Hypertension: Cloutier L

Padwal RS, Hemmelgarn BR, Khan NA, Grover S, McKay DW, Wilson T, Penner B, Burgess E, McAlister FA, Bolli P, Hill MD, Mahon J, Myers MG, Abbott C, Schiffrin EL, Honos G, Mann K, Tremblay G, Milot A, Cloutier L, Chockalingam A, Rabkin SW, Dawes M, Touyz RM, Bell C, Burns KD, Ruzicka M, Campbell NR, Vallée M, Prasad R, Lebel M, Tobe SW, Anonymous00149. · Division of General Internal Medicine, University of Alberta, Edmonton, Canada. · Can J Cardiol. · Pubmed #19417858 No free full text.

Abstract: OBJECTIVE: To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with hypertension. OPTIONS AND OUTCOMES: The diagnosis of hypertension is dependent on appropriate blood pressure measurement, the timely assessment of serially elevated readings, the degree of blood pressure elevation, the method of measurement (office, ambulatory, home) and associated comorbidities. The presence of cardiovascular risk factors and target organ damage should be ascertained to assess global cardiovascular risk and determine the urgency, intensity and type of treatment required. EVIDENCE: MEDLINE searches were conducted from November 2007 to October 2008 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: 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. Key messages include continued emphasis on the expedited, accurate diagnosis of hypertension, the importance of global risk assessment and the need for ongoing monitoring of hypertensive patients to identify incident type 2 diabetes. VALIDATION: All recommendations were graded according to strength of the evidence and voted on by the 57 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations were required to be supported by at least 70% of task force members. These guidelines will continue to be updated annually.

Padwal RS, Hemmelgarn BR, McAlister FA, McKay DW, Grover S, Wilson T, Penner B, Burgess E, Bolli P, Hill M, Mahon J, Myers MG, Abbott C, Schiffrin EL, Honos G, Mann K, Tremblay G, Milot A, Cloutier L, Chockalingam A, Khan NA, Rabkin SW, Dawes M, Touyz RM, Tobe SW, Anonymous00038. · Division of General Internal Medicine, University of Alberta, Edmonton, Alberta. · Can J Cardiol. · Pubmed #17534459 links to  free full text

Abstract: OBJECTIVE: To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with hypertension. OPTIONS AND OUTCOMES: The diagnosis of hypertension is dependent on the appropriate measurement of blood pressure, the timely assessment of serially elevated readings, the degree of blood pressure elevation, the method of measurement (office, ambulatory, home) and any associated comorbidities. The presence of cardiovascular risk factors and target organ damage should be ascertained to assess global cardiovascular risk, and to determine the urgency, intensity and type of treatment required. EVIDENCE: MEDLINE searches were conducted from November 2005 to October 2006 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: 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. Key messages in 2007 include continued emphasis on the expedited, accurate diagnosis of hypertension, the importance of assessing the risk of cerebrovascular events as part of global risk assessment, the need for ongoing reassessment of patients with high normal blood pressure, and reviews of recent studies involving laboratory testing and home monitoring. VALIDATION: All recommendations were graded according to strength of the evidence and were voted on by the 57 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here received at least 70% consensus. These guidelines will continue to be updated annually.

Thompson A, Campbell NR, Cloutier L, Costello JA, Dawes M, Hickey J, Kaczorowski J, Lewanczuk RZ, Semchuk W, Tsuyuki RT, Anonymous00022. · Regional Pharmacy Services, Alberta Health Services, 0G1.01 Walter J MacKenzie Centre, Edmonton, AB, Canada. · Can Fam Physician. · Pubmed #19074693 links to  free full text

This publication has no abstract.

Padwal RJ, Hemmelgarn BR, Khan NA, Grover S, McAlister FA, McKay DW, Wilson T, Penner B, Burgess E, Bolli P, Hill MD, Mahon J, Myers MG, Abbott C, Schiffrin EL, Honos G, Mann K, Tremblay G, Milot A, Cloutier L, Chockalingam A, Rabkin SW, Dawes MD, Touyz RM, Bell C, Burns KD, Ruzicka M, Campbell NR, Lebel M, Tobe SW, Anonymous00045. · Division of General Internal Medicine, University of Alberta, Edmonton, Canada. · Can J Cardiol. · Pubmed #18548142 links to  free full text

Abstract: OBJECTIVE: To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with hypertension. OPTIONS AND OUTCOMES: The diagnosis of hypertension is dependent on appropriate blood pressure measurement, the timely assessment of serially elevated readings, degree of blood pressure elevation, method of measurement (office, ambulatory, home) and associated comorbidities. The presence of cardiovascular risk factors and target organ damage should be ascertained to assess global cardiovascular risk and determine the urgency, intensity and type of treatment required. EVIDENCE: MEDLINE searches were conducted from November 2006 to October 2007 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: 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. Key messages in 2008 include continued emphasis on the expedited, accurate diagnosis of hypertension, the importance of global risk assessment and the need for ongoing monitoring of hypertensive patients to identify incident type 2 diabetes. VALIDATION: All recommendations were graded according to strength of the evidence and voted on by the 57 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here received at least 70% consensus. These guidelines will continue to be updated annually.

McLean D, Kingsbury K, Costello JA, Cloutier L, Matheson S, Anonymous00287. · No affiliation provided · Can J Cardiovasc Nurs. · Pubmed #17583316 No free full text.

Abstract: Recent data from the World Health Organization (WHO) indicate that nearly one billion people in the world are suffering from hypertension. Forecasts suggest that, with the aging of the population, this number could reach 1.5 billion by 2025 (Kearney, Whelton, & Reynolds, 2005). In developed countries, more than one in five adults have hypertension (Vasan, Beiser, Seshadri, Larson, Kannel, & D'Agostino, 2002). Statistics for Canada reveal that fewer than 15% of those diagnosed with hypertension are adequately controlled (Joffres, Hamet, MacLean, L'italien, & Fodor, 2001). Part of the effort to improve hypertension detection, assessment and treatment is an annual process to produce and update evidence-based recommendations for the management of hypertension and to implement the recommendations (Zarnke, Campbell, McAlister, & Levine, 2000; Campbell, Nagpal, & Drouin, 2001). The most up-to-date 2007 Canadian recommendations for the assessment and management of hypertension are presented. Contemporary nursing practice requires that nurses take responsibility and a role in the primary prevention, detection and treatment of hypertension.

Niyonsenga T, Vanasse A, Courteau J, Cloutier L. · Stempel School of Public Health, Epidemiology & Biostatistics, Florida International University, Miami, FL, USA. · J Clin Hypertens (Greenwich). · Pubmed #18453792 No free full text.

Abstract: The accuracy of blood pressure (BP) measurement is important; systematic small errors can mislabel BP status in many persons. The objective of this study was to assess the impact of 2 types of measurement errors on the evaluation of BP in family medicine: errors associated with terminal digit preference and those associated with calibration errors of sphygmomanometers. Secondary data analyses from 2 different projects were used to derive empiric distributions of terminal digit and BP device errors. Taking into account both types of errors, the proportion of false positives (falsely high BP) and false negatives (falsely normal BP) varied between 0. 82% and 5.18% of the population of consulting family physicians. In the United States, false positives and false negatives in patients' BP evaluations might lead to overtreating or undertreating 1.15 million to 7.25 million patients. Results support the need for the development of systematic interventions for quality control of BP measurements and periodic retraining for health professionals.