https://www.infirmiere-canadienne.com/blogs/ic-contenu/2025/05/26/hypertension-canada-nouvelles-lignes-directrices/
Patient support tool aimed at the public and other caregivers also available
By Jill Bruneau
May 26, 2025
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Nurses have a vital role to play in preventing hypertension and improving its treatment through better assessment, management and control.
Hypertension Canada has engaged nurses and other representatives to release a new hypertension guideline, Hypertension Canada Guideline for the Diagnosis and Treatment of Hypertension in Primary Care.
This guideline encourages health professionals and patients to improve blood pressure assessment and treatment that is critical to reverse the current declining trends in hypertension control in Canada. It is being published simultaneously in the Canadian Medical Association Journal and other journals before being made available on the Hypertension Canada website.
By engaging multiple individuals and, critically, nurses as the largest health professional group in Canada, in the development and implementation of the guideline, everyone will be able to play their part in improving population health in Canada. In fact, promoting a simplified, streamlined approach to hypertension diagnosis, treatment, and individualized care — using the key principles of the foundational World Health Organization’s HEARTs framework, with adaptation for relevant, context-driven guidelines — can lead to improved hypertension control for Canadians.
How can nurses implement this new guideline in practice?
Nurses have traditionally played an important role in hypertension screening, assessment and treatment through measuring blood pressure, giving anti-hypertensive medications, teaching patients, and encouraging healthy lifestyles; patient caregivers and others are also crucial to treatment and management of high blood pressure. Over the past 20 years, in various health settings, nurse practitioners have been involved in diagnosing and managing hypertension, prescribing medications according to Hypertension Canada guidelines, and monitoring and counselling individuals with hypertension.
Simplified algorithm for hypertension diagnosis
In everyday clinical practice, all nurses, along with other members of the interprofessional team, must be knowledgeable about current evidence by following expert guidelines such as Hypertension Canada Guideline for the Diagnosis and Treatment of Hypertension in Primary Care. Nurses can be actively involved with their patients and the public in knowledge translation of evidence into practice. For example, being aware and promoting dissemination of the new, simplified algorithm for the diagnosis of hypertension greater than or equal to 130/80mmHg (as shown in Figure 1 in the guideline) is an expectation of current, ethical, and safe practice. As well, being knowledgeable about the new treatment target of a BP of less than 130mmHg systolic (see Figure 2) is important to communicate to colleagues and individuals with hypertension or at high risk of developing hypertension. Also, it is critically important to understand when implementing all clinical practice guidelines is that care must be individualized to ensure patient safety and optimal care.
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Patient support tool for the public
As part of the process of developing the specific guideline for primary care, Hypertension Canada has also released a patient support tool, Understanding and Measuring Your Blood Pressure, which was developed with a patient partner working group (see Appendix 4). This easy-to-understand resource to the primary care guideline is intended to empower people to know more about what elevated blood pressure is and how it should be measured correctly, thus giving individuals, caregivers, and families the tools to advocate for themselves and others to obtain optimal hypertension care by nurses and other health-care providers. For example, an illustration and description of the appropriate positioning and process for blood pressure measurement (see Figure 3) is currently available in both the primary care and public guidelines.
Why now?
Hypertension is the number one cause of disability and death in the world. Hypertensive women, for example, are at high risk of developing cardiovascular disease (CVD) and stroke, beginning as early as their 20s and 30s. As well, hypertension during pregnancy means women are at two to three times the risk of developing CVD and more likely to die prior to the age of 70 (Heart and Stroke, 2025). Fortunately, hypertension is preventable and treatable.
The prevalence of hypertension, or high blood pressure, in Canada is 20%; globally, it’s approximately 35% (WHO, 2019). For decades, Canada has been a world leader in hypertension management and control; more recently, however, high blood pressure management has been declining, especially in women (Leung et al, 2020). For this reason, Hypertension Canada released its new guideline for primary care in an effort to engage health-care providers and the public in achieving its vision of healthy blood pressure for every Canadian.
In 2020, Hypertension Canada released guidelines for the prevention, diagnosis, risk assessment and treatment of hypertension in adults and children (Rabi et al., 2020). That was five years ago, and a lot has happened since then, including the COVID-19 pandemic, that has contributed to an overall decline in screening, diagnosis and management of hypertension in many areas around the world, including Canada (Leung et al., 2021).
New approach
In 2024-2025, Hypertension Canada took a new approach to developing the first specific guideline focused on implementation in primary health care settings at the community level, where the majority of hypertension is managed and aimed to improve population health. This new approach to guideline development involved a team-based approach engaging a nurse practitioner, family physicians, pharmacists, specialists, methodologists, and patient partners.
Inspiration for Hypertension Canada’s new approach arose from the HEARTs framework, developed by the World Health Organization (WHO, 2020), meant to be adapted by different countries around the world according to their own contexts, to ensure successful buy-in and implementation aimed at improving cardiovascular health. Hypertension Canada adapted the HEARTs framework to the Canadian context and in accordance with the other key principles of HEARTs (e.g., simplified hypertension diagnosis, team-based interprofessional care, patient-focused approach with cost-effective treatments and follow-up recommendations).
Looking ahead
Nurses have a vital role to play in preventing hypertension and improving its treatment through better assessment, management and control. In the future, Hypertension Canada will release plans for a “living” comprehensive set of guidelines that will address the recommendations and parameters for individuals (e.g., children, pregnant females) in specialized populations and unique clinical scenarios and complex comorbidities for appropriate hypertension diagnosis and management.
References
World Health Organization (WHO). Canada: hypertension profile. https://cdn.who.int/media/docs/default-source/country-profiles/hypertension/hypertension-2023/hypertension_can_2023.pdf?sfvrsn=e7436fc0_5&download=true
Heart and Stroke. (2025). High blood pressure in women. [Web page]. https://www.heartandstroke.ca/women/womens-risk-factors/high-blood-pressure-in-women
Leung, A. A. et. al. (2020). Worsening hypertension awareness, treatment, and control rates in Canadian women between 2007 and 2017. Canadian Journal of Cardiology, 36(5). doi: 10.1016/j.cjca.2020.02.092
Leung, A. A., Bell, A., Tsuyuki, R. T., & Campbell, N. R. C. (2021). Refocusing on hypertension control in Canada. Canadian Medical Association Journal, 193, E854-E855. doi: 10.1503/cmaj.210140
Rabi, D. M., McBrien, K. A., Sapir-Pichhadze, R., Nakhla, M., Ahmed, S. B., Dumanski, S. M., ... Daskalopoulou, S. S. (2020). Hypertension Canada’s 2020 comprehensive guidelines for the prevention, diagnosis, risk assessment, and treatment of hypertension in adults and children. Canadian Journal of Cardiology, 36(5), 596-624. https://doi:10.1016/j.cjca.2020.02.086
Dr. Jill Bruneau, BN, MHSc, PhD, NP, CCN(C), is an assistant professor and nurse practitioner program coordinator for the Master of Science in Nursing, NP Option, and the Post Master’s NP Graduate Diploma, at Memorial University in Newfoundland and Labrador.
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