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Thus it is more validto de?ne the afterload as being the left ventriculartransmural pressure which in this instance is theintracavity pressure minus the intrapleural pres-sure (Fig. Using this out-come data, it is estimated that treating 1000 patients forhypertension for 5 years can prevent 20 cases of dementia.In the Systolic Hypertension in the Elderly (SHEP) trial,hypertensive treatment was associated with a signifi cantreduction in stroke (36%; p = 0.0003) and a 16% reduc-tion in dementia (nonsignificant; SHEP 1991). If there is highclinical suspicion for PAD and the resting ABI isnormal, postexercise ABIs should be obtained

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non-syndromic nature of hearing loss is reviewed with the family and the patientis referred to other specialists as needed.

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