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

2014; Elsevier BV; Volume: 30; Issue: 5 Linguagem: Inglês

10.1016/j.cjca.2014.02.002

1916-7075

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 P.H. Prebtani, Robert J. Herman, Simon Bacon, Richard E. Gilbert, Marcel Ruzicka, Donald W. McKay, Tavis S. Campbell, Steven A. 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 Lavoie, Maxime Lamarre-Cliché, Guy Tremblay, Pavel Hamet, George Fodor, S. George Carruthers, George 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 Padwal, Luc Poirier,

Nutritional Studies and Diet

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.