Division of Nephrology, University of Calgary, Alberta.
Can J Cardiol. 2010 May;26(5):241-8. doi: 10.1016/s0828-282x(10)70378-0.
To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with hypertension.
MEDLINE searches were conducted from November 2008 to October 2009 with the aid of a medical librarian. Reference lists were scanned, experts were contacted, and the personal files of authors and subgroup members were used to identify additional studies. Content and methodological experts assessed studies using prespecified, standardized evidence-based algorithms. Recommendations were based on evidence from peer-reviewed full-text articles only.
Recommendations for blood pressure measurement, criteria for hypertension diagnosis and follow-up, assessment of global cardiovascular risk, diagnostic testing, diagnosis of renovascular and endocrine causes of hypertension, home and ambulatory monitoring, and the use of echocardiography in hypertensive individuals are outlined. Changes to the recommendations for 2010 relate to automated office blood pressure measurements. Automated office blood pressure measurements can be used in the assessment of office blood pressure. When used under proper conditions, an automated office systolic blood pressure of 135 mmHg or higher or diastolic blood pressure of 85 mmHg or higher should be considered analogous to a mean awake ambulatory systolic blood pressure of 135 mmHg or higher and diastolic blood pressure of 85 mmHg or higher, respectively.
All recommendations were graded according to strength of the evidence and voted on by the 63 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. To be approved, all recommendations were required to be supported by at least 70% of task force members. These guidelines will continue to be updated annually.
提供更新的、基于证据的成年人高血压诊断和评估建议。
在医学图书馆员的协助下，我们于 2008 年 11 月至 2009 年 10 月进行了 MEDLINE 搜索。扫描参考文献列表，联系专家，并使用作者和分组小组成员的个人档案来确定其他研究。内容和方法专家使用预先规定的、标准化的循证算法评估研究。建议仅基于同行评审全文文章的证据。
概述了血压测量、高血压诊断和随访标准、心血管总体风险评估、诊断性检查、肾血管和内分泌性高血压的诊断、家庭和动态监测以及高血压患者超声心动图的使用等建议。2010 年建议的更改与自动诊室血压测量有关。自动诊室血压测量可用于评估诊室血压。在适当的条件下使用时，自动诊室收缩压为 135mmHg 或更高，或舒张压为 85mmHg 或更高，应分别视为等同于平均清醒动态收缩压为 135mmHg 或更高和舒张压为 85mmHg 或更高。
所有建议均根据证据强度进行分级，并由加拿大高血压教育计划循证建议工作组的 63 名成员进行投票。所有建议都需要得到至少 70%的工作组成员的支持才能获得批准。这些指南将每年继续更新。
