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1、Part 1: Recommendations for Hypertension Diagnosis Assessment and Follow up,January, 2007,2007 Canadian Hypertension Education Program Recommendations,The Canadian Hypertension Education Program (CHEP) is jointly sponsored bythe Canadian Hypertension Society, Blood Pressure Canada, the Public Health
2、 Agency of Canada, the Heart and Stroke Foundation of Canada, the Canadian Council of Cardiovascular Nurses, the Canadian Pharmacists Association, the College of Family Physicians of Canada,A red flag has been posted where recommendations were updated for 2007.This slide kit for medical education, h
3、ealth care professional, patient and public information can be downloaded (English and French versions) from the Canadian Hypertension Society website at:http:/www.hypertension.ca,The 2007 Canadian Hypertension Education Program,2007 Canadian Hypertension Education Program Recommendations,The 2007 C
4、anadian Hypertension Education Program,Whats New for 2007 Approximately 95% of Canadians will develop hypertension if they live an average lifespan Most overweight patients with high normal blood pressure (130-139/85-89 mmHg) develop within 4 years and almost 1/2 within 2 years. Annual follow-up of
5、patients with high normal blood pressure is recommended.,2007 Canadian Hypertension Education Program Recommendations,What percent of Canadians have hypertension?,CCHS CMAJ 1992,2007 Canadian Hypertension Education Program Recommendations,Life time risk of Hypertension in Normotensive Women and Men
6、aged 65 years,Risk of Hypertension %,Years to Follow-up,Women,Risk of Hypertension %,Years to Follow-up,Men,JAMA 2002: Framingham data.,100,80,60,40,20,0,100,80,60,40,20,0,2007 Canadian Hypertension Education Program Recommendations,High risk of developing hypertension in those with high normal bloo
7、d pressure,40% of patients with systolic 130-139 or diastolic 85-89 mmHg developed hypertension in 2 years and 63% in 4 years NEJM 2006;354:1685-97Annual follow-up of patients with high normal blood pressure is recommended.,2007 Canadian Hypertension Education Program Recommendations,Reversible risk
8、s for developing hypertension,Obesity Poor dietary habits High sodium intake Sedentary High alcohol consumption High stress High normal blood pressure,The Canadian Hypertension Education Program: 2007 Recommendations Whats old but still important?,Assess blood pressure at all appropriate visits. Alm
9、ost one half of those with blood pressure 130-139/85-89 will develop hypertension within 2 years. They require annual reassessment. Assess global cardiovascular risk in all hypertensive patients. Lifestyle modification is the cornerstone for the prevention and management of hypertension and CVD.,Key
10、 CHEP messages for the management of hypertension,Key CHEP messages for the management of hypertension,Treat to target (140/90 mmHg; 130/80 mmHg in patients with diabetes or chronic kidney disease). To achieve targets sustained lifestyle modification and more than one drug is usually required. Follo
11、w patients with uncontrolled blood pressure at least monthly until blood pressure targets are achieved. Strategies to improve patient adherence to lifestyle modifications and antihypertensive therapy need to be incorporated in every patients management,2007 Canadian Hypertension Education Program Re
12、commendations,The 2007 Canadian Hypertension Education Program Table of contents,HYPERTENSION DIAGNOSIS, ASSESSMENT AND FOLLOW-UPAssess blood pressure at all appropriate visits Criteria for the diagnosis of hypertension and recommendations follow-up Assessment of overall cardiovascular risk in hyper
13、tensive patients Routine and optional laboratory tests for the investigation of patients with hypertension Assessment of renovascular hypertension Endocrine hypertension Home measurement of blood pressure Ambulatory blood pressure measurement Role of Echocardiography,2007 Canadian Hypertension Educa
14、tion Program Recommendations,I. Assess blood pressure at all appropriate visits,More than 90% of Canadians are estimated to develop hypertension during adulthood Approximately one half of adult Canadians are hypertensive by age 60. Even normotensive 55 or 65 year olds have a 90% chance of developing
15、 hypertension over the next 20 years 60% of those who are overweight and have high normal blood pressure will develop hypertension in 4 years,2007 Canadian Hypertension Education Program Recommendations,I. Assess blood pressure at all appropriate visits,Blood pressure of all adults should be measure
16、d whenever it is appropriate by trained healthcare professionals using standardized techniques.To screen for hypertension To assess cardiovascular risk To monitor antihypertensive treatment,2007 Canadian Hypertension Education Program Recommendations,I. Assess blood pressure at all appropriate visits,Assess blood pressure annually in those with high normal blood pressure.,2007 Canadian Hypertension Education Program Recommendations,
