Goupil Rémi, Tsuyuki Ross T, Santesso Nancy, Terenzi Kristin A, Habert Jeffrey, Cheng Gemma, Gysel Stephanie C, Bruneau Jill, Leung Alexander A, Campbell Norman R C, Schiffrin Ernesto L, Hundemer Gregory L
Division of Nephrology, Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, QC.
EPICORE, Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB.
Can Pharm J (Ott). 2025 May 27:17151635251343907. doi: 10.1177/17151635251343907.
Canada has historically been among the world leaders in hypertension care, but hypertension treatment and control rates have regressed in recent years. This guideline is intended to provide pragmatic primary care-focused recommendations to improve hypertension management in adults at the population level.
We employed Grading of Recommendations Assessment, Development and Evaluation and ADAPTE frameworks in accordance with Appraisal of Guidelines for Research and Evaluation (AGREE II) quality and reporting standards to develop recommendations on managing hypertension for adults aged 18 years and older. We used the HEARTS framework-a model of care developed by the World Health Organization to improve hypertension control and reduce cardiovascular burden-to integrate these recommendations into streamlined, pragmatic, and evidence-based algorithms. The guideline committee predominantly comprised primary care providers and also included patient, methodology, and hypertension specialist representatives. Our process for managing competing interests adhered to Guidelines International Network principles.
The 9 recommendations for managing hypertension in adults are grouped under the categories of diagnosis and treatment. Diagnostic recommendations include a standardized approach to measuring blood pressure (BP) and confirming hypertension, as well as providing a uniform definition for hypertension of BP ≥130/80 mmHg. Treatment recommendations include targeting a systolic BP <130 mmHg, implementing healthy lifestyle changes, and providing stepwise guidance on optimal medication choices for patients requiring pharmacotherapy.
Our aim is to enhance the standard of hypertension care in the Canadian primary care setting. Accurate diagnosis and optimal treatment of hypertension can reduce adverse cardiovascular events and risk of death.
加拿大在历史上一直是高血压护理领域的全球领先者之一，但近年来高血压治疗率和控制率有所下降。本指南旨在提供以基层医疗为重点的实用建议，以在人群层面改善成人高血压管理。
我们采用了推荐分级评估、制定和评价（Grading of Recommendations Assessment, Development and Evaluation）以及ADAPTE框架，按照研究与评价指南评估（Appraisal of Guidelines for Research and Evaluation, AGREE II）的质量和报告标准，制定关于18岁及以上成人高血压管理的建议。我们使用了HEARTS框架（世界卫生组织开发的一种护理模式，用于改善高血压控制和减轻心血管负担）将这些建议整合到简化、实用且基于证据的算法中。指南委员会主要由基层医疗服务提供者组成，还包括患者、方法学和高血压专科代表。我们管理利益冲突的过程遵循国际指南网络的原则。
针对成人高血压管理的9条建议分为诊断和治疗两类。诊断建议包括测量血压（BP）和确诊高血压的标准化方法，以及为血压≥130/80 mmHg的高血压提供统一的定义。治疗建议包括将收缩压目标设定为<130 mmHg，实施健康的生活方式改变，以及为需要药物治疗的患者提供关于最佳药物选择的逐步指导。
我们的目标是提高加拿大基层医疗环境中的高血压护理标准。准确诊断和优化治疗高血压可减少不良心血管事件和死亡风险。
