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Recommendations on screening for high blood pressure in Canadian adults
Patrice Lindsay1, Sarah Connor Gorber, Michel Joffres
1Department of Family Medicine, Queen's University, 220 Bagot St, Kingston, ON K7L 5E9. richard.birtwhistle@dfm.queensu.ca.
Objective:
To provide recommendations on screening for hypertension in adults aged 18 years and older without previously diagnosed hypertension.
Quality Of Evidence:
Evidence was found through a systematic search of MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews (EBM Reviews), from January 1985 to September 2011. Study types were limited to randomized controlled trials, systematic reviews, and observational studies with control groups.
Main Message:
Three strong recommendations were made based on moderate-quality evidence. It is recommended that blood pressure measurement occur at all appropriate primary care visits, according to the current techniques described in the Canadian Hypertension Education Program recommendations for office and ambulatory blood pressure measurement. The Canadian Hypertension Education Program criteria for assessment and diagnosis of hypertension should be applied for people found to have elevated blood pressure.
Conclusion:
After review of the most recent evidence, the Canadian Task Force on Preventive Health Care continues to recommend blood pressure measurement during regular physician visits.
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Prepare for the Procedure:
Pre-Procedural Guidelines for Assessing Blood Pressure
Hypertension I: Introduction
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Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
