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Hypertension Canada provides annually updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension in adults and children. This year, the adult and pediatric guidelines are combined in one document. The new 2018 pregnancy-specific hypertension guidelines are published separately. For 2018, 5 new guidelines are introduced, and 1 existing guideline on the blood pressure thresholds and targets in the setting of thrombolysis for acute ischemic stroke is revised. The use of validated wrist devices for the estimation of blood pressure in individuals with large arm circumference is now included. Guidance is provided for the follow-up measurements of blood pressure, with the use of standardized methods and electronic (oscillometric) upper arm devices in individuals with hypertension, and either ambulatory blood pressure monitoring or home blood pressure monitoring in individuals with white coat effect. We specify that all individuals with hypertension should have an assessment of global cardiovascular risk to promote health behaviours that lower blood pressure. Finally, an angiotensin receptor-neprilysin inhibitor combination should be used in place of either an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in individuals with heart failure (with ejection fraction < 40%) who are symptomatic despite appropriate doses of guideline-directed heart failure therapies. The specific evidence and rationale underlying each of these guidelines are discussed.

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Thirty-two series of bone marrow scans were performed on 29 patients. The scans were made with three colloid preparations, the most satisfactory of which has been colloidal Au198. Distinct pictures exhibiting the distribution of hematopoietic marrow have been obtained with the ORNL Research Scanner. Local lesions within the marrow organ has been demonstrated and confirmed by histologic studies. Variations in the size and distribution of the marrow organ have been shown in a graphic fashion which have hitherto been impossible. The doses of Au198 required, although rather large, do not produce any detectable early radiation effects. The possibility of harmful effects years after administration limits the present method to selected patients. Bone marrow scanning using the procedure reported here can be of considerable assistance to the investigator, and with improvements anticipated in the technic, it may find its place as a practical clinical procedure.