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Review
, 31 (5), 549-68

The 2015 Canadian Hypertension Education Program Recommendations for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension

Stella S Daskalopoulou  1 Doreen M Rabi  2 Kelly B Zarnke  3 Kaberi Dasgupta  4 Kara Nerenberg  5 Lyne Cloutier  6 Mark Gelfer  7 Maxime Lamarre-Cliche  8 Alain Milot  9 Peter Bolli  10 Donald W McKay  11 Guy Tremblay  12 Donna McLean  13 Sheldon W Tobe  14 Marcel Ruzicka  15 Kevin D Burns  15 Michel Vallée  16 G V Ramesh Prasad  14 Marcel Lebel  17 Ross D Feldman  18 Peter Selby  19 Andrew Pipe  20 Ernesto L Schiffrin  21 Philip A McFarlane  22 Paul Oh  23 Robert A Hegele  24 Milan Khara  25 Thomas W Wilson  26 S Brian Penner  27 Ellen Burgess  28 Robert J Herman  29 Simon L Bacon  30 Simon W Rabkin  31 Richard E Gilbert  32 Tavis S Campbell  33 Steven Grover  34 George Honos  35 Patrice Lindsay  36 Michael D Hill  37 Shelagh B Coutts  38 Gord Gubitz  39 Norman R C Campbell  40 Gordon W Moe  41 Jonathan G Howlett  42 Jean-Martin Boulanger  43 Ally Prebtani  44 Pierre Larochelle  45 Lawrence A Leiter  46 Charlotte Jones  47 Richard I Ogilvie  48 Vincent Woo  49 Janusz Kaczorowski  50 Luc Trudeau  51 Robert J Petrella  52 Swapnil Hiremath  53 James A Stone  54 Denis Drouin  55 Kim L Lavoie  56 Pavel Hamet  57 George Fodor  21 Jean C Grégoire  58 Anne Fournier  59 Richard Lewanczuk  13 George K Dresser  60 Mukul Sharma  61 Debra Reid  62 Geneviève Benoit  63 Janusz Feber  64 Kevin C Harris  65 Luc Poirier  66 Raj S Padwal  67
Affiliations
Review

The 2015 Canadian Hypertension Education Program Recommendations for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension

Stella S Daskalopoulou et al. Can J Cardiol.

Abstract

The Canadian Hypertension Education Program reviews the hypertension literature annually and provides detailed recommendations regarding hypertension diagnosis, assessment, prevention, and treatment. This report provides the updated evidence-based recommendations for 2015. This year, 4 new recommendations were added and 2 existing recommendations were modified. A revised algorithm for the diagnosis of hypertension is presented. Two major changes are proposed: (1) measurement using validated electronic (oscillometric) upper arm devices is preferred over auscultation for accurate office blood pressure measurement; (2) if the visit 1 mean blood pressure is increased but < 180/110 mm Hg, out-of-office blood pressure measurements using ambulatory blood pressure monitoring (preferably) or home blood pressure monitoring should be performed before visit 2 to rule out white coat hypertension, for which pharmacologic treatment is not recommended. A standardized ambulatory blood pressure monitoring protocol and an update on automated office blood pressure are also presented. Several other recommendations on accurate measurement of blood pressure and criteria for diagnosis of hypertension have been reorganized. Two other new recommendations refer to smoking cessation: (1) tobacco use status should be updated regularly and advice to quit smoking should be provided; and (2) advice in combination with pharmacotherapy for smoking cessation should be offered to all smokers. The following recommendations were modified: (1) renal artery stenosis should be primarily managed medically; and (2) renal artery angioplasty and stenting could be considered for patients with renal artery stenosis and complicated, uncontrolled hypertension. The rationale for these recommendation changes is discussed.

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