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Hypertension is the leading risk factor for cardiovascular disease (CVD) worldwide. Despite the availability of effective antihypertensive medications, the control of hypertension at a global level is dismal, and consequently, the CVD burden continues to increase. In response, countries in Latin America and the Caribbean are implementing How to cite this article: DiPette DJ, Goughnour K, Zuniga E, et al. Standardized treatment to improve hypertension control in primary health care: The HEARTS in the Americas Initiative. J

The COVID-19 pandemic has changed most aspects of everyday life in both the non-medical and medical settings. In the medical world, the pandemic has altered how healthcare is delivered and has necessitated an aggressive and new coordinated public health approach to limit its spread and reduce its disease burden and socioeconomic impact. This pandemic has resulted in a staggering morbidity and mortality and massive economic and physical hardships. Meanwhile, non-communicable diseases such as hypertension, diabetes mellitus, and cardiovascular disease in general continue to cause significant disease burden globally in the background. Though presently receiving less attention in the public eye than the COVID-19 pandemic, the hypertension crisis cannot be separated from the minds of healthcare providers, policymakers and the general public, as it continues to wreak havoc, particularly in vulnerable populations in resource limited settings. On this background, many of the strategies being employed to combat the COVID-19 pandemic can be used to reenergize and galvanize the fight against hypertension and hopefully bring the public health crisis associated with uncontrolled hypertension to an end.

Over the past 5 decades, as well as presently, the morbidity and mortality attributable to hypertension continues to be a major public health issue both at the local and global levels. Despite individual and population-based efforts to address the traditional and well-known modifiable risk factors that contribute to cardiovascular disease, including hypertension, such as reducing dietary sodium intake, weight reduction, increasing physical activity, and smoking cessation, the disease burden attributable to hypertension and its corresponding target organ damage is on the rise. This increase is associated with considerable individual, family, societal, and economic implications.Of the multiplicity of established risk factors associated with the development of hypertension and its complications (such as heart disease, stroke, chronic kidney disease, accelerated atherosclerosis, and premature death), hyperhomocysteinemia has arguably been one of the most elusive of the proposed risk factors to convincingly link to hypertension. Multiple clinical and epidemiological studies investigating the relationship of increased homocysteine levels to hypertension have come to contrasting conclusions. As such, the debate as to the causal link between hyperhomocysteinemia and hypertension continues. trial, demonstrated an increased prevalence of hypertension in persons with higher compared with lower homocysteine levels. 2,3 In the case of NHANES III, which provides some of the most convincing evidence for the association between hyperhomocysteinemia and hypertension, a 5-μmol/L increase in homocysteine levels (or 1 SD above the mean), was associated with a 0.7-and 0.5-mm Hg increase in systolic blood and diastolic BPs, respectively, in men and an increase of 1.2-and 0.7-mm Hg increase in systolic and diastolic BPs, respectively, in women.Additional support for the association between hyperhomocysteinemia and an elevation in BP includes evidence that reducing homocysteine levels by dietary B vitamin supplementation resulted in a reduction of BP. Thus, the observation of an increased prevalence of

Catheter-based ablation techniques have a well-established role in atrial fibrillation (AF) management. The prevalence and impact of AF is increasing globally, thus mandating an emphasis on improving ablation techniques through innovation. One key area of ongoing evolution in this field is the use of laser energy to perform pulmonary vein isolation during AF catheter ablation. While laser use is not as widespread as other ablation techniques, such as radiofrequency ablation and cryoballoon ablation, advancements in product design and procedural protocols have demonstrated laser balloon ablation to be equally safe and effective compared to these other modalities. Additionally, strategies to improve procedural efficiency and decrease radiation exposure through low fluoroscopy protocols make this technology an increasingly promising and exciting option.

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Cardiovascular disease is one of the leading causes of morbidity and mortality in persons with cancer. The elevated risk is thought to derive from the combination of cardiovascular risk factors and direct cardiotoxicity from cancer therapies. Exercise may be a potential strategy to counteract these toxicities and maintain cardiovascular reserve. In this article, we review the evidence for the potential cardioprotective effects of exercise training in cancer patients before, during, and following treatment. We also propose a patient-tailored approach for the development of targeted prescriptions based on individual exercise capacity and cardiovascular reserve.