TY - JOUR
T1 - Hypertension Canada's 2017 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults
AU - Hypertension Canada
AU - Leung, Alexander A.
AU - Daskalopoulou, Stella S.
AU - Dasgupta, Kaberi
AU - McBrien, Kerry
AU - Butalia, Sonia
AU - Zarnke, Kelly B.
AU - Nerenberg, Kara
AU - Harris, Kevin C.
AU - Nakhla, Meranda
AU - Cloutier, Lyne
AU - Gelfer, Mark
AU - Lamarre-Cliche, Maxime
AU - Milot, Alain
AU - Bolli, Peter
AU - Tremblay, Guy
AU - McLean, Donna
AU - Tobe, Sheldon W.
AU - Ruzicka, Marcel
AU - Burns, Kevin D.
AU - Vallée, Michel
AU - Prasad, G. V.Ramesh
AU - Gryn, Steven E.
AU - Feldman, Ross D.
AU - Selby, Peter
AU - Pipe, Andrew
AU - Schiffrin, Ernesto L.
AU - McFarlane, Philip A.
AU - Oh, Paul
AU - Hegele, Robert A.
AU - Khara, Milan
AU - Wilson, Thomas W.
AU - Penner, S. Brian
AU - Burgess, Ellen
AU - Sivapalan, Praveena
AU - Herman, Robert J.
AU - Bacon, Simon L.
AU - Rabkin, Simon W.
AU - Gilbert, Richard E.
AU - Campbell, Tavis S.
AU - Grover, Steven
AU - Honos, George
AU - Lindsay, Patrice
AU - Hill, Michael D.
AU - Coutts, Shelagh B.
AU - Gubitz, Gord
AU - Campbell, Norman R.C.
AU - Moe, Gordon W.
AU - Howlett, Jonathan G.
AU - Boulanger, Jean Martin
AU - Prebtani, Ally
N1 - Publisher Copyright:
© 2017 Canadian Cardiovascular Society
PY - 2017/5
Y1 - 2017/5
N2 - 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.
AB - 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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U2 - 10.1016/j.cjca.2017.03.005
DO - 10.1016/j.cjca.2017.03.005
M3 - Article
C2 - 28449828
AN - SCOPUS:85018679773
SN - 0828-282X
VL - 33
SP - 557
EP - 576
JO - Canadian Journal of Cardiology
JF - Canadian Journal of Cardiology
IS - 5
ER -