Table 1.

Summary of updates to the 2014 Canadian Hypertension Education Program (CHEP) guidelines

CHEP 2013	CHEP 2014*
Routine and optional laboratory tests for the investigation of patients with hypertension
Fasting blood glucose (Grade D)	Fasting blood glucose and/or glycated hemoglobin (A1c) (Grade D)
Global vascular protection therapy for adults with hypertension without compelling indications for specific agents
Strong consideration should be given to the addition of low-dose ASA therapy in hypertensive patients (Grade A in patients older than 50 years). Caution should be exercised if blood pressure is not controlled (Grade C).	Consideration should be given to the addition of low-dose ASA therapy in hypertensive patients ≥50 years (Grade B). Caution should be exercised if blood pressure is not controlled (Grade C).
Health behaviour management
For prevention and treatment of hypertension, a dietary sodium intake of 1500 mg (65 mmol) per day is recommended for adults 50 years or younger, 1300 mg (57 mmol) per day if age 51 to 70 years and 1200 mg (52 mmol) per day if older than 70 years (Grade B).	To decrease blood pressure, consider reducing sodium intake towards 2000 mg (5 g of salt or 87 mmol of sodium) per day (Grade A).
Choice of therapy for adults with hypertension without compelling indications for specific agents
Recommendations for hypertensive patients with coronary artery disease:  5) In high-risk patients, when combination therapy is being used, choices should be individualized. The combination of an ACE inhibitor and a dihydropyridine CCB is preferable to an ACE inhibitor and a diuretic in selected patients (Grade A).	Recommendations for hypertensive patients with coronary artery disease:  5) In high-risk patients, when combination therapy is being used, choices should be individualized. The combination of an ACE inhibitor and a dihydropyridine CCB is preferable to an ACE inhibitor and a diuretic in selected patients (Grade A).  6) When lowering SBP to target levels in patients with established CAD (especially if ISH is present), be cautious when the diastolic blood pressure is ≤60 mmHg because of concerns that myocardial ischemia may be exacerbated (Grade D).
Recommendations for individuals with isolated systolic hypertension  6) In the very elderly (80 years and older), the target for SBP should be <150 mmHg (Grade C).	Recommendations for individuals with isolated systolic hypertension  6) In the very elderly (80 years and older), who do not have diabetes or target organ damage, the SBP threshold for initiating drug therapy is ≥160 mmHg and the SBP target is <150 mmHg (Grade C).

ACE, angiotensin-converting enzyme; ASA, acetylsalicylic acid; CCB, calcium channel blocker; ISH, isolated systolic hypertension; SBP, systolic blood pressure. *Bold text represents changes to the 2014 guidelines from the 2013 guidelines.