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Review
. 2015 Nov;61(11):957-61.

Diagnosing hypertension: Evidence supporting the 2015 recommendations of the Canadian Hypertension Education Program

Mark Gelfer  1 , Martin Dawes  2 , Janusz Kaczorowski  3 , Raj Padwal  4 , Lyne Cloutier  5
Affiliations
Review

Diagnosing hypertension: Evidence supporting the 2015 recommendations of the Canadian Hypertension Education Program

Mark Gelfer et al. Can Fam Physician. 2015 Nov.

Erratum in

  • [Correction].
    [No authors listed] [No authors listed] Can Fam Physician. 2015 Dec;61(12):1050. Can Fam Physician. 2015. PMID: 26668283 Free PMC article. No abstract available.

Abstract

Objective: To highlight the 2015 Canadian Hypertension Education Program (CHEP) recommendations for the diagnosis and assessment of hypertension.

Quality of evidence: A systematic search was performed current to August 2014 by a Cochrane Collaboration librarian using the MEDLINE and PubMed databases. The search results were critically appraised by the CHEP subcommittee on blood pressure (BP) measurement and diagnosis, and evidence-based recommendations were presented to the CHEP Central Review Committee for independent review and grading. Finally, the findings and recommendations were presented to the Recommendations Task Force for discussion, debate, approval, and voting. The main recommendations are based on level II evidence.

Main message: Based on the most recent evidence, CHEP has made 4 recommendations in 2 broad categories for 2015 to improve BP measurement and the way hypertension is diagnosed. A strong recommendation is made to use electronic BP measurement in the office setting to replace auscultatory BP measurement. For patients with elevated office readings, CHEP is recommending early use of out-of-office BP measurement, preferably ambulatory BP measurement, in order to identify early in the process those patients with white-coat hypertension.

Conclusion: Improvements in diagnostic accuracy are critical to optimizing hypertension management in Canada. The annual updates provided by CHEP ensure that practitioners have up-to-date evidence-based information to inform practice.

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Figures

Figure 1.
Figure 1.
Diagnosis of hypertension: Measurement using electronic (oscillometric) upper-arm devices is preferred over auscultation. ABPM—ambulatory blood pressure measurement, AOBP—automated office blood pressure, BP—blood pressure, DBP—diastolic blood pressure, HBPM—home blood pressure measurement, OBPM—office blood pressure measurement, SBP—systolic blood pressure. Reproduced from Daskalopoulou et al with permission.
See this image and copyright information in PMC

Comment in

  • Is white-coat hypertension benign?
    Tsai DB. Tsai DB. Can Fam Physician. 2016 Apr;62(4):305. Can Fam Physician. 2016. PMID: 27076537 Free PMC article. No abstract available.
  • Response.
    Gelfer M, Dawes M, Kaczorowski J, Padwal R, Cloutier L. Gelfer M, et al. Can Fam Physician. 2016 Apr;62(4):306. Can Fam Physician. 2016. PMID: 27076538 Free PMC article. No abstract available.

References

    1. Cloutier L, Daskalopoulou SS, Padwal RS, Lamarre-Cliche M, Bolli P, McLean D, et al. A new algorithm for the diagnosis of hypertension in Canada. Can J Cardiol. 2015;31:620–30. Epub 2015 Feb 19. - PubMed
    1. Daskalopoulou SS, Rabi DM, Zarnke KB, Dasgupta K, Nerenberg K, Cloutier L, et al. The 2015 Canadian Hypertension Education Program (CHEP) recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention and treatment of hypertension. Can J Cardiol. 2015;31(5):549–68. - PubMed
    1. Villegas I, Arias IC, Botero A, Escobar A. Evaluation of the technique used by health-care workers for taking blood pressure. Hypertension. 1995;26(6 Pt 2):1204–6. - PubMed
    1. Dickson BK, Hajjar I. Blood Pressure Measurement Education and Evaluation Program improves measurement accuracy in community-based nurses: a pilot study. J Am Acad Nurse Pract. 2007;19(2):93–102. - PubMed
    1. Dickson RC, Gaebel K, Zizzo A, Neimanis I, Bridge M, Corsini J, et al. Self-reported physician adherence to guidelines for measuring blood pressure. J Am Board Fam Med. 2013;26(2):215–7. - PubMed

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