Table 1.

Summary of updates to Canadian Hypertension Education Program (CHEP) guidelines

2012 Updates
CHEP 2011	CHEP 2012
Using home BP measurements, patients can be diagnosed as hypertensive if the average SBP is ≥135 mmHg or the DBP is ≥85 mmHg (Grade C). If the average home BP is <135/85 mmHg, it is advisable to perform 24-hour ABPM to confirm that the mean 24-hour ABPM is <130/80 mmHg and the mean awake ABPM is <135/85 mmHg before diagnosing white coat hypertension (Grade D).	Using home BP measurements, patients can be diagnosed as hypertensive if the average SBP is >135 mmHg or the DBP is >85 mmHg (Grade C). If the average home BP is <135/85 mmHg, it is advisable to either repeat home monitoring to confirm the home BP is <135/85 mmHg or perform 24-hour ABPM to confirm that the mean 24-hour ABPM is <130/80 mmHg and the mean awake ABPM is <135/85 mmHg before diagnosing white coat hypertension (Grade D).
For patients with nondiabetic chronic kidney disease, target BP is <130/80 mmHg (Grade C).	For patients with nondiabetic chronic kidney disease, target blood pressure is <140/90 mmHg (Grade B).
In patients with systolic dysfunction, ACE inhibitors (Grade A) and beta-blockers (Grade A) are recommended for initial therapy. Aldosterone antagonists (Grade B) are also recommended for patients with NYHA class III or IV symptoms of heart failure or postmyocardial infarction.	In patients with systolic dysfunction (EF <40%), ACE inhibitors (Grade A) and beta-blockers (Grade A) are recommended for initial therapy; aldosterone antagonists (mineralocorticoid receptor antagonists) may be added for patients with a recent cardiovascular hospitalization, acute myocardial infarction, elevated BNP or NT-proBNP level, or NYHA class II to IV symptoms (Grade A). Careful monitoring for hyperkalemia is recommended when adding an aldosterone antagonist.
2013 Updates
CHEP 2012	CHEP 2013
Isolated systolic hypertension without other compelling indications (target BP is <140/90 mmHg) (Grade C for systolic, Grade A for diastolic)	Isolated systolic hypertension without other compelling indications (target BP for age <80 years is <140/90 mmHg; for age >80 years, the target systolic BP is <150 mmHg) (Grade C)

ABPM, ambulatory blood pressure monitoring; ACE, angiotensin-converting enzyme; BNP, B-type natriuretic peptide; BP, blood pressure; DBP, diastolic blood pressure; EF, ejection fraction; NT-proBNP, N-terminal prohormone of brain natriuretic peptide; NYHA, New York Heart Association; SBP, systolic blood pressure. Bold text represents changes in the guidelines from previous versions.