Volume 15 Issue 3, March 2018

The radical new US hypertension guidelines, released 3 years after the previous scientific statement, have implications far beyond their intended recipients. They include a new definition for hypertension, lower treatment targets, and extended guidance on the implementation of multidisciplinary care, including self-monitoring of blood pressure. Some recommendations are likely to generate controversy.

Conduction system disorders lead to slow heart rates that are insufficient to support the circulation, necessitating implantation of electronic pacemakers. Current pacemakers, although effective, have limitations including lead malfunction, lack of autonomic responsiveness, and device-related infections. In this Review, Marbán and colleagues discuss next-generation electronic devices designed to address current limitations, as well as biological pacemakers as alternatives to implantable hardware.

Over the past decade, marijuana has been legalized for medicinal purposes or recreational use in many countries, and the potency of marijuana and synthetic cannabinoids has substantially increased. In this Review, Pacher and colleagues summarize the role of the endocannabinoid system in cardiovascular health and disease, and critically discuss the beneficial and detrimental cardiovascular effects of marijuana and synthetic cannabinoid use.

The effects of microgravity and cosmic rays on the cardiovascular system are major health concerns for astronauts in space. In this Review, Hughson and colleagues summarize the current evidence on risk estimation and dysfunction of the cardiovascular system in space, and discuss potential countermeasures, including physical exercise, antioxidants, nutraceuticals, and radiation shielding.

Antiplatelet drugs are routinely used for the prevention and treatment of thrombosis, but also carry an inherent increased risk of bleeding. In this Review, McFadyen and colleagues assess the differences between thrombosis and haemostasis in the context of currently available antiplatelet drugs as well as novel antiplatelet agents that are entering preclinical and early-phase clinical testing.