The 2014 Canadian Hypertension Education Program Recommendations for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension

被引：205

作者：

Dasgupta, Kaberi ^{[1
]}

Quinn, Robert R. ^{[2
,3
]}

Zarnke, Kelly B. ^{[4
]}

Rabi, Doreen M. ^{[5
,6
,7
]}

Ravani, Pietro

Daskalopoulou, Stella S.

Rabkin, Simon W. ^{[8
]}

Trudeau, Luc ^{[9
]}

Feldman, Ross D. ^{[10
]}

Cloutier, Lyne ^{[11
]}

Prebtani, Ally ^{[12
]}

Herman, Robert J. ^{[13
]}

Bacon, Simon L. ^{[14
,15
]}

Gilbert, Richard E. ^{[16
]}

Ruzicka, Marcel ^{[17
]}

Mckay, Donald W. ^{[18
]}

Campbell, Tavis S. ^{[19
]}

Grover, Steven ^{[20
]}

Honos, George ^{[21
]}

Schiffrin, Ernesto L. ^{[22
,23
]}

Bolli, Peter ^{[24
]}

Wilson, Thomas W. ^{[25
]}

Lindsay, Patrice ^{[26
]}

Hill, Michael D. ^{[27
]}

Coutts, Shelagh B. ^{[27
,28
]}

Gubitz, Gord ^{[29
]}

Gelfer, Mark ^{[30
]}

Vallee, Michel ^{[31
]}

Prasad, G. V. Ramesh ^{[32
]}

Lebel, Marcel ^{[33
]}

McLean, Donna ^{[34
]}

Arnold, J. Malcolm O. ^{[10
]}

Moe, Gordon W. ^{[35
]}

Howlett, Jonathan G. ^{[36
]}

Boulanger, Jean-Martin ^{[37
]}

Larochelle, Pierre ^{[38
]}

Leiter, Lawrence A. ^{[32
,39
]}

Jones, Charlotte ^{[40
]}

Ogilvie, Richard I. ^{[41
,42
]}

Woo, Vincent ^{[43
]}

Kaczorowski, Janusz ^{[21
,44
]}

Burns, Kevin D. ^{[45
]}

Petrella, Robert J. ^{[46
]}

Hiremath, Swapnil ^{[47
]}

Milot, Alain ^{[33
]}

Stone, James A. ^{[48
]}

Drouin, Denis ^{[49
]}

Lavoie, Kim L. ^{[50
]}

Lamarre-Cliche, Maxime ^{[38
]}

Tremblay, Guy ^{[51
]}

机构：

[1] McGill Univ, Ctr Hlth, Dept Med, Div Gen Internal Med Clin Epidemiol & Endocrinol, Montreal, PQ H3A 1A1, Canada

[2] Univ Calgary, Dept Med, Div Nephrol, Foothills Med Ctr, Calgary, AB, Canada

[3] Univ Calgary, Foothills Med Ctr, Dept Community Hlth Sci, Calgary, AB, Canada

[4] Univ Calgary, Div Gen Internal Med, Calgary, AB, Canada

[5] Univ Calgary, Dept Med, Calgary, AB, Canada

[6] Univ Calgary, Dept Community Hlth, Calgary, AB, Canada

[7] Univ Calgary, Dept Cardiac Sci, Calgary, AB, Canada

[8] Univ British Columbia, Vancouver Hosp, Vancouver, BC V5Z 1M9, Canada

[9] McGill Univ, Div Internal Med, Montreal, PQ H3A 1A1, Canada

[10] Univ Western Ontario, London, ON, Canada

[11] Univ Quebec Trois Rivieres, Trois Rivieres, PQ GA9 5H7, Canada

[12] McMaster Univ, Hamilton, ON, Canada

[13] Univ Calgary, Calgary, AB, Canada

[14] Concordia Univ, Montreal Behav Med Ctr, Montreal, PQ, Canada

[15] Hop Sacre Coeur, Montreal, PQ H4J 1C5, Canada

[16] Univ Toronto, St Michaels Hosp, Div Endocrinol, Toronto, ON, Canada

[17] Univ Ottawa, Div Nephrol, Dept Med, Ottawa Hosp Res Inst, Ottawa, ON, Canada

[18] Mem Univ Newfoundland, Fac Med, St John, NF, Canada

[19] Univ Calgary, Dept Psychol, Calgary, AB T2N 1N4, Canada

[20] Montreal Gen Hosp, Div Clin Epidemiol, Montreal, PQ H3G 1A4, Canada

[21] Univ Montreal, Montreal, PQ, Canada

[22] McGill Univ, Jewish Gen Hosp, Dept Med, Montreal, PQ H3A 1A1, Canada

[23] McGill Univ, Jewish Gen Hosp, Lady Davis Inst Med Res, Montreal, PQ H3A 1A1, Canada

[24] Ambulatory Internal Med Teaching Clin, St Catharines, ON, Canada

[25] Univ Saskatchewan, Dept Med, Saskatoon, SK S7N 0W0, Canada

[26] Heart & Stroke Fdn, Toronto, ON, Canada

[27] Univ Calgary, Hotchkiss Brain Inst, Dept Clin Neurosci, Calgary, AB, Canada

[28] Univ Calgary, Hotchkiss Brain Inst, Dept Radiol, Calgary, AB, Canada

[29] Dalhousie Univ, Halifax Infirm, Div Neurol, Halifax, NS, Canada

[30] Univ British Columbia, Copeman Healthcare Ctr, Dept Family Med, Vancouver, BC V5Z 1M9, Canada

[31] Univ Montreal, Hop Maison Neuve Rosemont, Montreal, PQ, Canada

[32] Univ Toronto, Toronto, ON, Canada

[33] Univ Laval, Dept Med, Quebec City, PQ G1K 7P4, Canada

[34] Univ Alberta, Edmonton, AB, Canada

[35] Univ Toronto, St Michaels Hosp, Toronto, ON, Canada

[36] Univ Calgary, Dept Med, Calgary, ON, Canada

[37] Univ Sherbrooke, Charles LeMoyne Hosp Res Ctr, Sherbrooke, PQ J1K 2R1, Canada

[38] Univ Montreal, Inst Rech Clin Montreal, Montreal, PQ, Canada

[39] St Michaels Hosp, Li Ka Shing Knowledge Inst, Keenan Res Ctr, Toronto, ON M5B 1W8, Canada

[40] Univ British Columbia, Southern Med Program, Kelowna, BC, Canada

[41] Univ Toronto, Univ Hlth Network, Dept Med, Toronto, ON, Canada

[42] Univ Toronto, Dept Pharmacol, Toronto, ON, Canada

[43] Univ Manitoba, Winnipeg, MB, Canada

[44] CHUM, Montreal, PQ, Canada

[45] Ottawa Hosp Res Inst, Ottawa, ON, Canada

[46] Univ Western Ontario, Dept Family Med, London, ON, Canada

[47] Univ Ottawa, Div Nephrol, Ottawa, ON, Canada

[48] Univ Calgary, Dept Med, Div Cardiol, Calgary, AB, Canada

[49] Univ Laval, Fac Med, Quebec City, PQ G1K 7P4, Canada

[50] Univ Quebec Montreal UQAM, Dept Psychol, Montreal, PQ, Canada

来源：

CANADIAN JOURNAL OF CARDIOLOGY | 2014年 / 30卷 / 05期

关键词：

PART; 2; DIETARY PATTERNS; INTRACEREBRAL HEMORRHAGE; CARDIOVASCULAR EVENTS; MYOCARDIAL-INFARCTION; RANDOMIZED-TRIALS; MANAGEMENT; THERAPY; DISEASE; TARGETS;

D O I：

10.1016/j.cjca.2014.02.002

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：485 / 501

页数：17

共 58 条

[1]

Aburto NJ, 2013, BMJ-BRIT MED J, V346, DOI [10.1136/bmj.f1378, 10.1136/bmj.f1326]

[2] Rapid Blood-Pressure Lowering in Patients with Acute Intracerebral Hemorrhage [J].

Anderson, Craig S. ;

Heeley, Emma ;

Huang, Yining ;

Wang, Jiguang ;

Stapf, Christian ;

Delcourt, Candice ;

Lindley, Richard ;

Robinson, Thompson ;

Lavados, Pablo ;

Neal, Bruce ;

Hata, Jun ;

Arima, Hisatomi ;

Parsons, Mark ;

Li, Yuechun ;

Wang, Jinchao ;

Heritier, Stephane ;

Li, Qiang ;

Woodward, Mark ;

Simes, R. John ;

Davis, Stephen M. ;

Chalmers, John .

NEW ENGLAND JOURNAL OF MEDICINE, 2013, 368 (25) :2355-2365

[3]

[Anonymous], 1993, Blood Press, V2, P62

[4] A clinical trial of the effects of dietary patterns on blood pressure [J].

Appel, LJ ;

Moore, TJ ;

Obarzanek, E ;

Vollmer, WM ;

Svetkey, LP ;

Sacks, FM ;

Bray, GA ;

Vogt, TM ;

Cutler, JA ;

Windhauser, MM ;

Lin, PH ;

Karanja, N .

NEW ENGLAND JOURNAL OF MEDICINE, 1997, 336 (16) :1117-1124

[5] Blood pressure targets in patients with coronary artery disease: observations from traditional and Bayesian random effects meta-analysis of randomised trials [J].

Bangalore, Sripal ;

Kumar, Sunil ;

Volodarskiy, Alexander ;

Messerli, Franz H. .

HEART, 2013, 99 (09) :601-613

[6] J-curve revisited: an analysis of blood pressure and cardiovascular events in the Treating to New Targets (TNT) Trial† [J].

Bangalore, Sripal ;

Messerli, Franz H. ;

Wun, Chuan-Chuan ;

Zuckerman, Andrea L. ;

DeMicco, David ;

Kostis, John B. ;

LaRosa, John C. .

EUROPEAN HEART JOURNAL, 2010, 31 (23) :2897-2908

[7] What Is the Optimal Blood Pressure in Patients After Acute Coronary Syndromes? Relationship of Blood Pressure and Cardiovascular Events in the Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction (PROVE IT-TIMI) 22 Trial [J].

Bangalore, Sripal ;

Qin, Jie ;

Sloan, Sarah ;

Murphy, Sabina A. ;

Cannon, Christopher P. .

CIRCULATION, 2010, 122 (21) :2142-2151

[8] Immediate and late benefits of treating very elderly people with hypertension: results from active treatment extension to Hypertension in the Very Elderly randomised controlled trial [J].

Beckett, N. ;

Peters, R. ;

Tuomilehto, J. ;

Swift, C. ;

Sever, P. ;

Potter, J. ;

McCormack, T. ;

Forette, F. ;

Gil-Extremera, B. ;

Dumitrascu, D. ;

Staessen, J. A. ;

Thijs, L. ;

Fletcher, A. ;

Bulpitt, C. .

BMJ-BRITISH MEDICAL JOURNAL, 2012, 344

[9] Treatment of hypertension in patients 80 years of age or older [J].

Beckett, Nigel S. ;

Peters, Ruth ;

Fletcher, Astrid E. ;

Staessen, Jan A. ;

Liu, Lisheng ;

Dumitrascu, Dan ;

Stoyanovsky, Vassil ;

Antikainen, Riitta L. ;

Nikitin, Yuri ;

Anderson, Craig ;

Belhani, Alli ;

Forette, Francoise ;

Rajkumar, Chakravarthi ;

Thijs, Lutgarde ;

Banya, Winston ;

Bulpitt, Christopher J. .

NEW ENGLAND JOURNAL OF MEDICINE, 2008, 358 (18) :1887-1898

[10] Blood-pressure targets in patients with recent lacunar stroke: the SPS3 randomised trial [J].

Benavente, O. R. ;

Coffey, C. S. ;

Conwit, R. ;

Hart, R. G. ;

McClure, L. A. ;

Pearce, L. A. ;

Pergola, P. E. ;

Szychowski, J. M. ;

Benavente, O. R. ;

Hart, R. G. ;

Pergola, P. E. ;

Palacio, S. ;

Castro, I. ;

Farias, A. ;

Roldan, A. ;

Kase, C. ;

Gavras, I. ;

Lau, H. ;

Ogrodnik, M. ;

Allen, N. ;

Meissner, I. ;

Graves, J. ;

Herzig, D. ;

Covalt, J. ;

Meyer, B. ;

Jackson, C. ;

Gamble, P. ;

Kelly, N. ;

Warner, J. ;

Bell, J. ;

Demaerschalk, B. ;

Hogan, M. ;

Wochos, D. ;

Wieser, J. ;

Cleary, B. ;

Wood, L. ;

Hanna, J. ;

Zipp, T. ;

Bailey, S. ;

Cook, D. ;

Liskay, A. ;

Simcox, D. ;

Kappler, J. ;

Anderson, D. ;

Grimm, R. ;

Brauer, D. ;

Pettigrew, C. ;

Vaishnov, A. ;

Sawaya, P. ;

Fowler, A. .

LANCET, 2013, 382 (9891) :507-515

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