Zarnke K B, Campbell N R, McAlister F A, Levine M
London Health Sciences Centre, University Hospital Campus, 339 Windermere Road, London, Ontario N6A 5A5, Canada.
Can J Cardiol. 2000 Sep;16(9):1094-102.
There are numerous hypertension consensus recommendations intended for practising physicians. However, recommendations in their current format have limited impact on improving hypertension control.
A group of national societies, headed by the Canadian Hypertension Society, the Heart and Stroke Foundation of Canada, the Canadian Coalition for High Blood Pressure Prevention and Control, and Health Canada has developed strategies to maintain annually updated recommendations for hypertension management and to provide greater opportunities for their implementation into clinical practice. The process is overseen by a steering committee. Subcommittees have been formed for each of a list of topics seen as important to the control of hypertension. The subcommittees, with the aid of a central librarian, conduct annual literature reviews in accordance with Cochrane Collaboration strategies. Modified existing and new recommendations are forwarded to a group with expertise in clinical epidemiology. Grades of evidence are assigned to each recommendation. Revised recommendations based on the above process will be presented annually at the conjoint Canadian Hypertension Society/Canadian Cardiovascular Congress meeting. Under the leadership of the Cardiovascular Disease Division of the Laboratory Centre for Disease Control, Health Canada, a committee has been charged with the implementation process.
The improvements of the current process over previous national hypertension recommendations are four-fold. First, the recommendations will be updated annually. Second, the methodology has been improved. Third, the grading system can be used in the evaluation of complex study designs. Finally, the implementation process is extended. The authors are optimistic that these changes will contribute to the improvement of hypertension control in the Canadian population.
有许多针对执业医师的高血压共识建议。然而，当前形式的建议对改善高血压控制的影响有限。
由加拿大高血压协会、加拿大心脏与中风基金会、加拿大高血压预防与控制联盟以及加拿大卫生部牵头的一组国家学会制定了相关策略，以每年更新高血压管理建议，并为将这些建议应用于临床实践提供更多机会。该过程由一个指导委员会监督。针对一系列被视为对高血压控制很重要的主题分别成立了小组委员会。各小组委员会在一名中央图书馆员的协助下，根据Cochrane协作网的策略进行年度文献综述。修改后的现有建议和新建议被提交给一个临床流行病学专家小组。为每条建议赋予证据等级。基于上述过程修订后的建议将在加拿大高血压协会/加拿大心血管大会联合会议上每年发布一次。在加拿大卫生部疾病控制实验室中心心血管疾病司的领导下，一个委员会负责实施过程。
当前的流程相对于之前的国家高血压建议有四个方面的改进。第一，建议将每年更新。第二，方法得到了改进。第三，分级系统可用于评估复杂的研究设计。最后，实施过程得到了扩展。作者们乐观地认为，这些变化将有助于改善加拿大人群的高血压控制情况。
