Category: Clinical Skills

Dysmenorrhea is estimated to effect upwards of 70% of women during their lifetime and “heavy menstrual periods” is one of the most frequently given reasons for hysterectomy in the United States.  Despite the dramatic growth of dysmenorrhea treatment  with non-steroidal anti-inflammatory agents (NSADs) in the 1980s, young women continue to go undiagnosed and under treated. The diagnosis and management of heavy menstrual bleeding has even poorer general understanding because of its more complicated etiologies. With a working knowledge of the underlying pathophysiology, all clinicians should be able to establish both the diagnosis and a credible treatment plan that will result in a significant chance of clinical improvement for most patients.

Roger P. Smith, MD is Assistant Dean of Graduate Medical Education, Faculty and Academic Affairs, and Professor of Integrated Medical Science at Charles E. Schmidt College of Medicine at Florida Atlantic University. He has published widely in obstetrics and gynecology and is editor of Netter’s Obstetrics and Gynecology, 3e (Elsevier, 2017), a major textbook in ob/gyn.

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This guide is structured to assist physicians in the management of those hypertensive patients who present with specific comorbidities, such as diabetes, systolic dysfunction, obesity, renal disease, or previous cardiac events, often associated with hypertension. The clinical cases contained in this book have been selected to provide a paradigmatic set of scenarios frequently encountered in daily clinical practice, and will serve as an easy-to-access tool in applying general guidelines to individual patients, particularly in the choice of the most appropriate antihypertensive therapy. Treatment of hypertension with associated clinical conditions require specific therapies and combinations of drugs, which are necessarily different from one comorbidity to another. By discussing exemplary cases that may better represent clinical practice in a “real world” setting, and analyzing step by step the diagnostic and therapeutic process, this book will assist cardiologists and physicians in selecting the diagnostic tools and forms of treatment best suited to the individual patient and the particular cardiovascular risk profile.

Prof. Agostino Virdis is Associate Professor of Internal Medicine, Department of Clinical and Experimental Medicine, University of Pisa, Italy. After graduation in 1990 in Pisa, he specialized in Clinical Pharmacology and Internal Medicine. Afterwards, he worked as fellow in the Multidisciplinary Research Group on Hypertension, (Director: Dr. E.L. Schiffrin) in the Clinical Research Institute at the University of Montreal, Quebec, Canada. He’s been appointed “Clinical Hypertension Specialist” from the European Society of Hypertension (ESH). His major research interests focus on neuro-humoral control of peripheral vessels in primary and secondary forms of hypertension, and in other cardiovascular risk factors, including obesity and diabetes mellitus. Particular emphasis is given to the study of mechanisms accounting for vascular disease (including endothelial dysfunction and structural alterations in peripheral microcirculation associated with hypertension and other cardiovascular risk factors) both in humans and in animal models of disease, and to the impact of pharmacological therapy on vascular disease.

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