Physical assault at this point, producing massive baroreflex activation can cause dramatic falls in blood pressure and cerebral ischemia. Disease
The carotid sinus often has atherosclerotic plaques because of disturbed hemodynamics (low wall shear stress, flow reversal/recirculation). Since these plaques, if large and unstable, predispose to ischemic strokes and transient ischemic attacks, carotid endarterectomies are frequently done for prophylaxis. The carotid sinus can be oversensitive to manual stimulation, a condition known as carotid sinus hypersensitivity, carotid sinus syndrome or carotid sinus syncope, in which manual stimulation causes large changes in heart rate and/or blood pressure. This classically presents as a patient who has "fainted" (actually a presyncope) on several occasions while shaving, or in some other way coming into contact with their carotid sinus. Carotid sinus syndrome is a temporary loss of consciousness that sometimes accompanies convulsive seizures because of the intensity of the carotid sinus reflex when pressure builds in one or both carotid sinuses. Treatment of resistant hypertension
Stimulation of baroreceptors at the carotid sinus can be used to treat resistant hypertension via activation of the baroreflex. A pacemaker-like device can be implanted to electrically stimulate the receptors chronically, which is found to lower blood pressure by 15–25 mmHg. Massage
Massage of the carotid sinus, carotid sinus massage is used to diagnose carotid sinus syncope and is sometimes useful for differentiating supraventricular tachycardia (SVT) from ventricular tachycardia. Like the valsalva maneuver, it is a treatment for acute SVT.
This statistic has been supported by other studies in the US, with overall global prevalence statistics ranging from 9% to 11%.A UK national epidemiological study (based on DSM-IV screening criteria), reclassified into levels of severity rather than just diagnosis, reported in 2010 that the majority of people show some personality difficulties in one way or another (short of threshold for diagnosis), while the prevalence of the most complex and severe cases (including meeting criteria for multiple diagnoses in different clusters) was estimated at 1.3%. Even low levels of personality symptoms were associated with functional problems, but the most severely in need of services was a much smaller group.Personality disorders (especially Cluster A) are found more commonly among homeless people.There are some sex differences in the frequency of personality disorders which are shown in the table below. : 206  The known prevalence of some personality disorders, especially borderline PD and antisocial PD are affected by diagnostic bias. This is due to many factors including disproportionately high research towards borderline PD and antisocial PD, alongside social and gender stereotypes, and the relationship between diagnosis rates and prevalence rates. Since the removal of depressive PD, self-defeating PD, sadistic PD and passive-aggressive PD from the DSM-5, studies analysing their prevalence and demographics have been limited. History
Diagnostic and Statistical Manual history
Before the 20th century
Personality disorder is a term with a distinctly modern meaning, owing in part to its clinical usage and the institutional character of modern psychiatry.