The 2010 Canadian Hypertension Education Program recommendations for the management of hypertension: part I - blood pressure measurement, diagnosis and assessment of risk.
OBJECTIVE
To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with hypertension.


METHODS
MEDLINE searches were conducted from November 2008 to October 2009 with the aid of a medical librarian. Reference lists were scanned, experts were contacted, and the personal files of authors and subgroup members were used to identify additional studies. Content and methodological experts assessed studies using prespecified, standardized evidence-based algorithms. Recommendations were based on evidence from peer-reviewed full-text articles only.


CONCLUSIONS
Recommendations for blood pressure measurement, criteria for hypertension diagnosis and follow-up, assessment of global cardiovascular risk, diagnostic testing, diagnosis of renovascular and endocrine causes of hypertension, home and ambulatory monitoring, and the use of echocardiography in hypertensive individuals are outlined. Changes to the recommendations for 2010 relate to automated office blood pressure measurements. Automated office blood pressure measurements can be used in the assessment of office blood pressure. When used under proper conditions, an automated office systolic blood pressure of 135 mmHg or higher or diastolic blood pressure of 85 mmHg or higher should be considered analogous to a mean awake ambulatory systolic blood pressure of 135 mmHg or higher and diastolic blood pressure of 85 mmHg or higher, respectively.


RESULTS
All recommendations were graded according to strength of the evidence and voted on by the 63 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. To be approved, all recommendations were required to be supported by at least 70% of task force members. These guidelines will continue to be updated annually.
Quinn
Robert R
RR
Division of Nephrology, University of Calgary, Alberta. rob.quinn@albertahealthservices.ca
Hemmelgarn
Brenda R
BR
Padwal
Raj S
RS
Myers
Martin G
MG
Cloutier
Lyne
L
Bolli
Peter
P
McKay
Donald W
DW
Khan
Nadia A
NA
Hill
Michael D
MD
Mahon
Jeff
J
Hackam
Daniel G
DG
Grover
Steven
S
Wilson
Thomas
T
Penner
Brian
B
Burgess
Ellen
E
McAlister
Finlay A
FA
Lamarre-Cliche
Maxime
M
McLean
Donna
D
Schiffrin
Ernesto L
EL
Honos
George
G
Mann
Karen
K
Tremblay
Guy
G
Milot
Alain
A
Chockalingam
Arun
A
Rabkin
Simon W
SW
Dawes
Martin
M
Touyz
Rhian M
RM
Burns
Kevin D
KD
Ruzicka
Marcel
M
Campbell
Norman R C
NR
Vallée
Michel
M
Prasad
G V Ramesh
GV
Lebel
Marcel
M
Tobe
Sheldon W
SW
D000328:Adult; D000368:Aged; D001795:Blood Pressure Determination / Q000592:standards; D018660:Blood Pressure Monitoring, Ambulatory / Q000592:standards*; D002170:Canada; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care; D018570:Risk Assessment