Document Detail

Clinical problem solving based on the 1999 Canadian recommendations for the management of hypertension.
MedLine Citation:
PMID:  10624418     Owner:  NLM     Status:  MEDLINE    
The 1999 Canadian Recommendations for the Management of Hypertension are notable for the trends that they represent with regard to the evolution of the management of hypertension. Diagnostically, the Recommendations endorse the greater use of non-office-based measures of blood pressure control and greater emphasis on the assessment of other atherosclerotic risk factors, both when considering prognosis in hypertension and in the choice of therapy. On the treatment side of the equation, lower targets for blood pressure control have been advocated in subgroups of hypertensive patients, particularly in those with diabetes and renal disease. In conjunction with the recently published recommendations on lifestyle management, there is a greater emphasis on lifestyle modification, both as initial and adjunctive therapy in hypertension. Implicit in the recommendations for therapy is the principle that for the vast majority of hypertensive patients treated pharmacologically, practitioners should not follow a stepped-care approach. Instead, therapy should be individualized, primarily based on consideration of concurrent diseases, both cardiovascular and noncardiovascular (Tables 1 and 2). Through the consensus process, there was a general appreciation of how far we have come in the development of evidence-based recommendations for hypertension management. However, there was also an increasing appreciation of how far we have to go in effectively translating these recommendations into better blood pressure control.
R D Feldman; N R Campbell; P Larochelle
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne     Volume:  161 Suppl 12     ISSN:  0820-3946     ISO Abbreviation:  CMAJ     Publication Date:  1999  
Date Detail:
Created Date:  2000-01-14     Completed Date:  2000-01-14     Revised Date:  2010-09-10    
Medline Journal Info:
Nlm Unique ID:  9711805     Medline TA:  CMAJ     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  S18-22     Citation Subset:  AIM; IM    
Robarts Research Institute, University of Western Ontario, London.
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MeSH Terms
Antihypertensive Agents / therapeutic use*
Decision Making
Hypertension / complications,  diagnosis*,  drug therapy*
Middle Aged
Risk Factors
Reg. No./Substance:
0/Antihypertensive Agents
Comment In:
CMAJ. 2000 May 30;162(11):1555-6   [PMID:  10862227 ]
CMAJ. 2000 May 30;162(11):1554-5; author reply 1556   [PMID:  10862226 ]

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