Can J Cardiol Vol 18 No 6 June 2002 604 SPECIAL ARTICLE The 2001 Canadian recommendations for the management of hypertension: Part one – Assessment for diagnosis, cardiovascular risk, causes and lifestyle modification Kelly B Zarnke MD MSc 1 , Finlay A McAlister MD MSc 2 , Norman RC Campbell MD 3 , Mitchell Levine MD MSc 4 , Ernesto L Schiffrin MD 5 , Steven Grover MD 6 , Donald W McKay PhD 7 , Martin G Myers MD 8 , Thomas W Wilson MD 9 , Simon W Rabkin MD 10 , Ross D Feldman MD 11 , Ellen Burgess MD 12 , Peter Bolli MD 13 , George Honos MD 14 , Marcel Lebel MD 15 , Karen Mann PhD MD 16 , Carl Abbott MD 17 , Sheldon Tobe MD 18 , Robert Petrella MD PhD 19 , Rhian M Touyz MD PhD 5 , for the Canadian Hypertension Recommendations Working Group* *Members of the Canadian Hypertension Recommendations Working Group are listed in Appendix 1 1 Departments of Medicine, Epidemiology & Biostatistics, University of Western Ontario, London, Ontario; 2 Division of General Internal Medicine, University of Alberta, Edmonton, Alberta; 3 Division of General Internal Medicine, University of Calgary, Calgary, Alberta; 4 Centre for the Evaluation of Medicines, McMaster University, Hamilton, Ontario; 5 Institut de recherches cliniques de Montreal, Montréal, Québec; 6 Division of Clinical Epidemiology, Montreal General Hospital, McGill University, Montreal, Quebec; 7 Faculty of Medicine, Memorial University of Newfoundland, St John’s, Newfoundland and Labrador; 8 Division of Cardiology, Sunnybrook & Women’s Health Sciences Centre, Toronto, Ontario; 9 Departments of Pharmacology & Medicine, University of Saskatchewan, Saskatoon, Saskatchewan; 10 Department of Medicine, Division of Cardiology, University of British Columbia, Vancouver, British Columbia; 11 Robarts Research Institute and Departments of Medicine, of Physiology and of Pharmacology and Toxicology, University of Western Ontario, London, Ontario; 12 Division of Nephrology, University of Calgary, Calgary, Alberta; 13 Niagara Clinical Teaching & Research Centre, Hotel Dieu Health Sciences Hospital, St Catharines, Ontario; 14 Division of Cardiology, Jewish General Hospital, Montreal, Quebec; 15 Division of Nephrology, CHUQ, pavillon l’Hotel-Dieu de Québec, Québec, Québec; 16 Division of Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia; 17 Division of Endocrinology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia; 18 Division of Nephrology, Sunnybrook & Women’s Health Sciences Centre, Toronto, Ontario; 19 Departments of Family Medicine and Kinesiology and the Centre for Activity and Aging, University of Western Ontario, London, Ontario Correspondence: Dr KB Zarnke, London Health Sciences Centre, University Hospital Campus, 339 Windermere Road, London, Ontario N6A 5A5. Telephone 519-663-2972, fax 519-663-3211, e-mail Kelly.Zarnke@lhsc.on.ca, Web site www.chs.md Received for publication January 22, 2002. Accepted March 18, 2002 KB Zarnke, FA McAlister, NRC Campbell, et al. The 2001 Canadian recommendations for the management of hypertension: Part one – Assessment for diagnosis, cardiovascular risk, causes and lifestyle modification. Can J Cardiol 2002;18(6):604-624. OBJECTIVE: To provide updated, evidence-based recommen- dations for the assessment of the diagnosis, cardiovascular risk, identifiable causes and lifestyle modifications for adults with high blood pressure. OPTIONS: For persons in whom a high blood pressure value is recorded, hypertension is diagnosed based on the appropriate measurement of blood pressure, the level of the blood pressure elevation and the duration of follow-up. In addition, the presence of concomitant vascular risk factors, target organ damage and established atherosclerotic diseases must be assessed to determine the urgency, intensity and type of treatment. For persons receiv- ing a diagnosis of hypertension, defining the overall risk of adverse cardiovascular outcomes requires an assessment of con- comitant vascular risk factors, including laboratory testing, a search for target organ damage and an assessment for modifiable causes of hypertension. Home and ambulatory blood pressure continued on next page