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The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part I--Blood pressure measurement, diagnosis and assessment of risk.

https://arctichealth.org/en/permalink/ahliterature168977
Source
Can J Cardiol. 2006 May 15;22(7):573-81
Publication Type
Article
Date
May-15-2006
Author
B R Hemmelgarn
Finlay A McAlister
Steven Grover
Martin G Myers
Donald W McKay
Peter Bolli
Carl Abbott
Ernesto L Schiffrin
George Honos
Ellen Burgess
Karen Mann
Thomas Wilson
Brian Penner
Guy Tremblay
Alain Milot
Arun Chockalingam
Rhian M Touyz
Sheldon W Tobe
Author Affiliation
Division of Nephrology, University of Calgary, and Foothills Hospital, 1403 29th Street Northwest, Calgary, Alberta, Canada. brenda.hemmelgarn@calgaryhealthregion.ca
Source
Can J Cardiol. 2006 May 15;22(7):573-81
Date
May-15-2006
Language
English
Publication Type
Article
Keywords
Advisory Committees
Blood Pressure Determination
Canada
Echocardiography
Humans
Hyperaldosteronism - diagnosis
Hypertension - diagnosis
Mass Screening
Patient Education as Topic
Pheochromocytoma - diagnosis
Risk assessment
Risk factors
Abstract
To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with high blood pressure.
For persons in whom a high blood pressure value is recorded, a diagnosis of hypertension is dependent on the appropriate measurement of blood pressure, the level of the blood pressure elevation, the approach used to monitor blood pressure (office, ambulatory or home/self), and the duration of follow-up. In addition, the presence of cardiovascular risk factors and target organ damage should be assessed to determine the urgency, intensity and type of treatment. For persons diagnosed as having hypertension, estimating the overall risk of adverse cardiovascular outcomes requires an assessment for other vascular risk factors and hypertensive target organ damage.
MEDLINE searches were conducted from November 2004 to October 2005 to update the 2005 recommendations. Reference lists were scanned, experts were polled, and the personal files of the authors and subgroup members were used to identify other studies. Identified articles were reviewed and appraised using prespecified levels of evidence by content and methodological experts. As per previous years, the authors only included studies that had been published in the peer-reviewed literature and did not include evidence from abstracts, conference presentations or unpublished personal communications.
The present document contains recommendations for blood pressure measurement, diagnosis of hypertension, and assessment of cardiovascular risk for adults with high blood pressure. These include the accurate measurement of blood pressure, criteria for the diagnosis of hypertension and recommendations for follow-up, assessment of overall cardiovascular risk, routine and optional laboratory testing, assessment for renovascular and endocrine causes, home and ambulatory blood pressure monitoring, and the role of echocardiography for those with hypertension. Key features of the 2006 recommendations include continued emphasis on an expedited diagnosis of hypertension, an in-depth review of the role of global risk assessment in hypertension therapy, and the use of home/self blood pressure monitoring for patients with masked hypertension (subjects with hypertension who have a blood pressure that is normal in clinic but elevated on home/self measurement).
All recommendations were graded according to the strength of the evidence and were voted on by the 45 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported herein received at least 95% consensus. These guidelines will continue to be updated annually.
Notes
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Cites: Can J Cardiol. 2005 Jun;21(8):657-7216003449
Cites: Blood Press Monit. 2002 Dec;7(6):293-30012488648
PubMed ID
16755312 View in PubMed
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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
Cites: Lancet. 2003 Apr 5;361(9364):1149-5812686036
Cites: JAMA. 2003 Apr 23-30;289(16):2083-9312709466
Cites: Arch Intern Med. 2003 May 12;163(9):1069-7512742805
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: Lancet. 2003 Sep 6;362(9386):767-7113678869
Cites: Lancet. 2003 Sep 6;362(9386):782-813678872
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Cites: Congest Heart Fail. 2003 Nov-Dec;9(6):324-3214688505
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Cites: Can J Cardiol. 2004 Jan;20(1):55-914968143
Cites: Int J Cardiol. 2004 Feb;93(2-3):105-1114975535
Cites: Arch Intern Med. 2004 May 24;164(10):1084-9115159265
Cites: Lancet. 2004 Jun 19;363(9426):2022-3115207952
Cites: Am J Hypertens. 1997 Oct;10(10 Pt 1):1097-1029370379
Cites: Lancet. 1998 Oct 24;352(9137):1347-519802273
Cites: N Engl J Med. 2004 Nov 11;351(20):2058-6815531767
Cites: Bull World Health Organ. 2004 Dec;82(12):935-915654408
Cites: Lancet. 2005 Mar 12-18;365(9463):939-4615766995
Cites: Stroke. 2005 Jun;36(6):1218-2615879332
Cites: Arch Intern Med. 2005 Jun 27;165(12):1401-915983290
Cites: Can J Cardiol. 2005 Jun;21(8):657-7216003449
Cites: Lancet. 2005 Sep 10-16;366(9489):895-90616154016
Cites: Lancet. 2005 Oct 29-Nov 4;366(9496):1545-5316257341
Cites: Pharmacotherapy. 2000 Apr;20(4):410-610772372
PubMed ID
16755313 View in PubMed
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AARN applauds Romanow Report. Urges all levels of government to work together to improve health care.

https://arctichealth.org/en/permalink/ahliterature186148
Source
Alta RN. 2003 Jan;59(1):1, 4-5
Publication Type
Article
Date
Jan-2003

Aboriginal/non-Aboriginal relations and sustainable forest management in Canada: the influence of the Royal Commission on Aboriginal Peoples.

https://arctichealth.org/en/permalink/ahliterature147560
Source
J Environ Manage. 2011 Feb;92(2):300-10
Publication Type
Article
Date
Feb-2011
Author
Deborah McGregor
Author Affiliation
Department of Geography and Aboriginal Studies Program, University of Toronto, Room 5063, Sidney Smith Hall (100 St. George Street), Toronto, Ontario M5S3G3, Canada. d.mcgregor@utoronto.ca
Source
J Environ Manage. 2011 Feb;92(2):300-10
Date
Feb-2011
Language
English
Publication Type
Article
Keywords
Advisory Committees
Canada
Conservation of Natural Resources
Forestry - legislation & jurisprudence
Humans
Indians, North American - legislation & jurisprudence
Abstract
This paper provides an overview of the emerging role of Aboriginal people in Sustainable Forest Management (SFM) in Canada over the past decade. The 1996 Royal Commission on Aboriginal Peoples (RCAP) provided guidance and recommendations for improving Aboriginal peoples' position in Canadian society, beginning with strengthening understanding and building relationships between Aboriginal and non-Aboriginal parties. This paper explores the extent to which advances in Aboriginal/non-Aboriginal relationships and Aboriginal forestry have been made as a result of RCAP's call for renewed relationships based on co-existence among nations. Such changes have begun to alter the context in which Aboriginal/non-Aboriginal relationships exist with respect to SFM. While governments themselves have generally not demonstrated the leadership called for by RCAP in taking up these challenges, industry and other partners are demonstrating some improvements. A degree of progress has been achieved in terms of lands and resources, particularly with co-management-type arrangements, but a fundamental re-structuring needed to reflect nation-to-nation relationships has not yet occurred. Other factors related to increasing Aboriginal participation in SFM, such as the recognition of Aboriginal and treaty rights, are also highlighted, along with suggestions for moving Aboriginal peoples' SFM agenda forward in the coming years.
PubMed ID
19889497 View in PubMed
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Activating knowledge for patient safety practices: a Canadian academic-policy partnership.

https://arctichealth.org/en/permalink/ahliterature129005
Source
Worldviews Evid Based Nurs. 2012 Feb;9(1):49-58
Publication Type
Article
Date
Feb-2012
Author
Margaret B Harrison
Wendy Nicklin
Marie Owen
Christina Godfrey
Janice McVeety
Val Angus
Author Affiliation
School of Nursing, Queen's University, Kingston, Ontario, Canada. margaret.b.harrison@queensu.ca
Source
Worldviews Evid Based Nurs. 2012 Feb;9(1):49-58
Date
Feb-2012
Language
English
Publication Type
Article
Keywords
Advisory Committees - organization & administration - standards
Canada
Cooperative Behavior
Delivery of Health Care - organization & administration - standards
Evidence-Based Practice - methods - organization & administration - standards
Health Knowledge, Attitudes, Practice
Humans
Patient Care Team - organization & administration - standards
Quality Assurance, Health Care - methods - organization & administration - standards
Safety Management - methods - organization & administration - standards
State Medicine - organization & administration - standards
Abstract
Over the past decade, the need for healthcare delivery systems to identify and address patient safety issues has been propelled to the forefront. A Canadian survey, for example, demonstrated patient safety to be a major concern of frontline nurses (Nicklin & McVeety 2002). Three crucial patient safety elements, current knowledge, resources, and context of care have been identified by the World Health Organization (WHO 2009). To develop strategies to respond to the scope and mandate of the WHO report within the Canadian context, a pan-Canadian academic-policy partnership has been established.
This newly formed Pan-Canadian Partnership, the Queen's Joanna Briggs Collaboration for Patient Safety (referred throughout as "QJBC" or "the Partnership"), includes the Queen's University School of Nursing, Accreditation Canada, the Canadian Patient Safety Institute (CPSI), the Canadian Institutes of Health Research, and is supported by an active and committed advisory council representing over 10 national organizations representing all sectors of the health continuum, including patients/families advocacy groups, professional associations, and other bodies. This unique partnership is designed to provide timely, focused support from academia to the front line of patient safety. QJBC has adopted an "integrated knowledge translation" approach to identify and respond to patient safety priorities and to ensure active engagement with stakeholders in producing and using available knowledge. Synthesis of evidence and guideline adaptation methodologies are employed to access quantitative and qualitative evidence relevant to pertinent patient safety questions and subsequently, to respond to issues of feasibility, meaningfulness, appropriateness/acceptability, and effectiveness.
This paper describes the conceptual grounding of the Partnership, its proposed methods, and its plan for action. It is hoped that our journey may provide some guidance to others as they develop patient safety models within their own arenas.
PubMed ID
22151727 View in PubMed
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Ageing with telecare: care or coercion in austerity?

https://arctichealth.org/en/permalink/ahliterature256617
Source
Sociol Health Illn. 2013 Jul;35(6):799-812
Publication Type
Article
Date
Jul-2013
Author
Maggie Mort
Celia Roberts
Blanca Callén
Author Affiliation
Department of Sociology, Lancaster University, UK Fundación Española para la Ciencia y la Tecnología, Barcelona, Spain.
Source
Sociol Health Illn. 2013 Jul;35(6):799-812
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Advisory Committees
Aged
Aging - psychology
Coercion
Consumer Participation
Economic Recession
Geriatric Nursing - methods - standards
Health Services Misuse - prevention & control
Humans
Netherlands
Norway
Organizational Innovation
Professional-Patient Relations - ethics
Qualitative Research
Quality of Health Care
Spain
Telemedicine - instrumentation - standards - utilization
Abstract
In recent years images of independence, active ageing and staying at home have come to characterise a successful old age in western societies. 'Telecare' technologies are heavily promoted to assist ageing-in-place and a nexus of demographic ageing, shrinking healthcare and social care budgets and technological ambition has come to promote the 'telehome' as the solution to the problem of the 'age dependency ratio'. Through the adoption of a range of monitoring and telecare devices, it seems that the normative vision of independence will also be achieved. But with falling incomes and pressure for economies of scale, what kind of independence is experienced in the telehome? In this article we engage with the concepts of 'technogenarians' and 'shared work' to illuminate our analysis of telecare in use. Drawing on European-funded research we argue that home-monitoring based telecare has the potential to coerce older people unless we are able to recognise and respect a range of responses including non-use and 'misuse' in daily practice. We propose that re-imagining the aims of telecare and redesigning systems to allow for creative engagement with technologies and the co-production of care relations would help to avoid the application of coercive forms of care technology in times of austerity.
PubMed ID
23094945 View in PubMed
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The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups.

https://arctichealth.org/en/permalink/ahliterature123326
Source
J Thorac Cardiovasc Surg. 2012 Jul;144(1):33-8
Publication Type
Article
Date
Jul-2012
Author
Michael T Jaklitsch
Francine L Jacobson
John H M Austin
John K Field
James R Jett
Shaf Keshavjee
Heber MacMahon
James L Mulshine
Reginald F Munden
Ravi Salgia
Gary M Strauss
Scott J Swanson
William D Travis
David J Sugarbaker
Author Affiliation
Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. mjaklitsch@partners.org
Source
J Thorac Cardiovasc Surg. 2012 Jul;144(1):33-8
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Advisory Committees
Age Factors
Aged
Canada - epidemiology
Comorbidity
Humans
Lung Neoplasms - epidemiology - radiography
Mass Screening - standards
Middle Aged
Population Surveillance
Radiation Dosage
Risk assessment
Risk factors
Smoking - adverse effects - epidemiology
Thoracic Surgical Procedures - standards
Tomography, X-Ray Computed - standards
United States - epidemiology
Abstract
Lung cancer is the leading cause of cancer death in North America. Low-dose computed tomography screening can reduce lung cancer-specific mortality by 20%.
The American Association for Thoracic Surgery created a multispecialty task force to create screening guidelines for groups at high risk of developing lung cancer and survivors of previous lung cancer.
The American Association for Thoracic Surgery guidelines call for annual lung cancer screening with low-dose computed tomography screening for North Americans from age 55 to 79 years with a 30 pack-year history of smoking. Long-term lung cancer survivors should have annual low-dose computed tomography to detect second primary lung cancer until the age of 79 years. Annual low-dose computed tomography lung cancer screening should be offered starting at age 50 years with a 20 pack-year history if there is an additional cumulative risk of developing lung cancer of 5% or greater over the following 5 years. Lung cancer screening requires participation by a subspecialty-qualified team. The American Association for Thoracic Surgery will continue engagement with other specialty societies to refine future screening guidelines.
The American Association for Thoracic Surgery provides specific guidelines for lung cancer screening in North America.
Notes
Comment In: J Thorac Cardiovasc Surg. 2013 Jan;145(1):30823244262
Comment In: J Thorac Cardiovasc Surg. 2013 Jan;145(1):307-823244260
PubMed ID
22710039 View in PubMed
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248 records – page 1 of 25.