamic left ventricular outflow obstruction, and increased risk of sudden death. It is now well accepted that multiple mutations in genes encoding for the cardiac sarcomere are responsible for the disease. Complex morphologic and pathophysiologic differences, disparate natural history studies, and novel treatment strategies underscore the challenge to the practicing cardiologist when faced with the management of the hypertrophic cardiomyopathy patient.