Skip header and navigation

Refine By

591 records – page 1 of 60.

24-h ambulatory blood pressure is linked to chromosome 18q21-22 and genetic variation of NEDD4L associates with cross-sectional and longitudinal blood pressure in Swedes.

https://arctichealth.org/en/permalink/ahliterature81774
Source
Kidney Int. 2006 Aug;70(3):562-9
Publication Type
Article
Date
Aug-2006
Author
Fava C.
von Wowern F.
Berglund G.
Carlson J.
Hedblad B.
Rosberg L.
Burri P.
Almgren P.
Melander O.
Author Affiliation
Department of Clinical Sciences, University Hospital MAS, Malmö, Sweden.
Source
Kidney Int. 2006 Aug;70(3):562-9
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Adult
Alternative Splicing
Antihypertensive Agents - therapeutic use
Blood Pressure - genetics
Blood Pressure Monitoring, Ambulatory
Chromosomes, Human, Pair 18
Circadian Rhythm
Cross-Sectional Studies
Female
Genetic Predisposition to Disease - epidemiology
Genotype
Humans
Hypertension - drug therapy - epidemiology - genetics
Insulin - blood
Linkage (Genetics)
Longitudinal Studies
Male
Middle Aged
Phenotype
Polymorphism, Single Nucleotide
Risk factors
Sweden - epidemiology
Ubiquitin-Protein Ligases - genetics
Variation (Genetics)
Abstract
Numerous linkage studies have indicated chromosome 18q21-22 as a locus of importance for blood pressure regulation. This locus harbors the neural precursor cell expressed developmentally downregulated 4-like (NEDD4L) gene, which is instrumental for the regulation of the amiloride-sensitive epithelial sodium channel (ENaC). In a linkage study of 16 markers (including two single nucleotide polymorphism markers located within the NEDD4L gene) on chromosome 18 between 70-104 cM and ambulatory blood pressure (ABP), in 118 families, the strongest evidence of linkage was found for 24 h and day-time systolic ABP at the NEDD4L locus (82.25 cM) (P=0.0014). In a large population sample (n=4001), we subsequently showed that a NEDD4L gene variant (rs4149601), which by alternative splicing leads to varying expression of a functionally crucial C2 domain, was associated with diastolic blood pressure (DBP) (P=0.03) and DBP progression over time (P=0.04). A genotype combination of the rs4149601 and an intronic NEDD4L marker (rs2288774) was associated with systolic blood pressure (SBP) (P=0.01), DBP (P=0.04), and progression of both SBP (P=0.03) and DBP (P=0.05) over time. A quantitative transmission disequilibrium test in the family material of the rs4149601 supported this NEDD4L variant as being at least partially causative of the linkage result. In conclusion, our findings suggest that the chromosome 18 linkage peak at 82.25 cM is explained by genetic NEDD4L variation affecting cross-sectional and longitudinal blood pressure, possibly as a consequence of altered NEDD4L interaction with ENaC.
PubMed ID
16788695 View in PubMed
Less detail

1999 Canadian recommendations for the management of hypertension. Task Force for the Development of the 1999 Canadian Recommendations for the Management of Hypertension.

https://arctichealth.org/en/permalink/ahliterature199846
Source
CMAJ. 1999;161 Suppl 12:S1-17
Publication Type
Article
Date
1999
Author
R D Feldman
N. Campbell
P. Larochelle
P. Bolli
E D Burgess
S G Carruthers
J S Floras
R B Haynes
G. Honos
F H Leenen
L A Leiter
A G Logan
M G Myers
J D Spence
K B Zarnke
Author Affiliation
Robarts Research Institute, University of Western Ontario, London. feldmanr@lhsc.on.ca
Source
CMAJ. 1999;161 Suppl 12:S1-17
Date
1999
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - therapeutic use
Canada
Humans
Hypertension - diagnosis - drug therapy
Middle Aged
Abstract
To provide updated, evidence-based recommendations for health care professionals on the management of hypertension in adults.
For patients with hypertension, there are both lifestyle options and pharmacological therapy options that may control blood pressure. For those patients who are using pharmacological therapy, a range of antihypertensive drugs is available. The choice of a specific antihypertensive drug is dependent upon the severity of the hypertension and the presence of other cardiovascular risk factors and concurrent diseases.
The health outcomes considered were changes in blood pressure and in morbidity and mortality rates. Because of insufficient evidence, no economic outcomes were considered.
MEDLINE searches were conducted from the period of the last revision of the Canadian Recommendations for the Management of Hypertension (January 1993 to May 1998). Reference lists were scanned, experts were polled and the personal files of the authors were used to identify other studies. All relevant articles were reviewed, classified according to study design and graded according to levels of evidence.
A high value was placed on the avoidance of cardiovascular morbidity and premature death caused by untreated hypertension.
Harms and costs: The diagnosis and treatment of hypertension with pharmacological therapy will reduce the blood pressure of patients with sustained hypertension. In certain settings, and for specific drugs, blood pressure lowering has been associated with reduced cardiovascular morbidity and mortality.
This document contains detailed recommendations pertaining to all aspects of the diagnosis and pharmacological therapy of hypertensive patients. With respect to diagnosis, the recommendations endorse the greater use of non-office-based measures of blood pressure control (i.e., using home blood pressure and automatic ambulatory blood pressure monitoring equipment) and greater emphasis on the identification of other cardiovascular risk factors, both in the assessment of prognosis in hypertension and in the choice of therapy. On the treatment side, lower targets for blood pressure control are advocated for some subgroups of hypertensive patients, in particular, those with diabetes and renal disease. Implicit in the recommendations for therapy is the principle that for the vast majority of hypertensive patients treated pharmacologically, practitioners should not follow a stepped-care approach. Instead, therapy should be individualized, based on consideration of concurrent diseases, both cardiovascular and noncardiovascular.
All recommendations were graded according to the strength of the evidence and the consensus of all relevant stakeholders.
The Canadian Hypertension Society and the Canadian Coalition for High Blood Pressure Prevention and Control.
Notes
Cites: CMAJ. 1999 May 4;160(9 Suppl):S7-1210333848
Cites: Circulation. 1991 Jan;83(1):356-621984895
Cites: J Hum Hypertens. 1990 Dec;4(6):639-452096205
Cites: N Engl J Med. 1991 Aug 1;325(5):293-3022057034
Cites: BMJ. 1991 Jul 13;303(6794):81-71860008
Cites: Lancet. 1991 Nov 23;338(8778):1281-51682683
Cites: CMAJ. 1999 May 4;160(9 Suppl):S13-2010333849
Cites: CMAJ. 1999 May 4;160(9 Suppl):S21-810333850
Cites: CMAJ. 1999 May 4;160(9 Suppl):S29-3410333851
Cites: Ann Intern Med. 1993 Jan 15;118(2):129-388416309
Cites: Ann Intern Med. 1993 Apr 15;118(8):577-818452322
Cites: CMAJ. 1993 Aug 1;149(3):289-938339174
Cites: BMJ. 1993 Jul 10;307(6896):107-108343706
Cites: CMAJ. 1993 Aug 15;149(4):409-188348423
Cites: Ann Allergy. 1992 Nov;69(5):449-531360775
Cites: CMAJ. 1993 Sep 1;149(5):575-848364814
Cites: CMAJ. 1993 Sep 15;149(6):815-208374844
Cites: CMAJ. 1993 Sep 15;149(6):821-68374845
Cites: J Am Coll Cardiol. 1993 Oct;22(4 Suppl A):14A-19A8376685
Cites: J Hypertens. 1993 Jun;11(6):677-98397248
Cites: N Engl J Med. 1993 Nov 11;329(20):1456-628413456
Cites: CMAJ. 1999 May 4;160(9 Suppl):S35-4510333852
Cites: CMAJ. 1999 May 4;160(9 Suppl):S46-5010333853
Cites: Kidney Int Suppl. 1999 Jun;70:S17-2510369191
Cites: Ann Intern Med. 1999 Jul 6;131(1):7-1310391820
Cites: N Engl J Med. 1999 Sep 2;341(10):709-1710471456
Cites: CMAJ. 1997 Nov 1;157(9):1245-549361646
Cites: Am J Hypertens. 1994 Sep;7(9 Pt 1):824-87811441
Cites: Vasa. 1994;23(4):357-627817618
Cites: Circulation. 1995 Feb 1;91(3):698-7067828296
Cites: J Am Coll Cardiol. 1995 Feb;25(2):424-307829797
Cites: Am J Hypertens. 1995 Jun;8(6):591-77662244
Cites: Ann Intern Med. 1995 Nov 15;123(10):754-627574193
Cites: Kidney Int. 1995 Sep;48(3):851-97474675
Cites: J Hypertens. 1995 Aug;13(8):933-88557972
Cites: Am J Hypertens. 1995 Sep;8(9):909-148541006
Cites: Am J Med. 1995 Nov;99(5):497-5047485207
Cites: Can J Cardiol. 1995 Nov;11 Suppl H:29H-34H7489541
Cites: Neth J Med. 1995 Oct;47(4):185-948538823
Cites: Arch Intern Med. 1996 Feb 12;156(3):286-98572838
Cites: N Engl J Med. 1996 Apr 11;334(15):939-458596594
Cites: N Engl J Med. 1996 May 23;334(21):1349-558614419
Cites: JAMA. 1996 May 15;275(19):1507-138622227
Cites: JAMA. 1996 May 22-29;275(20):1549-568622245
Cites: Arch Intern Med. 1996 Jul 8;156(13):1414-208678709
Cites: Am J Hypertens. 1995 Dec;8(12 Pt 2):100s-105s8845091
Cites: Ann Intern Med. 1996 Aug 15;125(4):311-238678396
Cites: Kidney Int Suppl. 1996 Jun;55:S72-48743515
Cites: Diabetes Care. 1996 Apr;19(4):305-128729151
Cites: Am J Hypertens. 1996 Jan;9(1):1-118834700
Cites: N Engl J Med. 1996 Oct 10;335(15):1107-148813041
Cites: Am J Hypertens. 1997 Oct;10(10 Pt 1):1097-1029370379
Cites: J Intern Med. 1997 Nov;242(5):373-69408065
Cites: Kidney Int Suppl. 1997 Dec;63:S63-69407424
Cites: Stroke. 1997 Dec;28(12):2557-629412649
Cites: Circulation. 1998 Jan 6-13;97(1):48-549443431
Cites: JAMA. 1998 Mar 11;279(10):778-809508155
Cites: Arch Intern Med. 1998 Mar 9;158(5):481-89508226
Cites: J Hypertens Suppl. 1998 Jan;16(1):S65-709534100
Cites: Can J Cardiol. 1998 Apr;14 Suppl A:17A-21A9594929
Cites: Circulation. 1998 May 12;97(18):1837-479603539
Cites: Lancet. 1998 Jun 13;351(9118):1755-629635947
Cites: Lancet. 1998 Aug 29;352(9129):670-19728978
Cites: Lancet. 1998 Oct 17;352(9136):1252-69788454
Cites: Lancet. 1998 Oct 24;352(9137):1347-519802273
Cites: Lancet. 1998 Nov 7;352(9139):15569820335
Cites: N Engl J Med. 1998 Dec 31;339(27):1957-639869666
Cites: Lancet. 1999 Jan 2;353(9146):9-1310023943
Cites: N Engl J Med. 1999 Mar 4;340(9):677-8410053176
Cites: Lancet. 1999 Feb 20;353(9153):611-610030325
Cites: CMAJ. 1999 May 4;160(9 Suppl):S1-610333847
Cites: Lancet. 1976 Jun 12;1(7972):1265-873694
Cites: Can Med Assoc J. 1978 Nov 4;119(9):1034-9369673
Cites: JAMA. 1979 May 11;241(19):2035-8430798
Cites: Nephron. 1979;23 Suppl 1:3-6471150
Cites: Aust N Z J Med. 1979 Aug;9(4):451-4389225
Cites: Am J Epidemiol. 1983 Apr;117(4):429-426837557
Cites: Br Heart J. 1984 Feb;51(2):157-626197982
Cites: N Engl J Med. 1984 Jul 12;311(2):89-936738599
Cites: Lancet. 1985 Jun 15;1(8442):1349-542861311
Cites: N Engl J Med. 1986 Jun 12;314(24):1547-523520315
Cites: Drugs. 1986 Jun;31(6):467-993525084
Cites: Br Med J (Clin Res Ed). 1986 Nov 1;293(6555):1145-513094811
Cites: Int J Epidemiol. 1987 Mar;16(1):25-303553048
Cites: Am Heart J. 1988 Jan;115(1 Pt 2):282-82892388
Cites: J Hypertens. 1987 Oct;5(5):561-722892881
Cites: Kidney Int. 1989 Feb;35(2):670-42709671
Cites: Med Toxicol Adverse Drug Exp. 1989 Sep-Oct;4(5):369-802682132
Cites: J Hum Hypertens. 1989 Dec;3(6):457-612607519
Cites: J Cardiovasc Pharmacol. 1989;14 Suppl 10:S40-51; discussion S59-622483571
Cites: Lancet. 1990 Apr 7;335(8693):827-381969567
Cites: N Engl J Med. 1990 May 31;322(22):1561-62139921
Cites: J Hypertens. 1990 May;8(5):429-322163417
Cites: Lancet. 1993 Dec 11;342(8885):1441-67902479
Cites: BMJ. 1994 Jan 1;308(6920):18-218298346
Cites: N Engl J Med. 1994 Mar 31;330(13):877-848114857
Cites: J Hypertens. 1993 Dec;11(12):1441-98133026
Cites: Diabetes Care. 1994 May;17(5):420-48062609
Cites: BMJ. 1994 Oct 1;309(6958):833-77950612
Cites: J Hypertens. 1994 Jul;12(7):831-87963513
Cites: Hypertension. 1994 Dec;24(6):793-8017995639
Cites: J Am Soc Echocardiogr. 1996 Sep-Oct;9(5):736-608887883
Cites: JAMA. 1996 Dec 18;276(23):1886-928968014
Cites: Kidney Int. 1997 Jan;51(1):2-158995712
Cites: Circulation. 1997 Jan 21;95(2):411-49008458
Cites: J Hypertens Suppl. 1996 Oct;14(3):S23-79120662
Cites: J Hypertens. 1997 Jan;15(1):3-179050965
Cites: Stroke. 1997 Mar;28(3):580-39056614
Cites: Lancet. 1997 Mar 15;349(9054):747-529074572
Cites: Prog Cardiovasc Dis. 1997 Mar-Apr;39(5):445-569122425
Cites: Am J Hypertens. 1997 Apr;10(4 Pt 1):409-189128207
Cites: Circulation. 1997 Apr 15;95(8):2007-149133508
Cites: Fam Pract. 1997 Apr;14(2):130-59137951
Cites: Circulation. 1997 May 20;95(10):2368-739170398
Cites: J Hypertens. 1997 Apr;15(4):357-649211170
Cites: Lancet. 1997 Jun 28;349(9069):1857-639217756
Cites: Circulation. 1997 Aug 5;96(3):856-639264493
Cites: Lancet. 1997 Sep 13;350(9080):757-649297994
Cites: CMAJ. 1997 Sep 15;157(6):715-259307560
Cites: JAMA. 1997 Oct 1;278(13):1065-729315764
Cites: Am J Hypertens. 1997 Sep;10(9 Pt 1):985-919324103
Cites: CMAJ. 1997 Oct 1;157(7):907-199327800
Cites: Am J Nephrol. 1991;11(2):131-71951474
Cites: Diabetes Care. 1991 Nov;14 Suppl 4:13-261748053
Cites: BMJ. 1992 Feb 8;304(6823):339-431540729
Cites: Eur Heart J. 1992 Jan;13(1):28-321533587
Cites: J Clin Pharmacol. 1992 Jul;32(7):652-91353506
Cites: J Hypertens. 1992 Aug;10(8):887-961325524
Cites: Kidney Int. 1992 Aug;42(2):452-81405330
Comment In: CMAJ. 2000 May 30;162(11):1555-610862227
Comment In: CMAJ. 2000 May 30;162(11):1554-5; author reply 155610862226
PubMed ID
10624417 View in PubMed
Less detail

1999 WHO/ISH Guidelines applied to a 1999 MONICA sample from northern Sweden.

https://arctichealth.org/en/permalink/ahliterature52964
Source
J Hypertens. 2002 Jan;20(1):29-35
Publication Type
Article
Date
Jan-2002
Author
Mats Persson
Bo Carlberg
Tom Mjörndal
Kjell Asplund
Jens Bohlin
Lars Lindholm
Author Affiliation
Family Medicine, Department of Public Health and Clinical Medicine, 901 87 University of Umeå, Sweden. mats.persson@fammed.umu.se
Source
J Hypertens. 2002 Jan;20(1):29-35
Date
Jan-2002
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Antihypertensive Agents - therapeutic use
Blood Pressure - drug effects - physiology
Female
Humans
Hypertension - drug therapy - physiopathology
Male
Middle Aged
Research Support, Non-U.S. Gov't
Risk factors
Sweden - epidemiology
Treatment Outcome
Abstract
BACKGROUND: Treating hypertension with drugs is so far the most cost-effective way to reduce this important risk factor for cardiovascular disease (CVD). It is, however, important to determine absolute risk, and thereby estimate indication for drug treatment, in order to maintain a cost-effective drug treatment. WHO/ISH Hypertension Guidelines from 1999 propose a risk stratification for estimating absolute risk for CVD based on blood pressure and additional risk factors, target organ damage (TOD) and CVD. OBJECTIVES: We studied the consequences of applying the recent WHO/ISH risk stratification scheme to a MONICA sample of 6000 subjects from a geographically defined population in northern Sweden, regarding indications for treatment, target blood pressure and risk distribution. METHODS: We have risk-classified each of these patients using a computer program, according to the WHO/ISH scheme. Data on TOD were not available. RESULTS : In all, 917 (15%) had drug-treated hypertension. Three-quarters (n = 737) were inadequately treated, with blood pressure levels at or above 140 or 90 mmHg. 1773 (30% of 5997) untreated subjects had a blood pressure of 140/90 or above; 16% in the low-, 62% in the medium-, 8% in the high-, and 14% in the very-high-risk group. The corresponding risk-group pattern for the inadequately treated hypertensives (n = 737) was 5.5, 48.3, 11.1 and 35.2%, respectively. If we shifted the target blood pressure from below 140/90 to below 130/85 for drug-treated subjects under 60 (n = 278) the number of inadequately treated subjects increased by 34 (12.2% of 278); 14 in the low-risk group, 15 in the medium-risk group, and only five in the high- or very-high-risk groups. CONCLUSIONS: Only one-fifth of the drug-treated hypertensives were well controlled. Moreover, the incidence of newly detected blood pressure elevation was high. The majority of younger subjects with high blood pressure had low risk, but in those aged 45-54 this had already risen to a medium risk. Changing the target blood pressure to below 130/85, for subjects aged below 60, as recommended by WHO/ISH, affects predominantly low- and medium-risk groups.
PubMed ID
11791023 View in PubMed
Less detail

The 2001 Canadian hypertension recommendations: take-home messages.

https://arctichealth.org/en/permalink/ahliterature188323
Source
CMAJ. 2002 Sep 17;167(6):661-8
Publication Type
Article
Date
Sep-17-2002
Author
Norman R C Campbell
Denis Drouin
Ross D Feldman
Author Affiliation
Department of Internal Medicine, Faculty of Medicine, University of Calgary, Alta. ncampbel@ucalgary.ca
Source
CMAJ. 2002 Sep 17;167(6):661-8
Date
Sep-17-2002
Language
English
Publication Type
Article
Keywords
Aged
Antihypertensive Agents - therapeutic use
Blood Chemical Analysis
Blood Pressure Determination
Canada
Female
Humans
Hypertension - diagnosis - drug therapy - therapy
Life Style
Practice Guidelines as Topic
Risk assessment
Notes
Cites: Hypertension. 2000 May;35(5):1025-3010818057
Cites: N Engl J Med. 2001 Jan 4;344(1):3-1011136953
Cites: Can J Cardiol. 2000 Sep;16(9):1094-10211021953
Cites: BMJ. 2001 Mar 3;322(7285):531-611230071
Cites: JAMA. 2001 May 16;285(19):2486-9711368702
Cites: Can J Cardiol. 2001 May;17(5):535-811381276
Cites: Can J Cardiol. 2001 May;17(5):543-5911381277
Cites: Can J Cardiol. 2001 Dec;17(12):1249-6311773936
Cites: Can J Cardiol. 2002 Jun;18(6):604-2412107419
Cites: Can J Cardiol. 2002 Jun;18(6):625-4112107420
Cites: CMAJ. 2002 Jun 25;166(13):1692-312126328
Cites: Am J Epidemiol. 1983 Apr;117(4):429-426837557
Cites: J Hypertens. 1992 Aug;10(8):887-961325524
Cites: Fam Pract. 1997 Apr;14(2):130-59137951
Cites: J Hypertens. 1999 Feb;17(2):151-8310067786
Cites: CMAJ. 1999 May 4;160(9):1341-310333841
Cites: CMAJ. 1999 May 4;160(9 Suppl):S21-810333850
Cites: CMAJ. 1999 Aug 10;161(3):277-810463050
Cites: J Hum Hypertens. 1999 Sep;13(9):569-9210482967
Cites: Circulation. 1999 Sep 28;100(13):1481-9210500053
Cites: CMAJ. 1999 Sep 21;161(6):699-70410513276
Cites: CMAJ. 1999;161 Suppl 12:S1-1710624417
Cites: BMJ. 2000 Mar 11;320(7236):686-9010710578
Cites: BMJ. 2000 Mar 11;320(7236):709-1010710588
Erratum In: CMAJ 2002 Oct 29;167(9):989
PubMed ID
12358202 View in PubMed
Less detail

2001 Canadian hypertension recommendations. What has changed?

https://arctichealth.org/en/permalink/ahliterature187643
Source
Can Fam Physician. 2002 Oct;48:1662-5
Publication Type
Article
Date
Oct-2002
Source
Can Fam Physician. 2002 Oct;48:1662-5
Date
Oct-2002
Language
English
Publication Type
Article
Keywords
Aged
Antihypertensive Agents - therapeutic use
Canada
Humans
Hypertension - drug therapy
Life Style
Middle Aged
Patient compliance
Practice Guidelines as Topic
Risk assessment
Notes
Cites: CMAJ. 1999;161 Suppl 12:S1-1710624417
Cites: BMJ. 2000 Mar 11;320(7236):709-1010710588
Cites: Circulation. 1999 Sep 28;100(13):1481-9210500053
Cites: Can J Cardiol. 2002 Jun;18(6):625-4112107420
Cites: Can J Cardiol. 2002 Jun;18(6):604-2412107419
Cites: Science. 1996 Nov 1;274(5288):740-38966556
Cites: Am J Hypertens. 1997 Oct;10(10 Pt 1):1097-1029370379
Cites: J Hum Hypertens. 1999 Sep;13(9):569-9210482967
Cites: Can J Cardiol. 2000 Sep;16(9):1094-10211021953
Cites: BMJ. 2001 Mar 3;322(7285):531-611230071
Cites: JAMA. 2001 May 16;285(19):2486-9711368702
Cites: Can J Cardiol. 2001 May;17(5):543-5911381277
Cites: Lancet. 2001 Sep 29;358(9287):1033-4111589932
Cites: Can J Cardiol. 2001 Dec;17(12):1249-6311773936
PubMed ID
12449551 View in PubMed
Less detail

The 2001 Canadian recommendations for the management of hypertension: Part one--Assessment for diagnosis, cardiovascular risk, causes and lifestyle modification.

https://arctichealth.org/en/permalink/ahliterature189435
Source
Can J Cardiol. 2002 Jun;18(6):604-24
Publication Type
Article
Date
Jun-2002
Author
Kelly B Zarnke
Finlay A McAlister
Norman R C Campbell
Mitchell Levine
Ernesto L Schiffrin
Steven Grover
Donald W McKay
Martin G Myers
Thomas W Wilson
Simon W Rabkin
Ross D Feldman
Ellen Burgess
Peter Bolli
George Honos
Marcel Lebel
Karen Mann
Carl Abbott
Sheldon Tobe
Robert Petrella
Rhian M Touyz
Author Affiliation
London Health Sciences Centre, University Hospital Campus, London, Canada.
Source
Can J Cardiol. 2002 Jun;18(6):604-24
Date
Jun-2002
Language
English
Publication Type
Article
Keywords
Antihypertensive Agents - therapeutic use
Blood Pressure Determination - standards
Blood Pressure Monitoring, Ambulatory - standards
Canada
Cardiovascular Diseases - diagnosis - prevention & control - therapy
Diet
Exercise
Female
Humans
Hypertension - diagnosis - prevention & control - therapy
Life Style
Pregnancy
Pregnancy Complications, Cardiovascular - diagnosis - prevention & control
Risk assessment
Abstract
To provide updated, evidence-based recommendations for the assessment of the diagnosis, cardiovascular risk, identifiable causes and lifestyle modifications for adults with high blood pressure.
For persons in whom a high blood pressure value is recorded, hypertension is diagnosed based on the appropriate measurement of blood pressure, the level of the blood pressure elevation and the duration of follow-up. In addition, the presence of concomitant vascular risk factors, target organ damage and established atherosclerotic diseases must be assessed to determine the urgency, intensity and type of treatment. For persons receiving a diagnosis of hypertension, defining the overall risk of adverse cardiovascular outcomes requires an assessment of concomitant vascular risk factors, including laboratory testing, a search for target organ damage and an assessment for modifiable causes of hypertension. Home and ambulatory blood pressure assessment and echocardiography are options for selected patients.
The outcomes were: the identification of persons at increased risk of adverse cardiovascular outcomes; the quantification of overall cardiovascular risk; and the identification of persons with potentially modifiable causes of hypertension.
Medline searches were conducted from one year before the period of the last revision of the Canadian recommendations for the management of hypertension (May 1999 to May 2001). Reference lists were scanned, experts were polled, and the personal files of the subgroup members and authors were used to identify other studies. Identified articles were reviewed and appraised, using prespecified levels of evidence, by content experts and methodological experts. In addition to an update of the previous year's review, new sections on assessing overall cardiovascular risk and endocrine causes are provided.
A high value was placed on the identification of persons at increased risk of cardiovascular morbidity and mortality, and of persons with identifiable causes of hypertension.
The identification of persons at higher risk of cardiovascular disease will permit counseling for lifestyle manoeuvres and introduction of antihypertensive drugs to reduce blood pressure for patients with sustained hypertension. The identification of specific causes of hypertension may permit the use of cause-specific interventions. In certain subgroups of patients, and for specific classes of drugs, blood pressure lowering has been associated with reduced cardiovascular morbidity or mortality.
The present document contains recommendations for the assessment of the diagnosis, cardiovascular risk, identifiable causes and lifestyle modifications 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, the role of echocardiography and lifestyle modifications.
All recommendations were graded according to the strength of the evidence and voted on by the Canadian Hypertension Recommendations Working Group. Only those recommendations achieving high levels of consensus are reported. These guidelines will be updated annually.
These guidelines are endorsed by the Canadian Hypertension Society, The Canadian Coalition for High Blood Pressure Prevention and Control, The College of Family Physicians of Canada, The Heart and Stroke Foundation of Canada, The Adult Disease Division and Bureau of Cardio-Respiratory Diseases and Diabetes at the Centre for Chronic Disease Prevention and Control, Health Canada.
PubMed ID
12107419 View in PubMed
Less detail

The 2004 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/ahliterature181499
Source
Can J Cardiol. 2004 Jan;20(1):31-40
Publication Type
Article
Date
Jan-2004
Author
Brenda R Hemmelgarn
Kelly B Zarnke
Norman R C Campbell
Ross D Feldman
Donald W McKay
Finlay A McAlister
Nadia Khan
Ernesto L Schiffrin
Martin G Myers
Peter Bolli
George Honos
Marcel Lebel
Mitchell Levine
Raj Padwal
Author Affiliation
Division of Nephrology, University of Calgary, Calgary, Canada.
Source
Can J Cardiol. 2004 Jan;20(1):31-40
Date
Jan-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - therapeutic use
Blood Pressure Determination - standards
Blood Pressure Monitoring, Ambulatory - standards
Canada - epidemiology
Cardiovascular Diseases - prevention & control
Diet
Evidence-Based Medicine - standards
Female
Health Education - organization & administration
Humans
Hypertension - diagnosis - epidemiology - therapy
Incidence
Life Style
Male
Middle Aged
Prognosis
Risk assessment
Societies, Medical
Abstract
To provide updated, evidence-based recommendations for the assessment of the diagnosis, cardiovascular risk and identifiable causes for adults with high blood pressure.
For persons in whom a high blood pressure value is recorded, the assignment of a diagnosis of hypertension is dependent on the appropriate measurement of blood pressure, the level of the blood pressure elevation and the duration of follow-up. In addition, the presence of concomitant vascular risk factors, target organ damage and established atherosclerotic diseases should be assessed to determine the urgency, intensity and type of treatment. For persons diagnosed as having hypertension, defining overall risk of adverse cardiovascular outcomes requires an assessment of concomitant vascular risk factors, including laboratory testing, a search for target organ damage and an assessment for modifiable causes of hypertension. Home and ambulatory blood pressure assessment and echocardiography are options for selected patients.
The identification of persons at increased risk of adverse cardiovascular outcomes; the quantification of overall cardiovascular risk; and the identification of persons with potentially modifiable causes of hypertension.
Medline searches were conducted from November 2001, one year before the period of the last revision of the Canadian recommendations for the management of hypertension, to October 2003. Reference lists were scanned, experts were polled, and the personal files of subgroup members and authors were used to identify other studies. Identified articles were reviewed and appraised using prespecified levels of evidence by content experts and methodological experts.
A high value was placed on the identification of persons at increased risk of cardiovascular morbidity and mortality, and persons with identifiable and potentially modifiable causes of hypertension.
The identification of persons at higher risk of cardiovascular disease will permit counselling for lifestyle maneuvers and introduction of antihypertensive drugs to reduce blood pressure for patients with sustained hypertension. The identification of specific causes of hypertension may permit the use of cause-specific interventions. For certain subgroups of patients and specific classes of drugs, blood pressure lowering has been associated with reduced cardiovascular morbidity and/or mortality.
The 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 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.
All recommendations were graded according to strength of evidence and voted on by the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. Only the recommendations that achieved high levels of consensus are reported. These guidelines will be updated annually.
PubMed ID
14968141 View in PubMed
Less detail

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

2005 Canadian Hypertension Education Program recommendations. New and important aspects of the sixth annual Canadian Hypertension Education Program's recommendations for management of hypertension.

https://arctichealth.org/en/permalink/ahliterature174444
Source
Can Fam Physician. 2005 May;51:702-5
Publication Type
Article
Date
May-2005

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
Cites: N Engl J Med. 2003 Nov 13;349(20):1893-90614610160
Cites: Congest Heart Fail. 2003 Nov-Dec;9(6):324-3214688505
Cites: Can J Cardiol. 2004 Jan;20(1):41-5414968142
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
Less detail

591 records – page 1 of 60.