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2010 Canadian Hypertension Education Program (CHEP) recommendations: the scientific summary - an update of the 2010 theme and the science behind new CHEP recommendations.

https://arctichealth.org/en/permalink/ahliterature143446
Source
Can J Cardiol. 2010 May;26(5):236-40
Publication Type
Article
Date
May-2010
Author
Norman R C Campbell
Janusz Kaczorowski
Richard Z Lewanczuk
Ross Feldman
Luc Poirier
Margaret Moy Kwong
Marcel Lebel
Finlay A McAlister
Sheldon W Tobe
Author Affiliation
Department of Medicine, University of Calgary, Alberta. ncampbel@ucalgary.ca
Source
Can J Cardiol. 2010 May;26(5):236-40
Date
May-2010
Language
English
Publication Type
Article
Keywords
Antihypertensive Agents - administration & dosage
Canada
Diet, Sodium-Restricted
Female
Health promotion
Humans
Hypertension - prevention & control - therapy
Life Style
Male
Patient Education as Topic
Practice Guidelines as Topic
Randomized Controlled Trials as Topic
Risk Reduction Behavior
Abstract
The present article is a summary of the theme, the key recommendations for management of hypertension and the supporting clinical evidence of the 2010 Canadian Hypertension Education Program (CHEP). In 2010, CHEP emphasizes the need for health care professionals to stay informed about hypertension through automated updates at www.htnupdate.ca. A new interactive Internet-based lecture series will be available in 2010 and a program to train community hypertension leaders will be expanded. Patients can also sign up to receive regular updates in a pilot program at www.myBPsite.ca. In 2010, the new recommendations include consideration for using automated office blood pressure monitors, new targets for dietary sodium for the prevention and treatment of hypertension that are aligned with the national adequate intake values, and recommendations for considering treatment of selected hypertensive patients at high risk with calcium channel blocker/angiotensin-converting enzyme inhibitor combinations and the use of angiotensin receptor blockers.
Notes
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PubMed ID
20485687 View in PubMed
Less detail

The 2010 Canadian Hypertension Education Program recommendations for the management of hypertension: part 2 - therapy.

https://arctichealth.org/en/permalink/ahliterature143444
Source
Can J Cardiol. 2010 May;26(5):249-58
Publication Type
Article
Date
May-2010
Author
Daniel G Hackam
Nadia A Khan
Brenda R Hemmelgarn
Simon W Rabkin
Rhian M Touyz
Norman R C Campbell
Raj Padwal
Tavis S Campbell
M Patrice Lindsay
Michael D Hill
Robert R Quinn
Jeff L Mahon
Robert J Herman
Ernesto L Schiffrin
Marcel Ruzicka
Pierre Larochelle
Ross D Feldman
Marcel Lebel
Luc Poirier
J Malcolm O Arnold
Gordon W Moe
Jonathan G Howlett
Luc Trudeau
Simon L Bacon
Robert J Petrella
Alain Milot
James A Stone
Denis Drouin
Jean-Martin Boulanger
Mukul Sharma
Pavel Hamet
George Fodor
George K Dresser
S George Carruthers
George Pylypchuk
Ellen D Burgess
Kevin D Burns
Michel Vallée
G V Ramesh Prasad
Richard E Gilbert
Lawrence A Leiter
Charlotte Jones
Richard I Ogilvie
Vincent Woo
Philip A McFarlane
Robert A Hegele
Sheldon W Tobe
Author Affiliation
Department of Medicine and Epidemiology, Division of Clinical Pharmacology and Clinical Neurological Sciences, University of Western Ontario, London, Ontario. dhackam@uwo.ca
Source
Can J Cardiol. 2010 May;26(5):249-58
Date
May-2010
Language
English
Publication Type
Article
Keywords
Adult
Antihypertensive Agents - therapeutic use
Canada
Cardiovascular Diseases - prevention & control
Combined Modality Therapy
Diet, Sodium-Restricted
Evidence-Based Medicine
Female
Humans
Hypertension - diagnosis - prevention & control - therapy
Life Style
Male
Middle Aged
Patient Education as Topic
Practice Guidelines as Topic
Primary Prevention - standards
Prognosis
Risk assessment
Abstract
To update the evidence-based recommendations for the prevention and treatment of hypertension in adults for 2010.
For lifestyle and pharmacological interventions, randomized trials and systematic reviews of trials were 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 general lack of long-term morbidity and mortality data in this field. Progressive renal impairment 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 2008 to August 2009 to update the 2009 recommendations. To identify additional 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 1500 mg (65 mmol) per day in adults 50 years of age or younger, to 1300 mg (57 mmol) per day in adults 51 to 70 years of age, and to 1200 mg (52 mmol) per day in adults older than 70 years of age; perform 30 min to 60 min of moderate 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 (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 for men or nine standard drinks per week for women; follow a diet that emphasizes fruits, vegetables and low-fat dairy products, dietary and soluble fibre, whole grains and protein from plant sources, and that is low in saturated fat and cholesterol; and consider stress management in selected individuals with hypertension. For the pharmacological management of hypertension, treatment thresholds and targets should be predicated on the patient's global atherosclerotic risk, target organ damage and comorbid conditions. Blood pressure should be decreased to less than 140/90 mmHg in all patients, and to less than 130/80 mmHg in patients 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, considerations for initial therapy should include thiazide diuretics, angiotensin- converting enzyme (ACE) inhibitors (in patients who are not black), long-acting calcium channel blockers (CCBs), angiotensin receptor blockers (ARBs) or beta-blockers (in those younger than 60 years of age). A combination of two first-line agents may also be considered as initial treatment of hypertension if systolic blood pressure is 20 mmHg above target or if diastolic blood pressure is 10 mmHg above target. The combination of ACE inhibitors and ARBs should not be used, unless compelling indications are present to suggest consideration of dual therapy. Agents appropriate for first-line therapy for isolated systolic hypertension include thiazide diuretics, long-acting dihydropyridine CCBs or ARBs. In patients with coronary artery disease, ACE inhibitors, ARBs or betablockers 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. In selected high-risk patients in whom combination therapy is being considered, an ACE inhibitor plus a long-acting dihydropyridine CCB is preferable to an ACE inhibitor plus a thiazide diuretic. All hypertensive patients with dyslipidemia should be treated using the thresholds, targets and agents outlined in the Canadian lipid treatment guidelines. Selected patients with hypertension who do not achieve thresholds for statin therapy, but who are otherwise at high risk for cardiovascular events, should nonetheless receive statin therapy. Once blood pressure is controlled, low-dose acetylsalicylic acid therapy should be considered.
All recommendations were graded according to the strength of the evidence and voted on by the 63 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here achieved at least 80% consensus. These guidelines will continue to be updated annually.
The Canadian Hypertension Education Program process is sponsored by the Canadian Hypertension Society, Blood Pressure Canada, the Public Health Agency of Canada, the College of Family Physicians of Canada, the Canadian Pharmacists Association, the Canadian Council of Cardiovascular Nurses, and the Heart and Stroke Foundation of Canada.
Notes
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PubMed ID
20485689 View in PubMed
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The 2011 Canadian Hypertension Education Program recommendations for the management of hypertension: blood pressure measurement, diagnosis, assessment of risk, and therapy.

https://arctichealth.org/en/permalink/ahliterature132607
Source
Can J Cardiol. 2011 Jul-Aug;27(4):415-433.e1-2
Publication Type
Article
Author
Doreen M Rabi
Stella S Daskalopoulou
Raj S Padwal
Nadia A Khan
Steven A Grover
Daniel G Hackam
Martin G Myers
Donald W McKay
Robert R Quinn
Brenda R Hemmelgarn
Lyne Cloutier
Peter Bolli
Michael D Hill
Thomas Wilson
Brian Penner
Ellen Burgess
Maxime Lamarre-Cliché
Donna McLean
Ernesto L Schiffrin
George Honos
Karen Mann
Guy Tremblay
Alain Milot
Arun Chockalingam
Simon W Rabkin
Martin Dawes
Rhian M Touyz
Kevin D Burns
Marcel Ruzicka
Norman R C Campbell
Michel Vallée
G V Ramesh Prasad
Marcel Lebel
Tavis S Campbell
M Patrice Lindsay
Robert J Herman
Pierre Larochelle
Ross D Feldman
J Malcolm O Arnold
Gordon W Moe
Jonathan G Howlett
Luc Trudeau
Simon L Bacon
Robert J Petrella
Richard Lewanczuk
James A Stone
Denis Drouin
Jean-Martin Boulanger
Mukul Sharma
Pavel Hamet
George Fodor
George K Dresser
S George Carruthers
George Pylypchuk
Richard E Gilbert
Lawrence A Leiter
Charlotte Jones
Richard I Ogilvie
Vincent Woo
Philip A McFarlane
Robert A Hegele
Luc Poirier
Sheldon W Tobe
Author Affiliation
Department of Medicine, University of Calgary, Calgary, Alberta, Canada. doreen.rabi@albertahealthservices.ca
Source
Can J Cardiol. 2011 Jul-Aug;27(4):415-433.e1-2
Language
English
French
Publication Type
Article
Keywords
Adult
Antihypertensive Agents - therapeutic use
Blood Pressure Determination
Canada
Health education
Humans
Hypertension - diagnosis - drug therapy
Risk assessment
Abstract
We updated the evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in adults for 2011. The major guideline changes this year are: (1) a recommendation was made for using comparative risk analogies when communicating a patient's cardiovascular risk; (2) diagnostic testing issues for renal artery stenosis were discussed; (3) recommendations were added for the management of hypertension during the acute phase of stroke; (4) people with hypertension and diabetes are now considered high risk for cardiovascular events if they have elevated urinary albumin excretion, overt kidney disease, cardiovascular disease, or the presence of other cardiovascular risk factors; (5) the combination of an angiotensin-converting enzyme (ACE) inhibitor and a dihydropyridine calcium channel blocker (CCB) is preferred over the combination of an ACE inhibitor and a thiazide diuretic in persons with diabetes and hypertension; and (6) a recommendation was made to coordinate with pharmacists to improve antihypertensive medication adherence. We also discussed the recent analyses that examined the association between angiotensin II receptor blockers (ARBs) and cancer.
PubMed ID
21801975 View in PubMed
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The 2012 Canadian hypertension education program recommendations for the management of hypertension: blood pressure measurement, diagnosis, assessment of risk, and therapy.

https://arctichealth.org/en/permalink/ahliterature124290
Source
Can J Cardiol. 2012 May;28(3):270-87
Publication Type
Article
Date
May-2012
Author
Stella S Daskalopoulou
Nadia A Khan
Robert R Quinn
Marcel Ruzicka
Donald W McKay
Daniel G Hackam
Simon W Rabkin
Doreen M Rabi
Richard E Gilbert
Raj S Padwal
Martin Dawes
Rhian M Touyz
Tavis S Campbell
Lyne Cloutier
Steven Grover
George Honos
Robert J Herman
Ernesto L Schiffrin
Peter Bolli
Thomas Wilson
Ross D Feldman
M Patrice Lindsay
Brenda R Hemmelgarn
Michael D Hill
Mark Gelfer
Kevin D Burns
Michel Vallée
G V Ramesh Prasad
Marcel Lebel
Donna McLean
J Malcolm O Arnold
Gordon W Moe
Jonathan G Howlett
Jean-Martin Boulanger
Pierre Larochelle
Lawrence A Leiter
Charlotte Jones
Richard I Ogilvie
Vincent Woo
Janusz Kaczorowski
Luc Trudeau
Simon L Bacon
Robert J Petrella
Alain Milot
James A Stone
Denis Drouin
Maxime Lamarre-Cliché
Marshall Godwin
Guy Tremblay
Pavel Hamet
George Fodor
S George Carruthers
George Pylypchuk
Ellen Burgess
Richard Lewanczuk
George K Dresser
Brian Penner
Robert A Hegele
Philip A McFarlane
Mukul Sharma
Norman R C Campbell
Debra Reid
Luc Poirier
Sheldon W Tobe
Author Affiliation
Division of General Internal Medicine, McGill University, Montreal, Québec, Canada. stella.daskalopoulou@mcgill.ca
Source
Can J Cardiol. 2012 May;28(3):270-87
Date
May-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - therapeutic use
Blood Pressure Determination - methods
Canada
Cardiovascular Diseases - etiology - prevention & control
Education, Medical, Continuing - standards
Evidence-Based Medicine - standards
Female
Health Education - standards
Humans
Hypertension - complications - diagnosis - therapy
Male
Middle Aged
Monitoring, Physiologic - methods
Practice Guidelines as Topic - standards
Prognosis
Risk assessment
Treatment Outcome
Abstract
We updated the evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in adults for 2012. The new recommendations are: (1) use of home blood pressure monitoring to confirm a diagnosis of white coat syndrome; (2) mineralocorticoid receptor antagonists may be used in selected patients with hypertension and systolic heart failure; (3) a history of atrial fibrillation in patients with hypertension should not be a factor in deciding to prescribe an angiotensin-receptor blocker for the treatment of hypertension; and (4) the blood pressure target for patients with nondiabetic chronic kidney disease has now been changed to
PubMed ID
22595447 View in PubMed
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The 2013 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension.

https://arctichealth.org/en/permalink/ahliterature115112
Source
Can J Cardiol. 2013 May;29(5):528-42
Publication Type
Article
Date
May-2013
Author
Daniel G Hackam
Robert R Quinn
Pietro Ravani
Doreen M Rabi
Kaberi Dasgupta
Stella S Daskalopoulou
Nadia A Khan
Robert J Herman
Simon L Bacon
Lyne Cloutier
Martin Dawes
Simon W Rabkin
Richard E Gilbert
Marcel Ruzicka
Donald W McKay
Tavis S Campbell
Steven Grover
George Honos
Ernesto L Schiffrin
Peter Bolli
Thomas W Wilson
Ross D Feldman
Patrice Lindsay
Michael D Hill
Mark Gelfer
Kevin D Burns
Michel Vallée
G V Ramesh Prasad
Marcel Lebel
Donna McLean
J Malcolm O Arnold
Gordon W Moe
Jonathan G Howlett
Jean-Martin Boulanger
Pierre Larochelle
Lawrence A Leiter
Charlotte Jones
Richard I Ogilvie
Vincent Woo
Janusz Kaczorowski
Luc Trudeau
Robert J Petrella
Alain Milot
James A Stone
Denis Drouin
Kim L Lavoie
Maxime Lamarre-Cliche
Marshall Godwin
Guy Tremblay
Pavel Hamet
George Fodor
S George Carruthers
George B Pylypchuk
Ellen Burgess
Richard Lewanczuk
George K Dresser
S Brian Penner
Robert A Hegele
Philip A McFarlane
Mukul Sharma
Debra J Reid
Sheldon W Tobe
Luc Poirier
Raj S Padwal
Author Affiliation
Division of Clinical Pharmacology, Department of Medicine, Western University, London, Ontario, Canada. dhackam@uwo.ca
Source
Can J Cardiol. 2013 May;29(5):528-42
Date
May-2013
Language
English
Publication Type
Article
Keywords
Adult
Aging - physiology
Antihypertensive Agents - therapeutic use
Blood Pressure - physiology
Blood Pressure Determination
Canada
Cardiovascular Diseases - prevention & control
Exercise - physiology
Health education
Humans
Hypertension - diagnosis - drug therapy
Risk assessment
Abstract
We updated the evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in adults for 2013. This year's update includes 2 new recommendations. First, among nonhypertensive or stage 1 hypertensive individuals, the use of resistance or weight training exercise does not adversely influence blood pressure (BP) (Grade D). Thus, such patients need not avoid this type of exercise for fear of increasing BP. Second, and separately, for very elderly patients with isolated systolic hypertension (age 80 years or older), the target for systolic BP should be
PubMed ID
23541660 View in PubMed
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The 2014 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension.

https://arctichealth.org/en/permalink/ahliterature104360
Source
Can J Cardiol. 2014 May;30(5):485-501
Publication Type
Article
Date
May-2014
Author
Kaberi Dasgupta
Robert R Quinn
Kelly B Zarnke
Doreen M Rabi
Pietro Ravani
Stella S Daskalopoulou
Simon W Rabkin
Luc Trudeau
Ross D Feldman
Lyne Cloutier
Ally Prebtani
Robert J Herman
Simon L Bacon
Richard E Gilbert
Marcel Ruzicka
Donald W McKay
Tavis S Campbell
Steven Grover
George Honos
Ernesto L Schiffrin
Peter Bolli
Thomas W Wilson
Patrice Lindsay
Michael D Hill
Shelagh B Coutts
Gord Gubitz
Mark Gelfer
Michel Vallée
G V Ramesh Prasad
Marcel Lebel
Donna McLean
J Malcolm O Arnold
Gordon W Moe
Jonathan G Howlett
Jean-Martin Boulanger
Pierre Larochelle
Lawrence A Leiter
Charlotte Jones
Richard I Ogilvie
Vincent Woo
Janusz Kaczorowski
Kevin D Burns
Robert J Petrella
Swapnil Hiremath
Alain Milot
James A Stone
Denis Drouin
Kim L Lavoie
Maxime Lamarre-Cliche
Guy Tremblay
Pavel Hamet
George Fodor
S George Carruthers
George B Pylypchuk
Ellen Burgess
Richard Lewanczuk
George K Dresser
S Brian Penner
Robert A Hegele
Philip A McFarlane
Milan Khara
Andrew Pipe
Paul Oh
Peter Selby
Mukul Sharma
Debra J Reid
Sheldon W Tobe
Raj S Padwal
Luc Poirier
Author Affiliation
Divisions of General Internal Medicine, Clinical Epidemiology and Endocrinology, Department of Medicine, McGill University, McGill University Health Centre, Montreal, Québec, Canada. Electronic address: kaberi.dasgupta@mcgill.ca.
Source
Can J Cardiol. 2014 May;30(5):485-501
Date
May-2014
Language
English
Publication Type
Article
Keywords
Antihypertensive Agents - therapeutic use
Blood pressure
Blood Pressure Determination - standards
Canada
Health Promotion - organization & administration
Humans
Hypertension - diagnosis - drug therapy - prevention & control
Life Style
Patient Education as Topic
Practice Guidelines as Topic
Prognosis
Program Evaluation
Abstract
Herein, updated evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in Canadian adults are detailed. For 2014, 3 existing recommendations were modified and 2 new recommendations were added. The following recommendations were modified: (1) the recommended sodium intake threshold was changed from = 1500 mg (3.75 g of salt) to approximately 2000 mg (5 g of salt) per day; (2) a pharmacotherapy treatment initiation systolic blood pressure threshold of = 160 mm Hg was added in very elderly (age = 80 years) patients who do not have diabetes or target organ damage (systolic blood pressure target in this population remains at
PubMed ID
24786438 View in PubMed
Less detail

Canadian Hypertension Education Program: the science supporting New 2011 CHEP recommendations with an emphasis on health advocacy and knowledge translation.

https://arctichealth.org/en/permalink/ahliterature133965
Source
Can J Cardiol. 2011 Jul-Aug;27(4):407-14
Publication Type
Article
Author
Norman R C Campbell
Luc Poirier
Guy Tremblay
Patrice Lindsay
Deb Reid
Sheldon W Tobe
Author Affiliation
Department of Medicine, Faculty of Medicine, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada. ncampbel@ucalgary.ca
Source
Can J Cardiol. 2011 Jul-Aug;27(4):407-14
Language
English
French
Publication Type
Article
Keywords
Antihypertensive Agents - therapeutic use
Canada
Comorbidity
Health education
Humans
Hypertension - drug therapy
Patient Advocacy
Abstract
This is a summary of the theme, key new recommendations, and supporting science of the 2011 Canadian Hypertension Education Program (CHEP). In 2011, the ACCORD trial challenged current blood pressure treatment targets for people with diabetes. After consideration of multiple factors relating to the ACCORD trial design and its reporting, the current treatment target of
PubMed ID
21641177 View in PubMed
Less detail

Challenges and scientific considerations in hypertension management reflected in the 2012 recommendations of the Canadian Hypertension Education Program.

https://arctichealth.org/en/permalink/ahliterature128364
Source
Open Med. 2012;6(4):e127-33
Publication Type
Article
Date
2012
Author
Sheldon W Tobe
Luc Poirier
Guy Tremblay
Patrice Lindsay
Debra Reid
Norman Rc Campbell
Nadia Khan
Robert R Quinn
Doreen Rabi
Author Affiliation
Division of Nephrology, Faculty of Medicine, Sunnybrook Health Sciences Centre, A240, 2075 Bayview Avenue,Toronto, ON M4N 3M5, Canada. sheldon.tobe@sunnybrook.ca
Source
Open Med. 2012;6(4):e127-33
Date
2012
Language
English
Publication Type
Article
Keywords
Antihypertensive Agents - therapeutic use
Blood Pressure Monitoring, Ambulatory - methods
Canada - epidemiology
Disease Management
Health Education - methods - organization & administration
Health Promotion - methods - statistics & numerical data
Humans
Hypertension - diagnosis - epidemiology - etiology - therapy
Life Style - ethnology
Practice Guidelines as Topic
Prevalence
Randomized Controlled Trials as Topic
Risk Reduction Behavior
Abstract
This article provides the scientific rationale and background information for the Canadian Hypertension Education Program's 2012 recommendations for the management of hypertension. It also summarizes the key new recommendations and the theme for 2012, which is the prevention of hypertension. The full recommendations are available at www.hypertension.ca.
Notes
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Cites: JAMA. 2002 Feb 27;287(8):1003-1011866648
PubMed ID
23687527 View in PubMed
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Contemporary use of ß-blockers: clinical relevance of subclassification.

https://arctichealth.org/en/permalink/ahliterature104593
Source
Can J Cardiol. 2014 May;30(5 Suppl):S9-S15
Publication Type
Article
Date
May-2014
Author
Luc Poirier
Sheldon W Tobe
Author Affiliation
Clinique d'hypertension et département de pharmacie, CHUL, CHU de Québec, Québec, Québec, Canada. Electronic address: luc.poirier@chuq.qc.ca.
Source
Can J Cardiol. 2014 May;30(5 Suppl):S9-S15
Date
May-2014
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - administration & dosage - pharmacology
Age Factors
Angina Pectoris - diagnosis - drug therapy
Antihypertensive Agents - administration & dosage
Canada
Cardiovascular Diseases - diagnosis - drug therapy
Drug Utilization - statistics & numerical data
Female
Heart Failure - diagnosis - drug therapy
Hemodynamics - drug effects
Humans
Hypertension - diagnosis - drug therapy
Male
Middle Aged
Myocardial Infarction - diagnosis - drug therapy
Reproducibility of Results
Risk assessment
Treatment Outcome
Abstract
ß-Adrenergic receptor blockers or ß-blockers represent one of the oldest classes of cardiovascular agents and have been considered a cornerstone therapy for hypertension and heart disease for the past 5 decades. They are advocated as a first-line treatment for uncomplicated essential hypertension in patients younger than 60 years of age as recommended by the Canadian Hypertension Education Program. However, despite the well-established antihypertensive and cardiovascular benefits of ß-blockers, a number of studies argue that they might not have the same clinical advantages of other classes of agents in terms of morbidity/mortality outcomes. This review will focus on the heterogeneity of the pharmacologic characteristics of ß-blockers, and we will discuss the metabolic and hemodynamic differences within the ß-blocker class and try to assess the potential implications of these differences for optimal selection in hypertension.
PubMed ID
24684855 View in PubMed
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Identifying which treated hypertensive patients without known coronary artery disease should be tested for the presence of myocardial ischemia by perfusion imaging.

https://arctichealth.org/en/permalink/ahliterature160091
Source
J Clin Hypertens (Greenwich). 2007 Dec;9(12):921-8
Publication Type
Article
Date
Dec-2007
Author
Yves Lacourcière
Christian Côté
Jean Lefebvre
Luc Poirier
Marcel Dumont
Author Affiliation
Hypertension Unit, Centre Hospitalier de l'Université Laval, Québec, Canada. yves.lacourciere@crchul.ulaval.ca
Source
J Clin Hypertens (Greenwich). 2007 Dec;9(12):921-8
Date
Dec-2007
Language
English
Publication Type
Article
Keywords
Aged
Coronary Artery Disease - epidemiology - etiology - radionuclide imaging
Cross-Sectional Studies
Female
Humans
Hypertension - complications - epidemiology
Male
Mass Screening
Middle Aged
Perfusion
Prevalence
Quebec - epidemiology
Risk factors
Technetium Tc 99m Sestamibi - diagnostic use
Tomography, Emission-Computed
Abstract
Stress dipyridamole technetium-99(m) sestamibi single photon emission computed tomographic imaging was used to study myocardial perfusion in 1116 hypertensive patients without known coronary artery disease (CAD). The test confirmed the presence of CAD in 28.9% of patients. As expected, patients with diabetes mellitus (DM) had a significantly higher prevalence of myocardial perfusion abnormalities (35.9% vs 23.9%; odds ratio, 1.79; 95% confidence interval [CI], 1.38-2.33; P
PubMed ID
18046097 View in PubMed
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