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Practice Guideline
. 2017 May;33(5):557-576.
doi: 10.1016/j.cjca.2017.03.005. Epub 2017 Mar 10.

Hypertension Canada's 2017 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults

Alexander A Leung  1 Stella S Daskalopoulou  2 Kaberi Dasgupta  2 Kerry McBrien  3 Sonia Butalia  4 Kelly B Zarnke  5 Kara Nerenberg  6 Kevin C Harris  7 Meranda Nakhla  8 Lyne Cloutier  9 Mark Gelfer  10 Maxime Lamarre-Cliche  11 Alain Milot  12 Peter Bolli  13 Guy Tremblay  14 Donna McLean  15 Karen C TranSheldon W Tobe  16 Marcel Ruzicka  17 Kevin D Burns  17 Michel Vallée  18 G V Ramesh Prasad  16 Steven E Gryn  19 Ross D Feldman  20 Peter Selby  21 Andrew Pipe  22 Ernesto L Schiffrin  23 Philip A McFarlane  24 Paul Oh  25 Robert A Hegele  26 Milan Khara  27 Thomas W Wilson  28 S Brian Penner  29 Ellen Burgess  30 Praveena Sivapalan  28 Robert J Herman  5 Simon L Bacon  31 Simon W Rabkin  32 Richard E Gilbert  33 Tavis S Campbell  34 Steven Grover  35 George Honos  36 Patrice Lindsay  37 Michael D Hill  38 Shelagh B Coutts  39 Gord Gubitz  40 Norman R C Campbell  41 Gordon W Moe  42 Jonathan G Howlett  43 Jean-Martin Boulanger  44 Ally Prebtani  13 Gregory Kline  30 Lawrence A Leiter  45 Charlotte Jones  46 Anne-Marie Côté  47 Vincent Woo  48 Janusz Kaczorowski  49 Luc Trudeau  50 Ross T Tsuyuki  51 Swapnil Hiremath  52 Denis Drouin  53 Kim L Lavoie  54 Pavel Hamet  55 Jean C Grégoire  56 Richard Lewanczuk  15 George K Dresser  57 Mukul Sharma  58 Debra Reid  59 Scott A Lear  60 Gregory Moullec  61 Milan Gupta  62 Laura A Magee  63 Alexander G Logan  16 Janis Dionne  7 Anne Fournier  64 Geneviève Benoit  65 Janusz Feber  66 Luc Poirier  67 Raj S Padwal  68 Doreen M Rabi  69 Hypertension Canada
Affiliations
Practice Guideline

Hypertension Canada's 2017 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults

Alexander A Leung et al. Can J Cardiol. .

Erratum in

  • Erratum.
    Can J Cardiol. 2017 Dec;33(12):1733-1734. doi: 10.1016/j.cjca.2017.09.006. Epub 2017 Nov 1. Can J Cardiol. 2017. PMID: 29079390 No abstract available.

Abstract

Hypertension Canada provides annually updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension. This year, we introduce 10 new guidelines. Three previous guidelines have been revised and 5 have been removed. Previous age and frailty distinctions have been removed as considerations for when to initiate antihypertensive therapy. In the presence of macrovascular target organ damage, or in those with independent cardiovascular risk factors, antihypertensive therapy should be considered for all individuals with elevated average systolic nonautomated office blood pressure (non-AOBP) readings ≥ 140 mm Hg. For individuals with diastolic hypertension (with or without systolic hypertension), fixed-dose single-pill combinations are now recommended as an initial treatment option. Preference is given to pills containing an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in combination with either a calcium channel blocker or diuretic. Whenever a diuretic is selected as monotherapy, longer-acting agents are preferred. In patients with established ischemic heart disease, caution should be exercised in lowering diastolic non-AOBP to ≤ 60 mm Hg, especially in the presence of left ventricular hypertrophy. After a hemorrhagic stroke, in the first 24 hours, systolic non-AOBP lowering to < 140 mm Hg is not recommended. Finally, guidance is now provided for screening, initial diagnosis, assessment, and treatment of renovascular hypertension arising from fibromuscular dysplasia. The specific evidence and rationale underlying each of these guidelines are discussed.

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