title: The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part I--Blood pressure measurement, diagnosis and assessment of risk.
abstract: OBJECTIVE
  To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with high blood pressure.
  
  
  METHODS
  For persons in whom a high blood pressure value is recorded, a diagnosis of hypertension is dependent on the appropriate measurement of blood pressure, the level of the blood pressure elevation, the approach used to monitor blood pressure (office, ambulatory or home/self), and the duration of follow-up. In addition, the presence of cardiovascular risk factors and target organ damage should be assessed to determine the urgency, intensity and type of treatment. For persons diagnosed as having hypertension, estimating the overall risk of adverse cardiovascular outcomes requires an assessment for other vascular risk factors and hypertensive target organ damage.
  
  
  METHODS
  MEDLINE searches were conducted from November 2004 to October 2005 to update the 2005 recommendations. Reference lists were scanned, experts were polled, and the personal files of the authors and subgroup members were used to identify other studies. Identified articles were reviewed and appraised using prespecified levels of evidence by content and methodological experts. As per previous years, the authors only included studies that had been published in the peer-reviewed literature and did not include evidence from abstracts, conference presentations or unpublished personal communications.
  
  
  CONCLUSIONS
  The present document contains recommendations for blood pressure measurement, diagnosis of hypertension, and assessment of cardiovascular risk for adults with high blood pressure. These include the accurate measurement of blood pressure, criteria for the diagnosis of hypertension and recommendations for follow-up, assessment of overall cardiovascular risk, routine and optional laboratory testing, assessment for renovascular and endocrine causes, home and ambulatory blood pressure monitoring, and the role of echocardiography for those with hypertension. Key features of the 2006 recommendations include continued emphasis on an expedited diagnosis of hypertension, an in-depth review of the role of global risk assessment in hypertension therapy, and the use of home/self blood pressure monitoring for patients with masked hypertension (subjects with hypertension who have a blood pressure that is normal in clinic but elevated on home/self measurement).
  
  
  RESULTS
  All recommendations were graded according to the strength of the evidence and were voted on by the 45 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported herein received at least 95% consensus. These guidelines will continue to be updated annually.
authors.affiliation: Division of Nephrology, University of Calgary, and Foothills Hospital, 1403 29th Street Northwest, Calgary, Alberta, Canada. brenda.hemmelgarn@calgaryhealthregion.ca
authors.forename: B R
authors.initials: BR
authors.lastname: Hemmelgarn
authors.forename: Finlay A
authors.initials: FA
authors.lastname: McAlister
authors.forename: Steven
authors.initials: S
authors.lastname: Grover
authors.forename: Martin G
authors.initials: MG
authors.lastname: Myers
authors.forename: Donald W
authors.initials: DW
authors.lastname: McKay
authors.forename: Peter
authors.initials: P
authors.lastname: Bolli
authors.forename: Carl
authors.initials: C
authors.lastname: Abbott
authors.forename: Ernesto L
authors.initials: EL
authors.lastname: Schiffrin
authors.forename: George
authors.initials: G
authors.lastname: Honos
authors.forename: Ellen
authors.initials: E
authors.lastname: Burgess
authors.forename: Karen
authors.initials: K
authors.lastname: Mann
authors.forename: Thomas
authors.initials: T
authors.lastname: Wilson
authors.forename: Brian
authors.initials: B
authors.lastname: Penner
authors.forename: Guy
authors.initials: G
authors.lastname: Tremblay
authors.forename: Alain
authors.initials: A
authors.lastname: Milot
authors.forename: Arun
authors.initials: A
authors.lastname: Chockalingam
authors.forename: Rhian M
authors.initials: RM
authors.lastname: Touyz
authors.forename: Sheldon W
authors.initials: SW
authors.lastname: Tobe
mesh_terms: D026683:Advisory Committees; D001795:Blood Pressure Determination; D002170:Canada; D004452:Echocardiography; D006801:Humans; D006929:Hyperaldosteronism / Q000175:diagnosis; D006973:Hypertension / Q000175:diagnosis*; D008403:Mass Screening; D010353:Patient Education as Topic; D010673:Pheochromocytoma / Q000175:diagnosis; D018570:Risk Assessment; D012307:Risk Factors