1. Hypertension Canada’s 2018 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults and Children
- Author
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Lyne Cloutier, G. V. Ramesh Prasad, George K. Dresser, Steven E. Gryn, Kara Nerenberg, Sonia Butalia, Alexander A. Leung, Andrew C. Don-Wauchope, Vincent Woo, Karen C. Tran, Simon L. Bacon, Laura M. Kuyper, Andrew L. Pipe, Marcel Ruzicka, George Honos, Milan Gupta, Janusz Feber, Richard Lewanczuk, Pavel Hamet, Gordon W. Moe, Kerry McBrien, Kevin C. Harris, Evelyne Rey, Theodore Wein, Mike Sharma, Donna McLean, Tavis S. Campbell, Ally P.H. Prebtani, Michael Roerecke, Robert A. Hegele, Peter Bolli, Janis M. Dionne, Swapnil Hiremath, Raj Padwal, Geneviève Benoit, Michel Vallée, Simon W. Rabkin, Guy Tremblay, Stella S. Daskalopoulou, S. Brian Penner, Sheldon W. Tobe, Thalia S. Field, Janusz Kaczorowski, Laura A. Magee, Ernesto L. Schiffrin, Meranda Nakhla, Charlotte Jones, Kaberi Dasgupta, Richard E. Gilbert, Anne-Marie Côté, JoAnne Arcand, Ross D. Feldman, Jean Grégoire, Tabassum Firoz, Alexander G. Logan, Michael D. Hill, Steven A. Grover, Alain Milot, Jonathan Y. Gabor, Peter Selby, Luc Trudeau, Philip A. McFarlane, Ellen Burgess, Patrice Lindsay, Maxime Lamarre-Cliche, Ross T. Tsuyuki, Praveena Sivapalan, Norman R.C. Campbell, Jonathan G. Howlett, Kim L. Lavoie, Anne Fournier, Doreen M. Rabi, Kelly B. Zarnke, Lawrence A. Leiter, Paul Oh, Cedric Edwards, Robert J. Herman, Raymond R. Townsend, Mark Gelfer, Gregory A. Kline, Ashkan Shoamanesh, and Luc Poirier
- Subjects
lifestyle ,medicine.medical_specialty ,hypertension ,Ambulatory blood pressure ,pediatrics ,blood pressure measurement ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Renal artery stenosis ,tobacco ,pharmacotherapy ,03 medical and health sciences ,0302 clinical medicine ,adults ,medicine ,guidelines ,030212 general & internal medicine ,global cardiovascular risk ,automated blood pressure ,renal artery stenosis ,primary aldosteronism ,Ejection fraction ,business.industry ,Guideline ,Thrombolysis ,medicine.disease ,diagnostic algorithm ,pheochromocytoma ,smoking cessation ,home blood pressure monitoring ,ambulatory blood pressure monitoring ,lipid profile ,Blood pressure ,Heart failure ,recommendations ,Emergency medicine ,renovascular disease ,Cardiology and Cardiovascular Medicine ,business ,Risk assessment ,high blood pressure - Abstract
Hypertension Canada provides annually-updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension in adults and children. This year, the adult and pediatric guidelines are combined in one document. The new 2018 pregnancy-specific hypertension guidelines are published separately. For 2018, 5 new guidelines were introduced, and one existing guideline on the blood pressure thresholds and targets in the setting of thrombolysis for acute ischemic stroke was revised. The use of validated wrist devices for the estimation of blood pressure in individuals with large arm circumference is now included. Guidance is provided for the follow-up measurements of blood pressure, with the use of standardized methods and electronic (oscillometric) upper arm devices in individuals with hypertension, and either ambulatory blood pressure monitoring or home blood pressure monitoring in individuals with white coat effect. We specify that all individuals with hypertension should have an assessment of global cardiovascular risk to promote health behaviours that lower blood pressure. Finally, an angiotensin receptor-neprilysin inhibitor combination should be used in place of either an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in individuals with heart failure (with ejection fraction < 40%) who are symptomatic despite appropriate doses of guideline-directed heart failure therapies. The specific evidence and rationale underlying each of these guidelines are discussed.
- Published
- 2018