The 2013 Canadian Hypertension Education Program Recommendations for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension

被引:148
作者
Hackam, Daniel G. [1 ,2 ,3 ]
Quinn, Robert R. [4 ,5 ]
Ravani, Pietro [4 ,5 ]
Rabi, Doreen M. [6 ,7 ,8 ]
Dasgupta, Kaberi [9 ,10 ,11 ]
Daskalopoulou, Stella S. [9 ,10 ,11 ]
Khan, Nadia A. [12 ]
Herman, Robert J. [13 ]
Bacon, Simon L. [14 ]
Cloutier, Lyne
Dawes, Martin [15 ]
Rabkin, Simon W. [16 ]
Gilbert, Richard E. [17 ]
Ruzicka, Marcel [18 ]
McKay, Donald W. [19 ]
Campbell, Tavis S. [20 ]
Grover, Steven [21 ]
Honos, George [22 ]
Schiffrin, Ernesto L. [23 ,24 ]
Bolli, Peter [25 ]
Wilson, Thomas W. [26 ]
Feldman, Ross D. [27 ]
Lindsay, Patrice [28 ]
Hill, Michael D. [29 ]
Gelfer, Mark [30 ]
Burns, Kevin D. [15 ]
Vallee, Michel [31 ]
Prasad, G. V. Ramesh
Lebel, Marcel
McLean, Donna [32 ]
Arnold, J. Malcolm O. [27 ]
Moe, Gordon W. [33 ]
Howlett, Jonathan G. [34 ]
Boulanger, Jean-Martin [35 ]
Larochelle, Pierre [36 ]
Leiter, Lawrence A. [37 ,38 ]
Jones, Charlotte [15 ]
Ogilvie, Richard I. [39 ,40 ]
Woo, Vincent [41 ]
Kaczorowski, Janusz [22 ,42 ]
Trudeau, Luc [43 ]
Petrella, Robert J. [44 ]
Milot, Alain
Stone, James A. [45 ]
Drouin, Denis [46 ]
Lavoie, Kim L. [47 ]
Lamarre-Cliche, Maxime [36 ]
Godwin, Marshall [48 ]
Tremblay, Guy [49 ]
Hamet, Pavel [50 ]
机构
[1] Western Univ, Div Clin Pharmacol, Dept Med, London, ON, Canada
[2] Western Univ, Div Clin Pharmacol, Dept Clin Neurol Sci, London, ON, Canada
[3] Western Univ, Div Clin Pharmacol, Dept Epidemiol & Biostat, London, ON, Canada
[4] Univ Calgary, Foothills Med Ctr, Dept Med, Div Nephrol, Calgary, AB, Canada
[5] Univ Calgary, Foothills Med Ctr, Dept Community Hlth Sci, Calgary, AB, Canada
[6] Univ Calgary, Dept Med, Calgary, AB, Canada
[7] Univ Calgary, Dept Community Hlth, Calgary, AB, Canada
[8] Univ Calgary, Dept Cardiac Sci, Calgary, AB, Canada
[9] McGill Univ, Ctr Hlth, Dept Med, Div Gen Internal Med, Montreal, PQ, Canada
[10] McGill Univ, Ctr Hlth, Dept Med, Div Clin Epidemiol, Montreal, PQ, Canada
[11] McGill Univ, Ctr Hlth, Dept Med, Div Endocrinol, Montreal, PQ, Canada
[12] Univ British Columbia, Div Gen Internal Med, Vancouver, BC V5Z 1M9, Canada
[13] Univ Calgary, Calgary, AB, Canada
[14] Concordia Univ, Hop Sacre Coeur Montreal, Montreal Heart Inst, Montreal, PQ, Canada
[15] Univ British Columbia, Vancouver, BC V5Z 1M9, Canada
[16] Univ British Columbia, Vancouver Hosp, Vancouver, BC V5Z 1M9, Canada
[17] Univ Toronto, St Michaels Hosp, Div Endocrinol, Toronto, ON M5B 1W8, Canada
[18] Univ Ottawa, Ottawa Hosp Res Inst, Dept Med, Div Nephrol, Ottawa, ON, Canada
[19] Mem Univ Newfoundland, Fac Med, St John, NF, Canada
[20] Univ Calgary, Dept Psychol, Calgary, AB T2N 1N4, Canada
[21] Montreal Gen Hosp, Div Clin Epidemiol, Montreal, PQ H3G 1A4, Canada
[22] Univ Montreal, Montreal, PQ, Canada
[23] McGill Univ, Jewish Gen Hosp, Dept Med, Montreal, PQ H3T 1E2, Canada
[24] McGill Univ, Jewish Gen Hosp, Lady Davis Inst Med Res, Montreal, PQ H3T 1E2, Canada
[25] Ambulatory Internal Med Teaching Clin, St Catharines, ON, Canada
[26] Univ Saskatchewan, Dept Med, Saskatoon, SK S7N 0W0, Canada
[27] Western Univ, London, ON, Canada
[28] Univ Toronto, Ottawa Hosp Res Inst, Canadian Stroke Network, Toronto, ON, Canada
[29] Univ Calgary, Hotchkiss Brain Inst, Dept Clin Neurosci, Calgary, AB, Canada
[30] Univ British Columbia, Copeman Healthcare Ctr, Dept Family Med, Vancouver, BC V5Z 1M9, Canada
[31] Univ Montreal, Hop Maisonneuve Rosemont, Montreal, PQ, Canada
[32] Univ Alberta, Edmonton, AB, Canada
[33] Univ Toronto, St Michaels Hosp, Toronto, ON M5B 1W8, Canada
[34] Univ Calgary, Dept Med, Calgary, AB, Canada
[35] Univ Sherbrooke, Charles LeMoyne Hosp, Res Ctr, Sherbrooke, PQ J1K 2R1, Canada
[36] Univ Montreal, Inst Recherches Clin Montreal, Montreal, PQ, Canada
[37] St Michaels Hosp, Li Ka Shing Knowledge Inst, Keenan Res Ctr, Toronto, ON M5B 1W8, Canada
[38] Univ Toronto, Toronto, ON, Canada
[39] Univ Toronto, Dept Med, Univ Hlth Network, Toronto, ON, Canada
[40] Univ Toronto, Dept Pharmacol, Univ Hlth Network, Toronto, ON, Canada
[41] Univ Manitoba, Winnipeg, MB, Canada
[42] CHUM, Montreal, PQ, Canada
[43] McGill Univ, Div Internal Med, Montreal, PQ, Canada
[44] Western Univ, Dept Family Med, London, ON, Canada
[45] Univ Calgary, Dept Med, Div Cardiol, Calgary, AB, Canada
[46] Univ Laval, Fac Med, Quebec City, PQ G1K 7P4, Canada
[47] Univ Quebec, Dept Psychol, Montreal, PQ H3C 3P8, Canada
[48] Mem Univ Newfoundland, St John, NF, Canada
[49] CHU Quebec Hop St Sacrement, Quebec City, PQ, Canada
[50] Univ Montreal, Fac Med, Montreal, PQ H3C 3J7, Canada
关键词
J-CURVE; CARDIOVASCULAR RISK; DIETARY PATTERNS; PART II; MYOCARDIAL-INFARCTION; CONTROLLED-TRIALS; MANAGEMENT; THERAPY; DISEASE; EVENTS;
D O I
10.1016/j.cjca.2013.01.005
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We updated the evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in adults for 2013. This year's update includes 2 new recommendations. First, among nonhypertensive or stage 1 hypertensive individuals, the use of resistance or weight training exercise does not adversely influence blood pressure (BP) (Grade D). Thus, such patients need not avoid this type of exercise for fear of increasing BP. Second, and separately, for very elderly patients with isolated systolic hypertension (age 80 years or older), the target for systolic BP should be < 150 mm Hg (Grade C) rather than < 140 mm Hg as recommended for younger patients. We also discuss 2 additional topics at length (the pharmacological treatment of mild hypertension and the possibility of a diastolic J curve in hypertensive patients with coronary artery disease). In light of several methodological limitations, a recent systematic review of 4 trials in patients with stage 1 uncomplicated hypertension did not lead to changes in management recommendations. In addition, because of a lack of prospective randomized data assessing diastolic BP thresholds in patients with coronary artery disease and hypertension, no recommendation to set a selective diastolic cut point for such patients could be affirmed. However, both of these issues will be examined on an ongoing basis, in particular as new evidence emerges.
引用
收藏
页码:528 / 542
页数:15
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