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The 2005 Canadian Hypertension Education Program recommendations for the management of hypertension: part II - therapy.

https://arctichealth.org/en/permalink/ahliterature173954
Source
Can J Cardiol. 2005 Jun;21(8):657-72
Publication Type
Article
Date
Jun-2005
Author
Nadia A Khan
Finlay A McAlister
Richard Z Lewanczuk
Rhian M Touyz
Raj Padwal
Simon W Rabkin
Lawrence A Leiter
Marcel Lebel
Carol Herbert
Ernesto L Schiffrin
Robert J Herman
Pavel Hamet
George Fodor
George Carruthers
Bruce Culleton
Jacques DeChamplain
George Pylypchuk
Alexander G Logan
Norm Gledhill
Robert Petrella
Norman R C Campbell
Malcolm Arnold
Gordon Moe
Micharl D Hill
Charlotte Jones
Pierre Larochelle
Richard I Ogilvie
Sheldon Tobe
Robyn Houlden
Ellen Burgess
Ross D Feldman
Author Affiliation
Division of General Internal Medicine, University of British Columbia, Vancouver, Canada.
Source
Can J Cardiol. 2005 Jun;21(8):657-72
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Antihypertensive Agents - therapeutic use
Canada
Diet
Evidence-Based Medicine
Exercise
Humans
Hypertension - therapy
Patient Education as Topic
Weight Loss
Abstract
To provide updated, evidence-based recommendations for the management of hypertension in adults.
For lifestyle and pharmacological interventions, evidence from randomized controlled trials and systematic reviews of trials was preferentially reviewed. While changes in cardiovascular morbidity and mortality were the primary outcomes of interest, for lifestyle interventions, blood pressure lowering was accepted as a primary outcome given the lack of long-term morbidity/mortality data in this field, and for certain comorbid conditions, other relevant outcomes, such as development of proteinuria or worsening of kidney function, were considered.
MEDLINE searches were conducted from November 2003 to October 2004 to update the 2004 recommendations. Reference lists were scanned, experts were contacted, and the personal files of the subgroup members and authors were used to identify additional published studies. All relevant articles were reviewed and appraised independently, using prespecified levels of evidence, by content and methodology experts. As per previous years, only studies that had been published in the peer-reviewed literature were included; evidence from abstracts, conference presentations and unpublished personal communications was not included.
Lifestyle modifications to prevent and/or treat hypertension include the following: perform 30 min to 60 min of aerobic exercise on four to seven days of the week; maintain a healthy body weight (body mass index of 18.5 kg/m2 to 24.9 kg/m2) and waist circumference (less than 102 cm for men and less than 88 cm for women); limit alcohol consumption to no more than 14 units per week in men or nine units per week in women; follow a reduced fat, low cholesterol diet with an adequate intake of potassium, magnesium and calcium; restrict salt intake; and consider stress management (in selected individuals). Treatment thresholds and targets should take into account each individual's global atherosclerotic risk, target organ damage and any comorbid conditions. Blood pressure should be lowered to 140/90 mmHg or less in all patients, and to 130/80 mmHg or less in those with diabetes mellitus or chronic kidney disease. Most adults with hypertension require more than one agent to achieve target blood pressures. For adults without compelling indications for other agents, initial therapy should include thiazide diuretics. Other agents appropriate for first-line therapy for diastolic hypertension with or without systolic hypertension include beta-blockers (in those younger than 60 years), angiotensin-converting enzyme (ACE) inhibitors (except in black patients), long-acting calcium channel blockers and angiotensin receptor antagonists. Other agents appropriate for first-line therapy for isolated systolic hypertension include long-acting dihydropyridine calcium channel blockers and angiotensin receptor antagonists. Certain comorbid conditions provide compelling indications for first-line use of other agents: in patients with angina, recent myocardial infarction or heart failure, beta-blockers and ACE inhibitors are recommended as first-line therapy; in patients with diabetes mellitus, ACE inhibitors or angiotensin receptor antagonists (or thiazides in patients with diabetes mellitus without albuminuria) are appropriate first-line therapies; and in patients with nondiabetic chronic kidney disease, ACE inhibitors are recommended. All hypertensive patients should have their fasting lipids screened, and those with dyslipidemia should be treated using the thresholds, targets and agents recommended by the Canadian Hypertension Education Program Working Group on the management of dyslipidemia and the prevention of cardiovascular disease. Selected patients with hypertension, but without dyslipidemia, should also receive statin therapy and/or acetylsalicylic acid therapy.
All recommendations were graded according to the strength of the evidence and voted on by the 43 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here achieved at least 95% consensus. These guidelines will continue to be updated annually.
PubMed ID
16003449 View in PubMed
Less detail

The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part II - Therapy.

https://arctichealth.org/en/permalink/ahliterature168976
Source
Can J Cardiol. 2006 May 15;22(7):583-93
Publication Type
Article
Date
May-15-2006
Author
N A Khan
Finlay A McAlister
Simon W Rabkin
Raj Padwal
Ross D Feldman
Norman Rc Campbell
Lawrence A Leiter
Richard Z Lewanczuk
Ernesto L Schiffrin
Michael D Hill
Malcolm Arnold
Gordon Moe
Tavis S Campbell
Carol Herbert
Alain Milot
James A Stone
Ellen Burgess
B. Hemmelgarn
Charlotte Jones
Pierre Larochelle
Richard I Ogilvie
Robyn Houlden
Robert J Herman
Pavel Hamet
George Fodor
George Carruthers
Bruce Culleton
Jacques Dechamplain
George Pylypchuk
Alexander G Logan
Norm Gledhill
Robert Petrella
Sheldon Tobe
Rhian M Touyz
Author Affiliation
Division of General Internal Medicine, University of British Columbia, Vancouver, BC, Canada.
Source
Can J Cardiol. 2006 May 15;22(7):583-93
Date
May-15-2006
Language
English
Publication Type
Article
Keywords
Advisory Committees
Alcohol Drinking
Antihypertensive Agents - therapeutic use
Calcium, Dietary - administration & dosage
Canada
Cerebrovascular Disorders - therapy
Diabetes Mellitus - therapy
Diet
Exercise
Humans
Hypertension - therapy
Hypertrophy, Left Ventricular - therapy
Kidney Diseases - therapy
Life Style
Magnesium - administration & dosage
Myocardial Ischemia - therapy
Patient compliance
Potassium, Dietary - administration & dosage
Sodium, Dietary - administration & dosage
Stress, Psychological - prevention & control
Weight Loss
Abstract
To provide updated, evidence-based recommendations for the management of hypertension in adults.
For lifestyle and pharmacological interventions, evidence from randomized, controlled trials and systematic reviews of trials was preferentially reviewed. Changes in cardiovascular morbidity and mortality were the primary outcomes of interest. For lifestyle interventions, blood pressure (BP) lowering was accepted as a primary outcome given the lack of long-term morbidity/mortality data in this field. For treatment of patients with kidney disease, the development of proteinuria or worsening of kidney function was also accepted as a clinically relevant primary outcome.
MEDLINE searches were conducted from November 2004 to October 2005 to update the 2005 recommendations. In addition, reference lists were scanned and experts were contacted to identify additional published studies. All relevant articles were reviewed and appraised independently by content and methodological experts using prespecified levels of evidence.
Lifestyle modifications to prevent and/or treat hypertension include the following: perform 30 min to 60 min of aerobic exercise four to seven days per week; maintain a healthy body weight (body mass index of 18.5 kg/m2 to 24.9 kg/m2) and waist circumference (less than 102 cm for men and less than 88 cm for women); limit alcohol consumption to no more than 14 standard drinks per week in men or nine standard drinks per week in women; follow a diet that is reduced in saturated fat and cholesterol and that emphasizes fruits, vegetables and low-fat dairy products; restrict salt intake; and consider stress management in selected individuals. Treatment thresholds and targets should take into account each individual's global atherosclerotic risk, target organ damage and comorbid conditions. BP should be lowered to less than 140/90 mmHg in all patients, and to less than 130/80 mmHg in those with diabetes mellitus or chronic kidney disease (regardless of the degree of proteinuria). Most adults with hypertension require more than one agent to achieve these target BPs. For adults without compelling indications for other agents, initial therapy should include thiazide diuretics. Other agents appropriate for first-line therapy for diastolic hypertension with or without systolic hypertension include beta-blockers (in those younger than 60 years), angiotensin-converting enzyme (ACE) inhibitors (in nonblack patients), long-acting calcium channel blockers or angiotensin receptor antagonists. Other agents for first-line therapy for isolated systolic hypertension include long-acting dihydropyridine calcium channel blockers or angiotensin receptor antagonists. Certain comorbid conditions provide compelling indications for first-line use of other agents: in patients with angina, recent myocardial infarction or heart failure, beta-blockers and ACE inhibitors are recommended as first-line therapy; in patients with diabetes mellitus, ACE inhibitors or angiotensin receptor antagonists (or in patients without albuminuria, thiazides or dihydropyridine calcium channel blockers) are appropriate first-line therapies; and in patients with nondiabetic chronic kidney disease, ACE inhibitors are recommended. All hypertensive patients should have their fasting lipids screened, and those with dyslipidemia should be treated using the thresholds, targets and agents recommended by the Canadian Hypertension Education Program Working Group on the management of dyslipidemia and the prevention of cardiovascular disease. Selected patients with hypertension, but without dyslipidemia, should also receive statin therapy and/or acetylsalicylic acid therapy.
All recommendations were graded according to strength of the evidence and voted on by the 45 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here achieved at least 95% consensus. These guidelines will continue to be updated annually.
Notes
Cites: N Engl J Med. 2000 Jan 20;342(3):145-5310639539
Cites: Lancet. 2006 Jan 21;367(9506):209; author reply 21016427487
Cites: Can J Cardiol. 2000 Sep;16(9):1094-10211021953
Cites: Can J Cardiol. 2001 May;17(5):543-5911381277
Cites: Am J Med. 2001 Nov;111(7):553-811705432
Cites: N Engl J Med. 2002 Feb 7;346(6):393-40311832527
Cites: Can J Cardiol. 2002 Jun;18(6):625-4112107420
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Cites: J Hypertens. 2003 Jun;21(6):1055-7612777939
Cites: J Am Soc Nephrol. 2003 Jul;14(7 Suppl 2):S99-S10212819311
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Cites: Can J Cardiol. 2005 Jun;21(8):657-7216003449
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Cites: Pharmacotherapy. 2000 Apr;20(4):410-610772372
PubMed ID
16755313 View in PubMed
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The 2007 Canadian Hypertension Education Program recommendations for the management of hypertension: part 2 - therapy.

https://arctichealth.org/en/permalink/ahliterature163300
Source
Can J Cardiol. 2007 May 15;23(7):539-50
Publication Type
Conference/Meeting Material
Article
Date
May-15-2007
Author
Nadia A Khan
Brenda Hemmelgarn
Raj Padwal
Pierre Larochelle
Jeff L Mahon
Richard Z Lewanczuk
Finlay A McAlister
Simon W Rabkin
Michael D Hill
Ross D Feldman
Ernesto L Schiffrin
Norman R C Campbell
Alexander G Logan
Malcolm Arnold
Gordon Moe
Tavis S Campbell
Alain Milot
James A Stone
Charlotte Jones
Lawrence A Leiter
Richard I Ogilvie
Robert J Herman
Pavel Hamet
George Fodor
George Carruthers
Bruce Culleton
Kevin D Burns
Marcel Ruzicka
Jacques deChamplain
George Pylypchuk
Norm Gledhill
Robert Petrella
Jean-Martin Boulanger
Luc Trudeau
Robert A Hegele
Vincent Woo
Phil McFarlane
Rhian M Touyz
Sheldon W Tobe
Author Affiliation
Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia. nakhan@shaw.ca
Source
Can J Cardiol. 2007 May 15;23(7):539-50
Date
May-15-2007
Language
English
Publication Type
Conference/Meeting Material
Article
Keywords
Antihypertensive Agents - therapeutic use
Canada
Diet, Sodium-Restricted
Health promotion
Humans
Hypertension - drug therapy - prevention & control - therapy
Patient Education as Topic
Randomized Controlled Trials as Topic
Risk Reduction Behavior
Abstract
To provide updated, evidence-based recommendations for the prevention and management of hypertension in adults.
For lifestyle and pharmacological interventions, evidence was reviewed from randomized controlled trials and systematic reviews of trials. Changes in cardiovascular morbidity and mortality were the primary outcomes of interest. However, for lifestyle interventions, blood pressure lowering was accepted as a primary outcome given the lack of long-term morbidity and mortality data in this field. For treatment of patients with kidney disease, the progression of kidney dysfunction was also accepted as a clinically relevant primary outcome.
A Cochrane collaboration librarian conducted an independent MEDLINE search from 2005 to August 2006 to update the 2006 Canadian Hypertension Education Program recommendations. In addition, reference lists were scanned and experts were contacted to identify additional published studies. All relevant articles were reviewed and appraised independently by both content and methodological experts using prespecified levels of evidence.
Dietary lifestyle modifications for prevention of hypertension, in addition to a well-balanced diet, include a dietary sodium intake of less than 100 mmol/day. In hypertensive patients, the dietary sodium intake should be limited to 65 mmol/day to 100 mmol/day. Other lifestyle modifications for both normotensive and hypertensive patients include: performing 30 min to 60 min of aerobic exercise four to seven days per week; maintaining a healthy body weight (body mass index of 18.5 kg/m2 to 24.9 kg/m2) and waist circumference (less than 102 cm in men and less than 88 cm in women); limiting alcohol consumption to no more than 14 units per week in men or nine units per week in women; following a diet reduced in saturated fat and cholesterol, and one that emphasizes fruits, vegetables and low-fat dairy products, dietary and soluble fibre, whole grains and protein from plant sources; and considering stress management in selected individuals with hypertension. For the pharmacological management of hypertension, treatment thresholds and targets should take into account each individual's global atherosclerotic risk, target organ damage and any comorbid conditions: blood pressure should be lowered to lower than 140/90 mmHg in all patients and lower than 130/80 mmHg in those with diabetes mellitus or chronic kidney disease. Most patients require more than one agent to achieve these blood pressure targets. In adults without compelling indications for other agents, initial therapy should include thiazide diuretics; other agents appropriate for first-line therapy for diastolic and/or systolic hypertension include angiotensin-converting enzyme (ACE) inhibitors (except in black patients), long-acting calcium channel blockers (CCBs), angiotensin receptor blockers (ARBs) or beta-blockers (in those younger than 60 years of age). First-line therapy for isolated systolic hypertension includes long-acting dihydropyridine CCBs or ARBs. Certain comorbid conditions provide compelling indications for first-line use of other agents: in patients with angina, recent myocardial infarction, or heart failure, beta-blockers and ACE inhibitors are recommended as first-line therapy; in patients with cerebrovascular disease, an ACE inhibitor plus diuretic combination is preferred; in patients with nondiabetic chronic kidney disease, ACE inhibitors are recommended; and in patients with diabetes mellitus, ACE inhibitors or ARBs (or, in patients without albuminuria, thiazides or dihydropyridine CCBs) are appropriate first-line therapies. All hypertensive patients with dyslipidemia should be treated using the thresholds, targets and agents outlined in the Canadian Cardiovascular Society position statement (recommendations for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease). Selected high-risk patients with hypertension who do not achieve thresholds for statin therapy according to the position paper should nonetheless receive statin therapy. Once blood pressure is controlled, acetylsalicylic acid therapy should be considered.
All recommendations were graded according to strength of the evidence and voted on by the 57 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here achieved at least 95% consensus. These guidelines will continue to be updated annually.
Notes
Cites: Arch Intern Med. 2000 Mar 13;160(5):685-9310724055
Cites: JAMA. 2003 Apr 23-30;289(16):2083-9312709466
Cites: N Engl J Med. 2001 Jan 4;344(1):3-1011136953
Cites: Can J Cardiol. 2001 May;17(5):543-5911381277
Cites: Ann Intern Med. 2001 Jul 17;135(2):73-8711453706
Cites: Lancet. 2004 Sep 11-17;364(9438):937-5215364185
Cites: Kidney Int Suppl. 2004 Nov;(92):S90-615485427
Cites: Hypertension. 2004 Nov;44(5):637-4215381674
Cites: Lancet. 1990 Mar 31;335(8692):765-741969518
Cites: Hypertension. 1991 Jan;17(1 Suppl):I16-201986996
Cites: JAMA. 2003 May 21;289(19):2534-4412759325
Cites: Am J Cardiol. 2003 Jun 1;91(11):1316-2212767423
Cites: J Hypertens. 2003 Jun;21(6):1055-7612777939
Cites: J Am Soc Nephrol. 2003 Jul;14(7 Suppl 2):S99-S10212819311
Cites: Can J Cardiol. 2004 Jan;20(1):41-5414968142
Cites: Can J Cardiol. 2004 Jan;20(1):55-914968143
Cites: Arch Intern Med. 2004 May 24;164(10):1084-9115159265
Cites: Lancet. 2004 Jun 19;363(9426):2022-3115207952
Cites: Cochrane Database Syst Rev. 2004;(3):CD00493715266549
Cites: Diabetes Care. 1993 Jul;16(7):996-10038359108
Cites: Diabetes Care. 1996 Jan;19(1):79-898720542
Cites: Diabetes Care. 1999 Feb;22(2):307-1310333950
Cites: Ann Intern Med. 2005 Jul 5;143(1):1-915998749
Cites: Can J Cardiol. 2005 Jun;21(8):657-7216003449
Cites: J Hypertens. 2005 Dec;23(12):2157-7216269957
Cites: JAMA. 2005 Nov 16;294(19):2455-6416287956
Cites: J Hum Hypertens. 2005 Dec;19 Suppl 3:S10-916302005
Cites: J Am Coll Cardiol. 2006 Jan 3;47(1):65-7116386666
Cites: Hypertension. 2006 Feb;47(2):296-30816434724
Cites: Am J Clin Nutr. 2006 Feb;83(2):221-616469978
Cites: Can J Cardiol. 2006 May 15;22(7):583-9316755313
Cites: Am J Clin Nutr. 2006 Jun;83(6):1289-9616762939
Cites: Ann Intern Med. 2006 Jun 20;144(12):884-9316785477
Cites: Am J Med. 2001 Nov;111(7):553-811705432
Cites: N Engl J Med. 2002 Feb 7;346(6):393-40311832527
Cites: Lancet. 2002 Mar 23;359(9311):1004-1011937179
Cites: Can J Cardiol. 2002 Jun;18(6):625-4112107420
Cites: Lancet. 2003 Jan 11;361(9352):117-2412531578
Cites: Lancet. 2003 Mar 1;361(9359):717-2512620735
Cites: Lancet. 2003 Apr 5;361(9364):1149-5812686036
Comment In: Can J Cardiol. 2007 May 15;23(7):603-417593584
PubMed ID
17534460 View in PubMed
Less detail

The 2009 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 2--therapy.

https://arctichealth.org/en/permalink/ahliterature151164
Source
Can J Cardiol. 2009 May;25(5):287-98
Publication Type
Article
Date
May-2009
Author
Nadia A Khan
Brenda Hemmelgarn
Robert J Herman
Chaim M Bell
Jeff L Mahon
Lawrence A Leiter
Simon W Rabkin
Michael D Hill
Raj Padwal
Rhian M Touyz
Pierre Larochelle
Ross D Feldman
Ernesto L Schiffrin
Norman R C Campbell
Gordon Moe
Ramesh Prasad
Malcolm O Arnold
Tavis S Campbell
Alain Milot
James A Stone
Charlotte Jones
Richard I Ogilvie
Pavel Hamet
George Fodor
George Carruthers
Kevin D Burns
Marcel Ruzicka
Jacques DeChamplain
George Pylypchuk
Robert Petrella
Jean-Martin Boulanger
Luc Trudeau
Robert A Hegele
Vincent Woo
Phil McFarlane
Michel Vallée
Jonathan Howlett
Simon L Bacon
Patrice Lindsay
Richard E Gilbert
Richard Z Lewanczuk
Sheldon Tobe
Author Affiliation
Division of General Internal Medicine, University of British Columbia, Vancouver, Canada. nakhan@shaw.ca
Source
Can J Cardiol. 2009 May;25(5):287-98
Date
May-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - therapeutic use
Blood Pressure Determination - standards
Canada
Case Management - standards
Combined Modality Therapy
Diet, Sodium-Restricted
Female
Health Promotion - organization & administration
Humans
Hypertension - diagnosis - therapy
Life Style
Male
Middle Aged
Patient Education as Topic
Prognosis
Program Evaluation
Randomized Controlled Trials as Topic
Treatment Outcome
Abstract
To update the evidence-based recommendations for the prevention and management of hypertension in adults for 2009.
For lifestyle and pharmacological interventions, evidence from randomized controlled trials and systematic reviews of trials was preferentially reviewed. Changes in cardiovascular morbidity and mortality were the primary outcomes of interest. However, for lifestyle interventions, blood pressure lowering was accepted as a primary outcome given the lack of long-term morbidity and mortality data in this field. Progression of kidney dysfunction was also accepted as a clinically relevant primary outcome among patients with chronic kidney disease.
A Cochrane collaboration librarian conducted an independent MEDLINE search from 2007 to August 2008 to update the 2008 recommendations. To identify additional published studies, reference lists were reviewed and experts were contacted. All relevant articles were reviewed and appraised independently by both content and methodological experts using prespecified levels of evidence.
For lifestyle modifications to prevent and treat hypertension, restrict dietary sodium to less than 2300 mg (100 mmol)/day (and 1500 mg to 2300 mg [65 mmol to 100 mmol]/day in hypertensive patients); perform 30 min to 60 min of aerobic exercise four to seven days per week; maintain a healthy body weight (body mass index 18.5 kg/m(2) to 24.9 kg/m(2)) and waist circumference (smaller than 102 cm for men and smaller than 88 cm for women); limit alcohol consumption to no more than 14 units per week in men or nine units per week in women; follow a diet that is reduced in saturated fat and cholesterol, and that emphasizes fruits, vegetables and low-fat dairy products, dietary and soluble fibre, whole grains and protein from plant sources; and consider stress management in selected individuals with hypertension. For the pharmacological management of hypertension, treatment thresholds and targets should be predicated on by the patient's global atherosclerotic risk, target organ damage and comorbid conditions. Blood pressure should be decreased to lower than 140/90 mmHg in all patients, and to lower than 130/80 mmHg in those with diabetes mellitus or chronic kidney disease. Most patients will require more than one agent to achieve these target blood pressures. Antihypertensive therapy should be considered in all adult patients regardless of age (caution should be exercised in elderly patients who are frail). For adults without compelling indications for other agents, initial therapy should include thiazide diuretics. Other agents appropriate for first-line therapy for diastolic and/or systolic hypertension include angiotensin- converting enzyme (ACE) inhibitors (in patients who are not black), long-acting calcium channel blockers (CCBs), angiotensin receptor antagonists (ARBs) or beta-blockers (in those younger than 60 years of age). A combination of two first-line agents may also be considered as the initial treatment of hypertension if the systolic blood pressure is 20 mmHg above the target or if the diastolic blood pressure is 10 mmHg above the target. The combination of ACE inhibitors and ARBs should not be used. Other agents appropriate for first-line therapy for isolated systolic hypertension include long- acting dihydropyridine CCBs or ARBs. In patients with angina, recent myocardial infarction or heart failure, beta-blockers and ACE inhibitors are recommended as first-line therapy; in patients with cerebrovascular disease, an ACE inhibitor/diuretic combination is preferred; in patients with proteinuric nondiabetic chronic kidney disease, ACE inhibitors or ARBs (if intolerant to ACE inhibitors) are recommended; and in patients with diabetes mellitus, ACE inhibitors or ARBs (or, in patients without albuminuria, thiazides or dihydropyridine CCBs) are appropriate first-line therapies. All hypertensive patients with dyslipidemia should be treated using the thresholds, targets and agents outlined in the Canadian Cardiovascular Society position statement (recommendations for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease). Selected high-risk patients with hypertension who do not achieve thresholds for statin therapy according to the position paper should nonetheless receive statin therapy. Once blood pressure is controlled, acetylsalicylic acid therapy should be considered.
All recommendations were graded according to strength of the evidence and voted on by the 57 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here achieved at least 95% consensus. These guidelines will continue to be updated annually.
Notes
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Cites: Lancet. 2000 Dec 9;356(9246):1955-6411130523
PubMed ID
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