2007 CANADIAN HYPERTENSION EDUCATION PROGRAM RECOMMENDATIONS

 - An Annual Update

• · Adults with high normal blood pressure require annual blood pressure assessment. One
  in 5 adult Canadians have high normal blood pressure (130-139/85-89 mmHg) and up to 60% of these
  people will develop hypertension within 4 years. Appropriate lifestyle interventions to prevent
  hypertension and annual or more frequent blood pressure assessment are recommended for those with
  high normal blood pressure.
• · Reducing sodium in the diet of Canadians. Excess dietary sodium is a significant cause of
  hypertension. Patients and the general public need to be educated to select foods low in sodium (to aim
  for a sodium intake of less than 100 mmol/day) and the food sector needs to reduce the sodium content of
  food either voluntarily or by regulation.
• · All Canadian adults need to have blood pressure assessed at all appropriate clinical
  visits. Over 90% of Canadians will develop hypertension therefore all adults require ongoing
  assessment of blood pressure throughout their lives.
• · Optimum management requires assessment of overall cardiovascular risk. Over 90% of
  hypertensive Canadians have other cardiovascular risks. Identifying and managing these other risks
  (e.g. diet, inactivity, dyslipidemia, diabetes) can reduce cardiovascular disease by over 60% in
  hypertensive patients.
• · Lifestyle modifications are effective in reducing blood pressure and cardiovascular
  risk. Blood pressure is lowered and other cardiovascular risks are favorably impacted by a healthy diet,
  regular physical activity, moderation in alcohol, reductions in dietary sodium and in some, stress
  reduction. Planned but simple and brief health care professional interventions markedly increase the
  probability of a patient adhering to lifestyle changes.
• · Combinations of therapies (both drug and lifestyle) are generally necessary to achieve
  target blood pressures. Most patients require more than one antihypertensive drug and lifestyle
  changes to achieve recommended blood pressure targets.
• · Treat to target. In general, blood pressure should be lowered to less than 140/90 mmHg and in those
  with diabetes or chronic kidney disease, to less than 130/80 mmHg.
• · Monitor patients whose blood pressure is above target at least every 2 months and
  increase the intensity of treatment until the targets are achieved. Regular follow-up and
  titration of therapy is required to achieve blood pressure targets.
• · Focus on adherence. Non-adherence to therapy is an important cause of poor blood pressure
  control. Patient adherence to therapy should be assessed on each visit and interventions made to
  improve adherence should be a clinical routine.

DETAILED INFORMATION ON THE 2007 CANADIAN HYPERTENSION EDUCATION PROGRAM RECOMMENDATIONS CAN BE FOUND AT WWW.HYPERTENSION.CA

A version of the hypertension recommendations designed for patient and public education has been developed to assist
health care practitioners manage hypertension. The summary is available electronically at www.hypertension.ca and
www.heartandstroke.ca. Bulk orders of 25 or more copies can be obtained by contacting Megan Smith, Blood Pressure
Canada coordinator at hyperten@ucalgary.ca.
Acknowledgement: This manuscript was written by Dr. N. Campbell with the assistance of the CHEP Executive.
The preliminary drafts were reviewed by Drs R. Feldman, A. Milot, R. Touyz, G. Tremblay and R. Ward and
S. Matheson, RN.