The 2014 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension
Kaberi Dasgupta, Robert R Quinn, Kelly B Zarnke, Doreen M Rabi, Pietro Ravani, Stella S Daskalopoulou, Simon W Rabkin, Luc Trudeau, Ross D Feldman, Lyne Cloutier, Ally Prebtani, Robert J Herman, Simon L Bacon, Richard E Gilbert, Marcel Ruzicka, Donald W McKay, Tavis S Campbell, Steven Grover, George Honos, Ernesto L Schiffrin, Peter Bolli, Thomas W Wilson, Patrice Lindsay, Michael D Hill, Shelagh B Coutts, Gord Gubitz, Mark Gelfer, Michel Vallée, G V Ramesh Prasad, Marcel Lebel, Donna McLean, J Malcolm O Arnold, Gordon W Moe, Jonathan G Howlett, Jean-Martin Boulanger, Pierre Larochelle, Lawrence A Leiter, Charlotte Jones, Richard I Ogilvie, Vincent Woo, Janusz Kaczorowski, Kevin D Burns, Robert J Petrella, Swapnil Hiremath, Alain Milot, James A Stone, Denis Drouin, Kim L Lavoie, Maxime Lamarre-Cliche, Guy Tremblay, Pavel Hamet, George Fodor, S George Carruthers, George B Pylypchuk, Ellen Burgess, Richard Lewanczuk, George K Dresser, S Brian Penner, Robert A Hegele, Philip A McFarlane, Milan Khara, Andrew Pipe, Paul Oh, Peter Selby, Mukul Sharma, Debra J Reid, Sheldon W Tobe, Raj S Padwal, Luc Poirier, Canadian Hypertension Education Program, Kaberi Dasgupta, Robert R Quinn, Kelly B Zarnke, Doreen M Rabi, Pietro Ravani, Stella S Daskalopoulou, Simon W Rabkin, Luc Trudeau, Ross D Feldman, Lyne Cloutier, Ally Prebtani, Robert J Herman, Simon L Bacon, Richard E Gilbert, Marcel Ruzicka, Donald W McKay, Tavis S Campbell, Steven Grover, George Honos, Ernesto L Schiffrin, Peter Bolli, Thomas W Wilson, Patrice Lindsay, Michael D Hill, Shelagh B Coutts, Gord Gubitz, Mark Gelfer, Michel Vallée, G V Ramesh Prasad, Marcel Lebel, Donna McLean, J Malcolm O Arnold, Gordon W Moe, Jonathan G Howlett, Jean-Martin Boulanger, Pierre Larochelle, Lawrence A Leiter, Charlotte Jones, Richard I Ogilvie, Vincent Woo, Janusz Kaczorowski, Kevin D Burns, Robert J Petrella, Swapnil Hiremath, Alain Milot, James A Stone, Denis Drouin, Kim L Lavoie, Maxime Lamarre-Cliche, Guy Tremblay, Pavel Hamet, George Fodor, S George Carruthers, George B Pylypchuk, Ellen Burgess, Richard Lewanczuk, George K Dresser, S Brian Penner, Robert A Hegele, Philip A McFarlane, Milan Khara, Andrew Pipe, Paul Oh, Peter Selby, Mukul Sharma, Debra J Reid, Sheldon W Tobe, Raj S Padwal, Luc Poirier, Canadian Hypertension Education Program
Abstract
Herein, updated evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in Canadian adults are detailed. For 2014, 3 existing recommendations were modified and 2 new recommendations were added. The following recommendations were modified: (1) the recommended sodium intake threshold was changed from ≤ 1500 mg (3.75 g of salt) to approximately 2000 mg (5 g of salt) per day; (2) a pharmacotherapy treatment initiation systolic blood pressure threshold of ≥ 160 mm Hg was added in very elderly (age ≥ 80 years) patients who do not have diabetes or target organ damage (systolic blood pressure target in this population remains at < 150 mm Hg); and (3) the target population recommended to receive low-dose acetylsalicylic acid therapy for primary prevention was narrowed from all patients with controlled hypertension to only those ≥ 50 years of age. The 2 new recommendations are: (1) advice to be cautious when lowering systolic blood pressure to target levels in patients with established coronary artery disease if diastolic blood pressure is ≤ 60 mm Hg because of concerns that myocardial ischemia might be exacerbated; and (2) the addition of glycated hemoglobin (A1c) in the diagnostic work-up of patients with newly diagnosed hypertension. The rationale for these recommendation changes is discussed. In addition, emerging data on blood pressure targets in stroke patients are discussed; these data did not lead to recommendation changes at this time. The Canadian Hypertension Education Program recommendations will continue to be updated annually.
Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Source: PubMed