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Background: Hypertension is the most common cardiovascular risk factor that is responsible for complications such as cerebrovascular events, heart failure, acute myocardial infarction, kidney failure, arrhythmias and blindness. About 30% of the adult population older than 20 years is a carrier. 40% of carriers are unaware of suffering from it since its onset is generally asymptomatic. Unfortunately, of those who are already known to be hypertensive, only half take drug treatment and of these, only half achieve control figures (<14/90 mmHg). For several decades it has not been possible to forcefully modify the natural history of this disease despite the advancement of therapeutic drugs. The Mexican Institute of Social Security launches the initiative of the Integrated Care Protocols (PAI) of the main diseases. This protocol shows how the three levels of medical care are concatenated, the role of each of the members of the multidisciplinary team for medical care, including: doctor, nurse, social work, psychologist, nutritionist, among others and, to patient sharing. The main changes in diagnostic criteria, in-office and out-of-office blood pressure measurement, drug therapy (monotherapy, dual therapy and triple therapy) and non-drug therapy, and follow-up are presented. The diagnostic-therapeutic approach using algorithm as well as the diagnostic approach to secondary hypertension and special forms of hypertension such as in pregnancy, hypertensive crisis, hypertension in the elderly, ischemic or nephropathy patients., (© 2022 Revista Medica del Instituto Mexicano del Seguro Social.)

This paper shows the importance of the guideline clinical practice as well as the centers for comprehensive care of pulmonary arterial hypertension. The current treatment of pulmonary arterial hypertension is analyzed according to its severity, stratified through the evaluation of the multiple parameters of risk and its mortality to 1 year. The prognosis of the disease is considered and the place of the combined treatment indicated in sequential manner or from the beginning.

Cancer is a public health problem with an impact on Health Services in Mexico; it is also, one of the leading causes of mortality (mortality rate: 610.6 / 100 000) and is expected to double the total number of new cases by 2035 (GLOBOCAN). The most frequent neoplasms are the malignant tumor of breast, prostate, cervix and uterin, colorectal and pulmonary. The most affected groups are the female, and by age the 65 years and older (INEGI). At the IMSS, the mortality rate for malignant tumors has varied, with a sustained decline since 2010. In the last 15 years there has been a growth of 15% of the Disability Adjusted Life Years; during which the IMSS spent 2% of its current expenditure resources of the Health Insurance and Maternity. The IMSS has a network of medical units capable of attending to the process of prevention, early detection, diagnosis, treatment and rehabilitation of cancer patients. With the commitment of its improvement and to fulfill the National Health Programs, the OncoIMSS Program was created, with a reorganization of the care process with opportunity, quality, optimization of resources, regionalization, strengthening of infrastructure and trained human capital.

This Consenso Nacional de Hipertensión Arterial Sistémica (National Consensus on Systemic Arterial Hypertension) brings together experiences and joint work of 79 specialists who have been in contact with the patient affected by systemic arterial hypertension. All concepts here presented were outlined on the basis of the real world practice of Mexican hypertensive population. The consensus was developed under strict methodological guidelines. The Delphi technique was applied in two rounds for the development of an appropriate statistical analysis of the concepts exposed by all the specialists, who posed key questions, later developed by the panel of experts of the Hospital de Cardiología, and specialists from the Centro Médico Nacional. Several angles of this illness are shown: detection, diagnosis, pathophysiology, classification, treatment and prevention. The evidence analysis was carried out using PRISMA method. More than 600 articles were reviewed, leaving only the most representative in the references. This document concludes with practical and useful recommendations for the three levels of health care of our country.