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Recommendations for Managing High Blood Pressure


The Canadian Coalition for High Blood Pressure Prevention and Control have just released, in the Canadian Journal of Public Health Volume 89, # 5, 1998 (October), recommendations for the management of high blood pressure. To receive a faxed copy of the special insert, contact Karen Craven at the Canadian Public Health Association or go directly to CCHBPPC website and get either abstract or full article.

Contact the Editorial office: 1565 Carling Ave., Suite 400, Ottawa, Ontario (613) 725-3769, or by fax (613) 725-9826.

Recommendation 1:

Patients should be provided with written and verbal instructions regarding the etiology and prognosis of hypertension as well as the benefits of pharmacologic and non-pharmacologic therapy. Providing information at the reading level of the patients is crucial, as is a periodic follow-up. Audiovisual technologies may be useful for some patients.

Recommendation 2:

Medication regimens should be simplified and a combination of behaviour strategies provided. These should include tailoring pill taking to patients' daily habits and rituals, and advocating self-monitoring of pills and blood pressure.

Recommendation 3:

Physicians, nurses and pharmacists should spend time during the patient's visit reviewing adherence to treatment. Nurses and pharmacists should provide patients with advice on adherence and monitor patient adherence regularly. Physicians should try to avoid gaps in the information transmitted to patients. At each visit, health care professionals should assess a patient's adherence by direct questioning. Family support should be instigated where appropriate.

Recommendation 4:

For most patients, it is preferable to prescribe medications that can be taken once a day. As well, the medications chosen must be realistically priced from the patient's perspective.

Submitted by: Debbie Bang, St. Joseph's Community Health Centre