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Updates to the Guidelines for the Management of High Blood Pressure and the Guidelines for the Management of Dyslipidemia have been recently published in the eighth report of the Joint National Committee. Both are evidencebased and rely on clinical trial results, leaving aside, when possible, recommendations made by experts. Both have introduced important methodological changes in the form of cataloging and summarizing the evidence used. The High Blood Pressure Guideline is considered to be a reliable guide; it has simplified recommendations and is easy to implement. A potentially interesting change in the Dyslipidemia Guideline is the abandonment of the numerical therapeutic target in order to use the modification of the level of risk, which could promote a discussion about the intensity of treatment, and initiate shared decision-making. [ABSTRACT FROM AUTHOR]

A 55-year-old man with a two weeks history of lethargy, weakness, hyporexia and headache. Laboratory tests showed anemia, severe hyponatremia, elevated creatine kinase and transaminasas levels, elevated TSH and very low levels ofT4 and T3. Diagnosis of myxedema coma was established and treatment was begun with oral levothyroxine, IV corticosteroids and hypertonic saline. Because of worsening clinical status a centrat venous catheter was placed without complications with IV midazolam as sedative. Patient developed respiratory insufficiency, decreased mental status and died. Metabolism of midazolam is impaired, and its use can cause respiratory insufficiency in the setting of hypoventilation associated with hypothyroidism. [ABSTRACT FROM AUTHOR]