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Table 5 Key question 3 eligibility criteria (In adults without a prior diagnosis of hypertension, and taking into account measurement method, at what cardiovascular disease risk levels should primary care providers initiate discussions regarding potential interventions for hypertension?)

From: Screening for hypertension in adults: protocol for evidence reviews to inform a Canadian Task Force on Preventive Health Care guideline update

 

Inclusion

Exclusion

Population

Reviews of adults aged 18 years or older who are not on current pharmacological treatment for hypertension

Reviews exclusively in individuals < 18 years, pregnant women

Reviews of patients with secondary hypertension and highly selected groups of patients (e.g., those with chronic kidney disease or renal transplant)

Interventions

Treatment initiation at a lower thresholda

• Systolic blood pressure targets: 110–119 mmHg, 120–129 mmHg, 130–139 mmHg, 140–59 mmHg, 160 mmHg, or above

• Diastolic blood pressure targets: 75–79 mmHg, 80–84 mmHg, 85–89 mmHg, 90–94 mmHg, 95 mmHg, or above

• Cardiovascular risk thresholds: (1) 5–9%, (2) 10–14%, (3) 15–19%, (4) above 20%

N/A

Comparator

Treatment initiation at higher blood pressure and/or cardiovascular risk thresholds

• Noncomparative data where all participants start at the same treatment threshold

• Studies do not stratify by two or more baseline blood pressure or CVD risk groups

Outcomes

Potential benefits

1. Reduced all-cause mortality

2. Reduced CVD-related mortality

3. Reduced macrovascular CVD events (e.g., stroke, myocardial infarction)

4. Reduced microvascular CVD complications (e.g., renal disease, retinal disease)

Potential harms

1. Increased psychosocial impact (e.g., stress)

2. Increased adverse effects from antihypertensive treatment

N/A

Study design

Systematic reviews of randomized controlled trials (RCTs)b,c

Primary studies, editorials, commentaries

Language

English and French

Any other language

Setting

Reviews in primary care and community-based settings (e.g., pharmacy)

No country-based restrictions (for systematic reviews or included primary studies)

Reviews in inpatient or medical specialist settings (e.g., hospital, ICU, specialist’s office)

Publication date

2018-present

N/A

Study quality

No restrictions

N/A

  1. aThe BP measurement method will be recorded, and data will be presented by both BP/CVD risk threshold and measurement method, when available. Intervention treatment categories may be recategorized depending on what is reported in systematic reviews and our findings in KQ2.
  2. bReviews will be considered systematic if they meet the four following criteria: (1) searches at least one database, (2) reports their selection criteria, (3) conducts quality or risk-of-bias assessment on included studies, and (4) provides a list and synthesis of included studies.
  3. cSystematic reviews that include non-randomized studies will also be included if they report results from RCTs separately
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Systematic Reviews

ISSN: 2046-4053