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The 2000 Canadian recommendations for the management of hypertension: part two--diagnosis and assessment of people with high blood pressure.

https://arctichealth.org/en/permalink/ahliterature192030
Source
Can J Cardiol. 2001 Dec;17(12):1249-63
Publication Type
Conference/Meeting Material
Article
Date
Dec-2001
Author
K B Zarnke
M. Levine
F A McAlister
N R Campbell
M G Myers
D W McKay
P. Bolli
G. Honos
M. Lebel
K. Mann
T W Wilson
C. Abbott
S. Tobe
E. Burgess
S. Rabkin
Author Affiliation
Department of Medicine, London Health Sciences Centre, University of Western Ontario, 339 Windermere Road, London, Ontario N6A 5A5, Canada. Kelly.Zarnke@lhsc.on.ca
Source
Can J Cardiol. 2001 Dec;17(12):1249-63
Date
Dec-2001
Language
English
French
Publication Type
Conference/Meeting Material
Article
Keywords
Adrenal Gland Neoplasms - complications
Adult
Blood Pressure Determination - methods - psychology - standards
Blood Pressure Monitoring, Ambulatory - methods - standards
Canada
Cardiovascular Diseases - etiology - prevention & control
Clinical Laboratory Techniques - standards
Diabetes Complications
Diabetic Nephropathies - complications - diagnosis
Echocardiography - standards
Electrocardiography
Evidence-Based Medicine - methods
Humans
Hypertension - complications - diagnosis - etiology - psychology
Hypertension, Renovascular - diagnosis
Hypertrophy, Left Ventricular - complications - ultrasonography
Office Visits
Patient compliance
Pheochromocytoma - complications - diagnosis
Risk factors
Self Care - methods - standards
Abstract
To provide updated, evidence-based recommendations for the diagnosis and assessment of high blood pressure in adults.
For people with high blood pressure, the assignment of a diagnosis of hypertension depends on the appropriate measurement of blood pressure, the level of the blood pressure elevation, the duration of follow-up and the presence of concomitant vascular risk factors, target organ damage and established atherosclerotic diseases. For people diagnosed with hypertension, defining the overall risk of adverse cardiovascular outcomes requires laboratory testing, a search for target organ damage and an assessment of the modifiable causes of hypertension. Out-of-clinic blood pressure assessment and echocardiography are options for selected patients.
People at increased risk of adverse cardiovascular outcomes and were identified and quantified.
Medline searches were conducted from the period of the last revision of the Canadian recommendations for the management of hypertension (May 1998 to October 2000). Reference lists were scanned, experts were polled, and the personal files of the subgroup members and authors were used to identify other studies. All relevant 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 people at increased risk of cardiovascular morbidity and mortality.
The identification of people at higher risk of cardiovascular disease will permit counselling for lifestyle manoeuvres and the introduction of antihypertensive drugs to reduce blood pressure for patients with sustained hypertension. In certain settings, and for specific classes of drugs, blood pressure lowering has been associated with reduced cardiovascular morbidity and/or mortality.
The present document contains detailed recommendations pertaining to aspects of the diagnosis and assessment of patients with hypertension, including the accurate measurement of blood pressure, criteria for the diagnosis of hypertension and recommendations for follow-up, routine and optional laboratory testing, assessment for renovascular hypertension, home and ambulatory blood pressure monitoring, and the role of echocardiography in hypertension.
All recommendations were graded according to strength of the evidence and voted on by the Canadian Hypertension Recommendations Working Group. Only the recommendations achieving high levels of consensus are reported here. These guidelines will be updated annually.
These recommendations 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 of Health Canada.
PubMed ID
11773936 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

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
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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 2004 Canadian recommendations for the management of hypertension: Part III--Lifestyle modifications to prevent and control hypertension.

https://arctichealth.org/en/permalink/ahliterature181497
Source
Can J Cardiol. 2004 Jan;20(1):55-9
Publication Type
Article
Date
Jan-2004
Author
R M Touyz
N. Campbell
A. Logan
N. Gledhill
R. Petrella
R. Padwal
Author Affiliation
Clinical Research Institute of Montreal, University of Montreal, Montreal, Quebec, Canada. touyzr@icrm.qc.ca
Source
Can J Cardiol. 2004 Jan;20(1):55-9
Date
Jan-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antioxidants - administration & dosage
Blood Pressure Determination - standards
Canada
Diet
Dietary Supplements
Evidence-Based Medicine - standards
Female
Humans
Hypertension - prevention & control - therapy
Life Style
Male
Middle Aged
Primary prevention - methods
Prognosis
Risk assessment
Severity of Illness Index
Societies, Medical
Treatment Outcome
Abstract
To provide updated, evidence-based recommendations regarding the role of lifestyle modification in the treatment and prevention of hypertension.
Lifestyle modification interventions including exercise, weight reduction, alcohol consumption, dietary modification, intake of dietary cations and stress management are reviewed. Antioxidants and fish oil supplements are also reviewed, although specific recommendations cannot be made at present.
MEDLINE searches were conducted from January 2002 to September 2003 to update the 2001 recommendations for the management of hypertension. Supplemental searches in the Cochrane Collaboration databases were also performed. 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.
Key recommendations include the following: lifestyle modification should be extended to nonhypertensive individuals who are at risk for developing high blood pressure; 30 min to 45 min of aerobic exercise should be performed on most days (four to five days) of the week; an ideal body weight (body mass index 18.5 kg/m2 to 24.9 kg/m2) should be maintained and weight loss strategies should use a multidisciplinary approach; alcohol consumption should be limited to two drinks or fewer per day, and weekly intake should not exceed 14 standard drinks for men and nine standard drinks for women; a reduced fat, low cholesterol diet that emphasizes fruits, vegetables and low fat dairy products, and maintains an adequate intake of potassium, magnesium and calcium, should be followed; salt intake should be restricted to 65 mmol/day to 100 mmol/day in hypertensive individuals and less than 100 mmol/day in normotensive individuals at high risk for developing hypertension; and stress management should be considered as an intervention in selected individuals.
All recommendations were graded according to the strength of the evidence and voted on by the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. Individuals with irreconcilable competing interests (declared by all members, compiled and circulated before the meeting) relative to any specific recommendation were excluded from voting on that recommendation. Only those recommendations achieving at least 70% consensus are reported here. These guidelines will continue to be updated annually.
PubMed ID
14968143 View in PubMed
Less detail

The 2004 Canadian recommendations for the management of hypertension: Part II--Therapy.

https://arctichealth.org/en/permalink/ahliterature181498
Source
Can J Cardiol. 2004 Jan;20(1):41-54
Publication Type
Article
Date
Jan-2004
Author
Nadia A Khan
Finlay A McAlister
Norman R C Campbell
Ross D Feldman
Simon Rabkin
Jeff Mahon
Richard Lewanczuk
Kelly B Zarnke
Brenda Hemmelgarn
Marcel Lebel
Mitchell Levine
Carol Herbert
Author Affiliation
Division of General Internal Medicine, University of British Columbia, Vancouver, Canada.
Source
Can J Cardiol. 2004 Jan;20(1):41-54
Date
Jan-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - administration & dosage
Blood Pressure Determination - standards
Canada - epidemiology
Cardiovascular Diseases - prevention & control
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Therapy, Combination
Evidence-Based Medicine - standards
Female
Humans
Hypertension - diagnosis - drug therapy - epidemiology
Male
Middle Aged
Prognosis
Risk assessment
Severity of Illness Index
Societies, Medical
Treatment Outcome
Abstract
To provide updated, evidence-based recommendations for the management of hypertension in adults.
For patients who require pharmacological therapy for hypertension, a number of antihypertensive agents may be used. Randomized trials evaluating first-line therapy with diuretics, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers (CCBs), alpha-blockers, centrally acting agents or angiotensin receptor antagonists were reviewed. Also, randomized trials evaluating other agents, such as statins or acetylsalicylic acid, in patients with hypertension were reviewed. Changes in cardiovascular morbidity and mortality were the primary outcomes of interest. In addition, other relevant outcomes such as development of end-stage renal disease or changes in blood pressure were examined where appropriate.
MEDLINE searches were conducted from November 2001 to October 2003 to update the 2001 Recommendations for the management of hypertension. 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.
This document contains detailed recommendations and supporting evidence on treatment thresholds, target blood pressures and choice of agents for hypertensive patients with or without comorbidities. Lifestyle modifications are a key component of any antiatherosclerotic management strategy and detailed recommendations are contained in a separate document. Key recommendations for pharmacotherapy include the following: treatment thresholds and targets should take into account each individual's global atherosclerotic risk, target organ damage and comorbidities, with particular attention to systolic blood pressure; blood pressure should be lowered to 140/90 mmHg or less in all patients, and 130/80 mmHg or less in those with diabetes mellitus or renal disease (125/75 mmHg or less in those with nondiabetic renal disease and more than 1 g of proteinuria per day); 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), ACE inhibitors (in non-Blacks), long-acting dihydropyridine CCBs or angiotensin receptor antagonists; other agents appropriate for first-line therapy for isolated systolic hypertension include long-acting dihydropyridine CCBs or angiotensin receptor antagonists; certain comorbidities 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 mild to moderate nondiabetic renal 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 as per the Recommendations for the management of dyslipidemia and the prevention of cardiovascular disease; and selected patients with hypertension should also receive statin and/or acetylsalicylic acid therapy.
All recommendations were graded according to the strength of the evidence and voted on by the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. Individuals with irreconcilable competing interests (declared by all members, compiled and circulated before the meeting) relative to any specific recommendation were excluded from voting on that recommendation. Only recommendations achieving at least 70% consensus are reported here. These guidelines will continue to be updated annually.
PubMed ID
14968142 View in PubMed
Less detail

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
Cites: Can J Cardiol. 2002 Jun;18(6):625-4112107420
Cites: CMAJ. 2005 Aug 30;173(5):480-316129865
Cites: Can J Cardiol. 2001 May;17(5):543-5911381277
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Cites: J Hypertens. 2002 Apr;20(4):579-8111910284
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PubMed ID
16755312 View in PubMed
Less detail

2006 Ontario Survey on the Prevalence and Control of Hypertension (ON-BP): rationale and design of a community-based cross-sectional survey.

https://arctichealth.org/en/permalink/ahliterature156763
Source
Can J Cardiol. 2008 Jun;24(6):503-5
Publication Type
Article
Date
Jun-2008
Author
J George Fodor
Frans H H Leenen
Eftyhia Helis
Penelope Turton
Author Affiliation
University of Ottawa Heart Institute, Ottawa, Canada. gfodor@ottawaheart.ca
Source
Can J Cardiol. 2008 Jun;24(6):503-5
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - therapeutic use
Blood Pressure Determination
Cross-Sectional Studies
Epidemiologic Research Design
Female
Humans
Hypertension - drug therapy - epidemiology
Male
Middle Aged
Ontario - epidemiology
Pilot Projects
Population Surveillance - methods
Prevalence
Abstract
The presently available Canadian data, based on direct measurements of blood pressure (BP) from the Canadian Heart Health Surveys, are more than 15 years old. In view of major changes in the demographics and health status of the Ontario population, there is an urgent need to update this information. On the initiative of the Heart and Stroke Foundation of Ontario, the University of Ottawa Heart Institute, jointly with Statistics Canada, designed and implemented a population-based cross-sectional survey of hypertension in the Province of Ontario: the 2006 Ontario Survey on the Prevalence and Control of Hypertension (ON-BP).
To establish the prevalence of hypertension in the Ontario adult population between the ages of 20 and 79 years; to assess the awareness, current status and management of hypertension; and to gather respondent information about sex, age, physical measurements, personal health practices, socioeconomic measures, ethnicity and comorbidities.
The present paper describes the background history and the successive steps undertaken during the implementation of this project.
The authors' experiences from the ON-BP indicate that close co-operation between research scientists, statisticians, governmental and nongovernmental organizations -- in the present case, the Heart and Stroke Foundation of Ontario -- is essential to conduct a successful, large-scale survey of BP distribution.
Notes
Cites: Am J Hypertens. 2001 Mar;14(3):241-711281235
Cites: JAMA. 2003 May 14;289(18):2363-912746359
Cites: JAMA. 2003 Jul 9;290(2):199-20612851274
Cites: Am J Hypertens. 2004 Apr;17(4):354-6015062890
Cites: J Hypertens. 2004 Jan;22(1):11-915106785
Cites: J Hypertens. 2004 Aug;22(8):1479-8515257169
Cites: Br J Gen Pract. 2004 Oct;54(507):765-7115469676
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Cites: Can J Cardiol. 2007 May 15;23(7):561-517534463
Cites: Am J Hypertens. 2008 Mar;21(3):280-318219304
Cites: CMAJ. 2008 May 20;178(11):1441-918490640
PubMed ID
18548149 View in PubMed
Less detail

The 2007 Canadian Hypertension Education Program recommendations for the management of hypertension: part 1- blood pressure measurement, diagnosis and assessment of risk.

https://arctichealth.org/en/permalink/ahliterature163301
Source
Can J Cardiol. 2007 May 15;23(7):529-38
Publication Type
Conference/Meeting Material
Article
Date
May-15-2007
Author
Raj S Padwal
Brenda R Hemmelgarn
Finlay A McAlister
Donald W McKay
Steven Grover
Thomas Wilson
Brian Penner
Ellen Burgess
Peter Bolli
Michael Hill
Jeff Mahon
Martin G Myers
Carl Abbott
Ernest L Schiffrin
George Honos
Karen Mann
Guy Tremblay
Alain Milot
Lyne Cloutier
Arun Chockalingam
Nadia A Khan
Simon W Rabkin
Martin Dawes
Rhian M Touyz
Sheldon W Tobe
Author Affiliation
Division of General Internal Medicine, University of Alberta, Edmonton, Alberta. rpadwal@ualberta.ca
Source
Can J Cardiol. 2007 May 15;23(7):529-38
Date
May-15-2007
Language
English
Publication Type
Conference/Meeting Material
Article
Keywords
Blood Pressure Determination
Blood Pressure Monitoring, Ambulatory
Canada
Health promotion
Humans
Hypertension - diagnosis - physiopathology - prevention & control
Patient Education as Topic
Risk factors
Abstract
To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with hypertension.
The diagnosis of hypertension is dependent on the appropriate measurement of blood pressure, the timely assessment of serially elevated readings, the degree of blood pressure elevation, the method of measurement (office, ambulatory, home) and any associated comorbidities. The presence of cardiovascular risk factors and target organ damage should be ascertained to assess global cardiovascular risk, and to determine the urgency, intensity and type of treatment required.
MEDLINE searches were conducted from November 2005 to October 2006 with the aid of a medical librarian. Reference lists were scanned, experts were contacted, and the personal files of authors and subgroup members were used to identify additional studies. Content and methodological experts assessed studies using prespecified, standardized evidence-based algorithms. Recommendations were based on evidence from peer-reviewed, full-text articles only.
Recommendations for blood pressure measurement, criteria for hypertension diagnosis and follow-up, assessment of global cardiovascular risk, diagnostic testing, diagnosis of renovascular and endocrine causes of hypertension, home and ambulatory monitoring, and the use of echocardiography in hypertensive individuals are outlined. Key messages in 2007 include continued emphasis on the expedited, accurate diagnosis of hypertension, the importance of assessing the risk of cerebrovascular events as part of global risk assessment, the need for ongoing reassessment of patients with high normal blood pressure, and reviews of recent studies involving laboratory testing and home monitoring.
All recommendations were graded according to strength of the evidence and were voted on by the 57 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here received at least 70% consensus. These guidelines will continue to be updated annually.
Notes
Cites: Lancet. 2001 Nov 17;358(9294):1682-611728544
Cites: Clin Sci (Lond). 2001 Dec;101(6):671-911724655
Cites: J Hypertens. 2002 Apr;20(4):579-8111910284
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Comment In: Can J Cardiol. 2007 May 15;23(7):603-417593584
PubMed ID
17534459 View in PubMed
Less detail

The 2008 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 1 - blood pressure measurement, diagnosis and assessment of risk.

https://arctichealth.org/en/permalink/ahliterature156767
Source
Can J Cardiol. 2008 Jun;24(6):455-63
Publication Type
Article
Date
Jun-2008
Author
Raj S Padwal
Brenda R Hemmelgarn
Nadia A Khan
Steven Grover
Finlay A McAlister
Donald W McKay
Thomas Wilson
Brian Penner
Ellen Burgess
Peter Bolli
Michael D Hill
Jeff Mahon
Martin G Myers
Carl Abbott
Ernesto L Schiffrin
George Honos
Karen Mann
Guy Tremblay
Alain Milot
Lyne Cloutier
Arun Chockalingam
Simon W Rabkin
Martin Dawes Dawes
Rhian M Touyz
Chaim Bell
Kevin D Burns
Marcel Ruzicka
Norman R C Campbell
Marcel Lebel
Sheldon W Tobe
Author Affiliation
Division of General Internal Medicine, University of Alberta, Edmonton, Canada. rpadwal@ualberta.ca
Source
Can J Cardiol. 2008 Jun;24(6):455-63
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Antihypertensive Agents - therapeutic use
Blood Pressure - physiology
Blood Pressure Determination - standards
Canada
Clinical Competence
Diagnosis, Differential
Education, Medical, Continuing - standards
Humans
Hypertension - diagnosis - drug therapy - physiopathology
Practice Guidelines as Topic
Program Evaluation - trends
Risk Assessment - methods
Abstract
To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with hypertension.
The diagnosis of hypertension is dependent on appropriate blood pressure measurement, the timely assessment of serially elevated readings, degree of blood pressure elevation, method of measurement (office, ambulatory, home) and associated comorbidities. The presence of cardiovascular risk factors and target organ damage should be ascertained to assess global cardiovascular risk and determine the urgency, intensity and type of treatment required.
MEDLINE searches were conducted from November 2006 to October 2007 with the aid of a medical librarian. Reference lists were scanned, experts were contacted, and the personal files of authors and subgroup members were used to identify additional studies. Content and methodological experts assessed studies using prespecified, standardized evidence-based algorithms. Recommendations were based on evidence from peer-reviewed, full-text articles only.
Recommendations for blood pressure measurement, criteria for hypertension diagnosis and follow-up, assessment of global cardiovascular risk, diagnostic testing, diagnosis of renovascular and endocrine causes of hypertension, home and ambulatory monitoring, and the use of echocardiography in hypertensive individuals are outlined. Key messages in 2008 include continued emphasis on the expedited, accurate diagnosis of hypertension, the importance of global risk assessment and the need for ongoing monitoring of hypertensive patients to identify incident type 2 diabetes.
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 received at least 70% consensus. These guidelines will continue to be updated annually.
Notes
Cites: Am Heart J. 2000 Feb;139(2 Pt 1):272-8110650300
Cites: Arch Intern Med. 2007 Nov 26;167(21):2296-30318039987
Cites: Clin Radiol. 2000 May;55(5):346-5310816399
Cites: Can J Cardiol. 2000 Sep;16(9):1094-10211021953
Cites: JAMA. 2001 Jul 11;286(2):180-711448281
Cites: Clin Sci (Lond). 2001 Dec;101(6):671-911724655
Cites: Stroke. 2002 Jul;33(7):1776-8112105351
Cites: Lancet. 2002 Dec 14;360(9349):1903-1312493255
Cites: Lancet. 2003 Apr 5;361(9364):1149-5812686036
Cites: Eur Heart J. 2003 Jun;24(11):987-100312788299
Cites: Lancet. 2003 Nov 29;362(9398):1776-714654312
Cites: Diabetes Care. 2004 Jan;27(1):247-5514693997
Cites: Hypertension. 2004 Jan;43(1):10-714638619
Cites: Hypertension. 2004 May;43(5):963-915037557
Cites: Lancet. 2004 Sep 11-17;364(9438):937-5215364185
Cites: Circulation. 1991 Jan;83(1):356-621984895
Cites: JAMA. 1996 May 22-29;275(20):1571-68622248
Cites: Arch Intern Med. 1996 Jul 8;156(13):1414-208678709
Cites: Arch Intern Med. 1998 Mar 23;158(6):655-629521231
Cites: Am J Cardiol. 2005 Jan 1;95(1):29-3515619390
Cites: Can J Cardiol. 2005 Jun;21(8):645-5616003448
Cites: Can J Cardiol. 2006 May 15;22(7):559-6416755310
Cites: Can J Cardiol. 2006 May 15;22(7):573-8116755312
Cites: Can J Cardiol. 2006 May 15;22(7):606-1316755316
Cites: Hypertension. 2006 Aug;48(2):219-2416801488
Cites: N Engl J Med. 2006 Oct 12;355(15):1551-6216980380
Cites: Arch Intern Med. 2006 Nov 13;166(20):2191-20117101936
Cites: Lancet. 2007 Jan 20;369(9557):201-717240286
Cites: AJR Am J Roentgenol. 2007 Mar;188(3):798-81117312071
Cites: Can J Cardiol. 2007 May 15;23(7):529-3817534459
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Cites: Hypertension. 2007 Sep;50(3):467-7317679652
Cites: N Engl J Med. 2000 Mar 30;342(13):905-1210738048
PubMed ID
18548142 View in PubMed
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