The 2009 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 2 – therapy

Khan, Nadia; Hemmelgarn, Brenda R.; Herman, Robert J.; Bell, Chaim M.; Mahon, Jeff; Leiter, Lawrence A.; Rabkin, Simon W.; Hill, Michael D.; Padwal, Raj; Touyz, Rhian M.; Larochelle, Pierre; Feldman, Ross D.; Schiffrin, Ernesto L.; Campbell, Norman R.C.; Moe, Gordon W.; Prasad, Ramesh; Arnold, Malcolm; Campbell, Tavis S.; Milot, Alain; Stone, James A.; Jones, Charlotte; Ogilvie, Richard I.; Hamet, Pavel; Fodor, George; Carruthers, George; Burns, Kevin D.; Ruzicka, Marcel; deChamplain, Jacques; Pylypchuk, George; Petrella, Robert J.; Boulanger, Jean-Martin; Trudeau, Luc; Hegele, Robert A.; Woo, Vincent; McFarlane, Phil; Vallée, Michel; Howlett, Jonathan G.; Bacon, Simon; Lindsay, Patrice; Gilbert, Richard E.; Lewanczuk, Richard; Tobe, Sheldon W.

doi:10.1016/s0828-282x(09)70492-1

Cited by 122 publications

(88 citation statements)

References 64 publications

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“…This results are in agreement with previous studies during dynamic and isometric exercises demonstrating low diastolic correlation between the two methods [1,11]. Emerging evidence that nonfatal and fatal cardiovascular diseases increase progressively with higher levels of BP [24] makes early identification of persons at increased risk for developing hypertension a priority. It has been suggested that the development of hypertension is preceded by a pre-hypertensive state that may be manifested by abnormal dynamic physical stress tests [25], widely used in hospitals.…”

Section: Discussionsupporting

confidence: 92%

Comparison of Direct vs. Indirect Blood Pressure Measurements on Treadmill and Bicycle in Hypertensive Responders

Saghiv¹,

Goldhammer²

2013

Organic Chem Current Res

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Objectives: This study tested whether the systolic and diastolic blood pressures measured simultaneously by direct and indirect methods provide similar readings for blood pressure response during symptom-limited exercise on a treadmill and bicycle, and if it can be used to monitor blood pressure in hypertensive patients treated with β-blockers. Method:Comparisons were made with simultaneously determined intra-arterial catheter and auscultation measurements on a treadmill and bicycle. Eight hypertensive patients (41.9 ± 2.0 years) active participants in supervised aerobic programs (12.1 ± 1.2 METs work capacity) for at least 12 months were recruited to the study.Results: At rest, indirect systolic pressure was highly correlated with the direct method (r=0.85), with mean of 139 ± 7 and 134 ± 6 mmHg, respectively, at peak treadmill exercise (r=0.90), with mean of 198 ± 11 and 189 ± 9 and bicycle (r=0.92) with mean of 204 ± 10 196±9 mmHg respectively. Indirect diastolic blood pressure correlates well with intra-arterial at rest (r=0.82), with mean of 96 ± 11 and 88 ± 9 mmHg, respectively. However, at peak treadmill exercise, the correlation coefficient between the direct and the indirect methods was low (r=0.40), with mean of 105 ± 9 and 112 ± 12 mmHg, respectively. At peak bicycle exercise correlation was (r=0.58) with mean of 107 ± 9 and 112 ± 12 mmHg. Conclusions:These results suggest that at peak treadmill exercise and bicycle, the indirect method tends to bias low compared with direct therefore it is not valid for the assessment of diastolic pressure in hypertensive patients. Intensity should be considered when using cardiovascular variables as outcome measures.

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Section: Discussionsupporting

confidence: 92%

Comparison of Direct vs. Indirect Blood Pressure Measurements on Treadmill and Bicycle in Hypertensive Responders

Saghiv¹,

Goldhammer²

2013

Organic Chem Current Res

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“…Extensive trials of over 100 randomized trials indicates the efficacy of behavioral treatments for hypertension 5 . Behavioral changes should also include anti-stress activities 6 .…”

Section: Introductionmentioning

confidence: 99%

Effect of psychological stress on blood pressure increase: a meta-analysis of cohort studies

et al. 2009

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Studies have suggested that chronic exposure to stress may have an influence on increased blood pressure. A systematic review followed by a meta-analysis was conducted aiming to assess the effect of psychological stress on blood pressure increase. Research was mainly conducted in Ingenta, Psycinfo, PubMed, Scopus and Web of Science. Inclusion criteria were: published in any language; from January 1970 to December 2006; prospective cohort design; adults; main exposure psychological/emotional stress; outcome arterial hypertension or blood pressure increase > 3.5mmHg. A total of 2,043 studies were found, of which 110 were cohort studies. Of these, six were eligible and yielded 23 comparison groups and 34,556 subjects. Median follow-up time and loss to follow-up were 11.5 years and 21%. Results showed individuals who had stronger responses to stressor tasks were 21% more likely to develop blood pressure increase when compared to those with less strong responses (OR: 1.21; 95%CI: 1.14-1.28; p < 0.001). Although the magnitude of effect was relatively small, results suggest the relevance of the control of psychological stress to the non-therapeutic management of high blood pressure.

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Section: Combining Therapies To Reduce Blood Pressurementioning

confidence: 99%

“…An ACE inhibitor or ARB is a potential first-line therapy in all people with hypertension and diabetes (23). Alternative first-line treatments include long-acting calcium channel blockers and low-dose diuretics in people without microalbuminuria (23). Diuretic therapy is markedly underutilized in people with hypertension and diabetes but is generally considered necessary for blood pressure control when multiple antihypertensive drugs are prescribed (24,25).…”

Section: Combining Therapies To Reduce Blood Pressurementioning

confidence: 99%

Hypertension in Diabetes: A Call to Action

Campbell

Tsuyuki

2009

Can Pharm J

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The 2009 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 2 – therapy

Cited by 122 publications

References 64 publications

Comparison of Direct vs. Indirect Blood Pressure Measurements on Treadmill and Bicycle in Hypertensive Responders

Comparison of Direct vs. Indirect Blood Pressure Measurements on Treadmill and Bicycle in Hypertensive Responders

Effect of psychological stress on blood pressure increase: a meta-analysis of cohort studies

Hypertension in Diabetes: A Call to Action

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