Hypertension Canada's 2016 Canadian Hypertension Education Program Guidelines for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension.
Hypertension Canada's Canadian Hypertension Education Program Guidelines Task Force provides annually updated, evidence-based recommendations to guide the diagnosis, assessment, prevention, and treatment of hypertension. This year, we present 4 new recommendations, as well as revisions to 2 previous recommendations. In the diagnosis and assessment of hypertension, automated office blood pressure, taken without patient-health provider interaction, is now recommended as the preferred method of measuring in-office blood pressure. Also, although a serum lipid panel remains part of the routine laboratory testing for patients with hypertension, fasting and nonfasting collections are now considered acceptable. For individuals with secondary hypertension arising from primary hyperaldosteronism, adrenal vein sampling is recommended for those who are candidates for potential adrenalectomy. With respect to the treatment of hypertension, a new recommendation that has been added is for increasing dietary potassium to reduce blood pressure in those who are not at high risk for hyperkalemia. Furthermore, in selected high-risk patients, intensive blood pressure reduction to a target systolic blood pressure ≤ 120 mm Hg should be considered to decrease the risk of cardiovascular events. Finally, in hypertensive individuals with uncomplicated, stable angina pectoris, either a β-blocker or calcium channel blocker may be considered for initial therapy. The specific evidence and rationale underlying each of these recommendations are discussed. Hypertension Canada's Canadian Hypertension Education Program Guidelines Task Force will continue to provide annual updates.
Division of Endocrinology and Metabolism, Department of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address: aacleung@ucalgary.ca.
Alexander A
AA
Leung
Department of Medicine and Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada.
Kara
K
Nerenberg
Divisions of General Internal Medicine, Clinical Epidemiology and Endocrinology, Department of Medicine, McGill University, McGill University Health Centre, Montreal, Quebec, Canada.
Stella S
SS
Daskalopoulou
Departments of Family Medicine and Community Health Sciences, Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Kerry
K
McBrien
Division of General Internal Medicine, University of Calgary, Calgary, Alberta, Canada.
Kelly B
KB
Zarnke
Divisions of General Internal Medicine, Clinical Epidemiology and Endocrinology, Department of Medicine, McGill University, McGill University Health Centre, Montreal, Quebec, Canada.
Kaberi
K
Dasgupta
Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.
Lyne
L
Cloutier
Department of Family Medicine, University of British Columbia, Copeman Healthcare Centre, Vancouver, British Columbia, Canada.
Mark
M
Gelfer
Institut de Recherches Cliniques de Montréal, Université de Montréal, Montréal, Quebec, Canada.
Maxime
M
Lamarre-Cliche
Department of Medicine, Université Laval, Québec, Quebec, Canada.
Alain
A
Milot
Ambulatory Internal Medicine Teaching Clinic, St Catharines, Ontario, Canada.
Peter
P
Bolli
CHU-Québec-Hopital St Sacrement, Québec, Quebec, Canada.
Guy
G
Tremblay
University of Alberta, Edmonton, Alberta, Canada.
Donna
D
McLean
University of Toronto, Toronto, Ontario, Canada.
Sheldon W
SW
Tobe
Division of Nephrology, Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
Marcel
M
Ruzicka
Division of Nephrology, Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
Kevin D
KD
Burns
Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, Quebec, Canada.
Michel
M
Vallée
University of Toronto, Toronto, Ontario, Canada.
G V Ramesh
GV
Prasad
Department of Medicine, Université Laval, Québec, Quebec, Canada.
Marcel
M
Lebel
Discipline of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada.
Ross D
RD
Feldman
Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
Peter
P
Selby
University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Andrew
A
Pipe
Department of Medicine and Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Ernesto L
EL
Schiffrin
Division of Nephrology, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Philip A
PA
McFarlane
University Health Network, University of Toronto, Toronto, Ontario, Canada.
Paul
P
Oh
Departments of Medicine (Division of Endocrinology) and Biochemistry, Western University, London, Ontario, Canada.
Robert A
RA
Hegele
Vancouver Coastal Health Addiction Services, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Milan
M
Khara
Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Thomas W
TW
Wilson
Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
S Brian
SB
Penner
Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Ellen
E
Burgess
Division of General Internal Medicine, University of Calgary, Calgary, Alberta, Canada.
Robert J
RJ
Herman
Department of Exercise Science, Concordia University, and Montreal Behavioural Medicine Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Quebec, Canada.
Simon L
SL
Bacon
Vancouver Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Simon W
SW
Rabkin
Division of Endocrinology, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Richard E
RE
Gilbert
Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
Tavis S
TS
Campbell
Division of Clinical Epidemiology, Montreal General Hospital, Montreal, Quebec, Canada.
Steven
S
Grover
University of Montreal, Montreal, Quebec, Canada.
George
G
Honos
Best Practices and Performance, Heart and Stroke Foundation, Toronto, Ontario, Canada.
Patrice
P
Lindsay
Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
Michael D
MD
Hill
Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
Shelagh B
SB
Coutts
Division of Neurology, Halifax Infirmary, Dalhousie University, Halifax, Nova Scotia, Canada.
Gord
G
Gubitz
Medicine, Community Health Sciences, Physiology and Pharmacology, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.
Norman R C
NR
Campbell
St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Gordon W
GW
Moe
Departments of Medicine and Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada.
Jonathan G
JG
Howlett
Charles LeMoyne Hospital Research Centre, Sherbrooke University, Sherbrooke, Quebec, Canada.
Jean-Martin
JM
Boulanger
McMaster University, Hamilton, Ontario, Canada.
Ally
A
Prebtani
Institut de Recherches Cliniques de Montréal, Université de Montréal, Montréal, Quebec, Canada.
Pierre
P
Larochelle
Keenan Research Centre in the Li Ka Shing Knowledge Institute of St Michael's Hospital, and University of Toronto, Toronto, Ontario, Canada.
Lawrence A
LA
Leiter
University of British Columbia, Vancouver, British Columbia, Canada.
Charlotte
C
Jones
University Health Network, Departments of Medicine and Pharmacology, University of Toronto, Toronto, Ontario, Canada.
Richard I
RI
Ogilvie
University of Manitoba, Winnipeg, Manitoba, Canada.
Vincent
V
Woo
Université de Montréal and CHUM, Montréal, Quebec, Canada.
Janusz
J
Kaczorowski
Division of Internal Medicine, McGill University, Montréal, Quebec, Canada.
Luc
L
Trudeau
Department of Family Medicine, Western University, London, Ontario, Canada.
Robert J
RJ
Petrella
Faculty of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Swapnil
S
Hiremath
Faculty of Medicine, Université Laval, Québec, Quebec, Canada.
Denis
D
Drouin
Department of Psychology, University of Quebec at Montreal (UQAM), Montréal, Quebec, Canada.
Kim L
KL
Lavoie
Faculté de Médicine, Université de Montréal, Montréal, Quebec, Canada.
Pavel
P
Hamet
University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
George
G
Fodor
Université de Montréal, Institut de cardiologie de Montréal, Montréal, Quebec, Canada.
Jean C
JC
Grégoire
University of Alberta, Edmonton, Alberta, Canada.
Richard
R
Lewanczuk
Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
George K
GK
Dresser
The Canadian Stroke Network, Ottawa, Ontario, Canada.
Mukul
M
Sharma
Canadian Forces Health Services, Department of National Defence and Dietitians of Canada, Ottawa, Ontario, Canada.
Debra
D
Reid
Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia.
Scott A
SA
Lear
Research Center, Hôpital du Sacré-Coeur de Montréal, Public Health School, University of Montréal, Montréal, Quebec, Canada.
Gregory
G
Moullec
University of Toronto, Toronto, Ontario, Canada; McMaster University, Hamilton, Ontario, Canada.
Milan
M
Gupta
St George's, University of London, London, United Kingdom.
Laura A
LA
Magee
University of Toronto, Toronto, Ontario, Canada.
Alexander G
AG
Logan
Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Kevin C
KC
Harris
Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Janis
J
Dionne
Service de cardiologie, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada.
Anne
A
Fournier
Service de néphrologie, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada.
Geneviève
G
Benoit
Division of Neurology, Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
Janusz
J
Feber
Centre Hospitalier Universitaire de Québec et Faculté de Pharmacie, Université Laval, Québec, Quebec, Canada.
Luc
L
Poirier
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Raj S
RS
Padwal
Departments of Medicine, Community Health and Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada.
Doreen M
DM
Rabi
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001795:Blood Pressure Determination / Q000379:methods; D002170:Canada; D019317:Evidence-Based Medicine; D006266:Health Education; D006801:Humans; D006929:Hyperaldosteronism / Q000188:drug therapy; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D018570:Risk Assessment; D012307:Risk Factors
D000959:Antihypertensive Agents