title: Report of the Canadian Hypertension Society Consensus Conference: 2. Diagnosis of hypertension in adults.
abstract: OBJECTIVE
  To update recommendations for the diagnosis of mild hypertension in adults and to assess the role of echocardiography, self-measurement of blood pressure and ambulatory blood pressure monitoring.
  
  
  METHODS
  Literature reviews of previous consensus conferences were updated with searches of MEDLINE for the period Jan. 1, 1988, to Nov. 15, 1991, and supplemented by reference lists and personal files.
  
  
  METHODS
  Panel members selected relevant articles and rated them according to methodologic criteria.
  
  
  METHODS
  The data extracted concerned the measurement of blood pressure, the diagnosis of hypertension, the treatment of mild hypertension, and the reliability and validity of echocardiography, self-measurement of blood pressure and ambulatory blood pressure monitoring in the diagnosis of mild hypertension. The recommendations made were graded according to the level of evidence available, circulated to many experts and approved at a consensus conference.
  
  
  RESULTS
  Previous recommendations for the accurate measurement of blood pressure remain mostly unchanged. Antihypertensive treatment should be prescribed for patients (including the elderly) with an average diastolic blood pressure of at least 100 mm Hg, for those with isolated systolic hypertension (systolic blood pressure of at least 160 mm Hg and diastolic blood pressure of less than 90 mm Hg) and for patients with a diastolic blood pressure of 90 to 99 mm Hg and target-organ damage. Clinical judgement is required in treating patients with a diastolic blood pressure of 90 to 99 mm Hg without target-organ damage, and individual risk for cardiovascular disease must be taken into account. There is insufficient evidence to warrant the routine use of echocardiography, self-measurement of blood pressure or ambulatory blood pressure monitoring in diagnosis.
  
  
  CONCLUSIONS
  Recent high-quality evidence supports several new recommendations for the diagnosis of mild hypertension in adults. Additional research is needed to determine the role of echocardiography, self-measurement of blood pressure and ambulatory blood pressure monitoring.
authors.affiliation: Health Information Research Unit, McMaster University, Hamilton, Ont.
authors.forename: R B
authors.initials: RB
authors.lastname: Haynes
authors.forename: Y
authors.initials: Y
authors.lastname: Lacourcière
authors.forename: S W
authors.initials: SW
authors.lastname: Rabkin
authors.forename: F H
authors.initials: FH
authors.lastname: Leenen
authors.forename: A G
authors.initials: AG
authors.lastname: Logan
authors.forename: N
authors.initials: N
authors.lastname: Wright
authors.forename: C E
authors.initials: CE
authors.lastname: Evans
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001795:Blood Pressure Determination / Q000379:methods; D002170:Canada; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000628:therapy; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D012648:Self Care