New guidelines for managing hypertension in primary care

On this episode of the CMAJ Podcast, hosts Dr. Mojola Omole and Dr. Blair Bigham speak with two authors of the latest “Hypertension Canada guideline for the diagnosis and treatment of hypertension in adults in primary care”

The discussion reflects a shared urgency: despite past successes, Canada’s hypertension control rates are declining. The new guidelines aim to reverse this trend by simplifying diagnosis and treatment for frontline clinicians.

Dr. Rémi Goupil, a nephrologist and clinician researcher at Sacré-Cœur Hospital in Montreal, and Dr. Greg Hundemer, a nephrologist and clinician scientist at The Ottawa Hospital, explain that the updated guideline is deliberately designed for primary care providers. They highlight key shifts: lowering the diagnostic threshold for hypertension to  ≥ 130/80 mm Hg, simplifying blood pressure targets, and emphasizing accurate, standardized measurement techniques both in clinic and at home. The guidelines were created with input from a majority-primary care committee—including family physicians, nurses, pharmacists, and patient partners—to ensure clinical applicability.

Together, the panel outlines a streamlined nine-step treatment algorithm, emphasizing combination therapy as first-line pharmacologic management. They explain the evidence supporting ARB–thiazide combinations, discuss cost considerations for drug selection, and address adherence challenges. They also explore red flags for secondary hypertension and how the algorithm supports—but does not replace—clinical judgment.

For physicians, this guideline offers a clear and practical roadmap: measure blood pressure correctly, aim for systolic pressure below 130 mm Hg, and use the simplified treatment sequence to improve adherence and outcomes. Designed to be easy to implement, the new approach aims to empower primary care providers to act with confidence.

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Transcript

Dr. Mojola Omole

I'm Mojola Omole

Dr. Blair Bigham

I'm Blair Bigham. This is the CMAJ Podcast. Jola, today we are talking about high blood pressure.

Dr. Mojola Omole

Something that you regularly cause in me. 

Dr. Blair Bigham

Well, I do cause high blood pressure in people, but for all sorts of reasons. Anyways, the reason we're talking about it today is not my good looks, it is because Hypertension Canada has released new guidelines for the diagnosis and treatment of hypertension in adults in primary care. They, of course, had a very rigorous methodology using GRADE and GRADE II to come up with nine specific recommendations.

And we're going to get into those today. And Jola, I think that although hypertension is sort of common and people kind of roll their eyes and go, okay, who doesn't have hypertension? This is particularly important because hypertension is actually getting worse.

Less and less people have their blood pressure controlled than in the past. And so these guidelines are really designed to help primary care providers do the right thing and get this little epidemic under control.

Dr. Mojola Omole

I don't know if you'd call it an epidemic though.

Dr. Blair Bigham

People have more and more hypertension than, okay, you're right. It's not an epidemic, but it is a substantial burden of disease.

Dr. Mojola Omole

But I think that having an algorithm that is user-friendly is really important to primary care, given just that a lot of people, younger people, are coming in with hypertension.

Dr. Blair Bigham

So let's jump on the line with our panel here, the authors of the guideline, to help us understand how best to diagnose and treat hypertension. Dr. Rémi Goupil and Dr. Greg Hundemer are two of the co-authors of the new Guideline for the diagnosis and treatment of hypertension in adults in primary care. Dr. Goupil is a nephrologist and clinician researcher at the Sacré-Cœur Hospital in Montreal, and Dr. Hundemer is a nephrologist and clinician scientist at the Ottawa Hospital. Gentlemen, welcome to the podcast.

Dr. Greg Hundemer

Hi, thanks for having us.

Dr. Blair Bigham

Let's start with this question. Why do we need new hypertension guidelines today?

Dr. Rémi Goupil

Well, the last one was published five years ago in 2020, and usually Hypertension Canada was publishing guidelines every one or two years. So there was a big gap, mostly due to COVID and all that, but we decided with the Guidelines Committee to try to overhaul everything, make advantage of this gap in publication years, and change the strategy. The reason behind that is that we're seeing that the blood pressure control rates in Canada are slowly going down, and we felt that the current strategy was maybe not working, or it had achieved its peak efficacy.

So we wanted to try something else with these new guidelines.

Dr. Blair Bigham

So wait, over the last couple of years, you've seen things declining? So people's blood pressure is less well controlled? 

Dr. Rémi Goupil

Right. So they're slowly going down. So the control rates in Canada were always amongst the best in the world, but we see a concerning trend toward the down. So it's about 70%, and it's slowly creeping down with the following years.

Dr. Mojola Omole

Do we know why it's declining?

Dr. Greg Hundemer

We don't. There's been a number of ideas postulated for why these trends are heading the direction they are, and these were actually occurring before the pandemic even set in, which is important to know. A lot of the theories behind it is the prior guidelines, there was sometimes felt to be unclear in terms of what was defining hypertension, what targets should be achieved for a certain patient.

So there's a lot of confusion about kind of what target each individual person should be at. Also, there was some concern that we weren't reaching the kind of the right providers with these guidelines, and that probably over 90% of hypertension is managed in primary care, because when you think about it, one in four Canadians has hypertension. So this overwhelmingly applies to primary care, and that we weren't really making our algorithm so easy to implement in day-to-day practice or kind of reaching the right clinicians to actually get these implemented.

So that's kind of why we focus on primary care guidelines here, because we really wanted to emphasize and engage primary care in this process.

Dr. Mojola Omole

Was there something different about the way these guidelines were developed compared to previous guidelines?

Dr. Greg Hundemer

Yeah, so they're quite a bit different than the prior. So the way Hypertension Canada used to do it is every year or two, they would have one kind of overarching comprehensive guideline, which would cover all topics of hypertension all at once. We took a bit of a different approach because we saw these rates going down over time, and we haven't had new guidelines for five years.

So we're actually looking at the guideline as a two-step process now, where the first step is focusing on primary care, which we think is where you get the most bang for your buck, because again, that's where most of hypertension is seen and managed. And so this is the first step was these primary care guidelines. We are going to do the comprehensive guidelines, but more on a topic-by-topic basis on sort of having a living set of guidelines that will continuously being updated.

So this is just step one in that two-part process. And kind of another unique aspect of it is we created our guideline committee because our audience is primary care. Our committee overwhelmingly consisted of primary care providers.

So if you look at the makeup of our committee for this guideline process, yeah, we did have some hypertension specialists, but overwhelmingly, it was primary care providers, meaning family physicians, nurses, nurse practitioners, pharmacists, patient partners. That was really the kind of the overarching makeup of our committee. And we feel like by having them and their perspective, they're actually able to build our recommendations and algorithms to meet their day-to-day needs.

Dr. Blair Bigham

We're going to get into the specifics of the changes. But first, Greg, can you tell me a little bit more about what that sort of committee composition meant? Can you give us an example of how the guidelines are more serving of that population?

Dr. Greg Hundemer

Yeah. So when you look at the old guidelines, it was almost 100 pages. It was this very long sort of guideline document.

This one, the whole purpose was to keep it streamlined and very straightforward, simple, easy to follow. So if you see it, we limited our recommendations to, we wanted to keep it to a very small list. So we actually narrowed it down to the nine treatment and diagnostic recommendations that we felt were most relevant to primary care.

And a lot of the primary care providers were saying, oh no, these are the things we want to focus on. We didn't want to get off topic and keep it where this is how we should manage most patients with hypertension and not get too off tangent into these kind of more niche conditions in hypertension. It was really focused on the basics of diagnosis and management.

And so they really kept us focused. The other things they pointed out, some things, and Rémi can probably speak to this as well, they were very clear in wanting one number to label as hypertension. They didn't want a bunch of different numbers that are hard to remember and hard to apply to practice.

They wanted one number for what is hypertension and they wanted one number for what number do we target when we're treating somebody for hypertension. So they wanted a specific threshold. They wanted to keep it simple, single numbers, easy to remember, and easy to put into practice because of that.

Dr. Blair Bigham

So let's start with the bottom line. What are the numbers for hypertension now? And what are some of the big changes that have come from the new guidelines? What's different?

Dr. Rémi Goupil

So the number to remember is 130. So we changed the diagnostic thresholds for hypertension to what was before hypertension was above 135 over 85 when it's measured in an optimal fashion. And we lowered it to 130 over 80 for several reasons.

The main one is that most of the literature tends to support this threshold for defining hypertension, meaning that when it's above that, the risk becomes, let's say, unacceptable, that needs to be taken care of. So when the blood pressure is above 130 over 80, that means you have high blood pressure. And again, for the treatment targets, it's again 130, but this time just the systolic blood pressure, because we now know that treating the diastolic...

Dr. Blair Bigham

I think you just diagnosed me with hypertension. I feel like I'm, you know, often my nurses sometimes joke around and take my blood pressure and I feel like I'm sometimes in the 130s, but not usually higher than 140. I should probably book an appointment with my primary care doctor.

Dr. Mojola Omole

Sorry, does that mean that if you hit 130 over 80, that you should start treatment right away?

Dr. Rémi Goupil

Well, first, you want to make sure that your blood pressure is high, because we all know that when we measure blood pressure in different situations, sometimes it's a bit artificially high, meaning that you're not relaxed enough, you only measured once. So you need to have a proper measuring technique, which is called a standardized automated office blood pressure technique. So when you do this correct way of measuring blood pressure, you get highly accurate measurements.

And you want to make sure that there's several of them and that the average is not too high, in the case below, above 130 over 80. And then it's always important to check your... 

Dr. Blair Bigham

So about how many measurements?

Dr. Rémi Goupil

Three is enough. So you take a... you rest a bit.

We don't recommend a specific length of rest. It really depends on how the patient is when he comes to your office and to your waiting room. But make sure the patient is rested and then take three measurements.

The average of the three will give you an accurate measurement. And once you find that the blood pressure is a bit high, you have to check it at home too. We always tell our patients, you don't live in the office, so we want to make sure your blood pressure is high at home too.

So there's some you can measure with an ABPM device, meaning it's an ambulatory blood pressure monitoring device, or just regular home blood pressure device. We want to make sure the blood pressure is also high at home. And then if that's the case, you have hypertension.

Dr. Mojola Omole

Are the ones you use at the pharmacy, are they good enough?

Dr. Rémi Goupil

Yes. So the blood pressure machines in the pharmacy, most of the time are validated and they're accurate enough. You still have to make sure that you measure the blood pressure correctly, meaning that you remove your coat, you have a bear arm with the machine, you take a few minutes to rest, you measure it a couple of times.

But if it's measured correctly, it will give you accurate measurements. And in pharmacy, it's really one of the best way to measure blood pressure because not everybody can buy or can afford a home blood pressure machine. Ambulatory blood pressure monitoring is not always accessible, but there's blood pressure machines in most of the pharmacies.

So it's easy to get a screening there.

Dr. Mojola Omole

So I just want to go back to the 130 over 80 threshold. So does that mean that, is that like a diagnostic threshold or a treatment threshold?

Dr. Greg Hundemer

Yeah. So that's a good question. So it's really, we're considering that the diagnostic threshold is 130 over.

We don't want it to be interpreted as everybody, everybody who's over 130 over 80 should be treated. But what treatment means can vary person to person. Treatment doesn't always mean drugs.

Treatment can mean lifestyle modification as well. So in our, if you look at our treatment recommendations, we clarify when to start drug treatment as well. So anybody over 130 over 80, we suggest lifestyle modifications and that can be all sorts of things, as you all know.

So it can be losing weight, eating, having less sodium in your diet, exercising more, cutting out alcohol, things like that. We think that should apply to everybody who meets this criteria for hypertension. Now, when to start drugs is a bit of a different story.

So we lay out when to start drugs on different patients. And so for anybody with over, greater than or equal to 140 over 90, we do suggest that in addition to lifestyle modifications, you also start medication at that time. We kind of lay out which medications you typically want to start with.

For patients with systolic pressures of 130 to 139 though, we suggest that you stratify them into their cardiovascular risks. So people that are high cardiovascular risk, it can be based on age, based on having diabetes, chronic kidney disease, things like that. Those are the patients that even if they're 130 to 139, you want to start medications.

People that don't have any high cardiovascular risk factors, we suggest just focusing on lifestyle modifications and reassessing on a one to two year, once to twice per year. So every six to 12 months or so, reassessing how they're doing with those lifestyle changes. Are they at target now?

Or did they cross that 140 threshold where you should start medications? So we think it's important to think of treatment as both lifestyle modifications as well as medications.

Dr. Blair Bigham

In terms of taking blood pressures at home, a lot of,  a lot of rumors are out there on how like you take your blood pressure once and if you take it again, then it's going to be higher and then people get anxious. So then it goes up and then they take it a third time and then it's even higher. How much faith would you have when somebody brings you their blood pressure log from home showing recordings over many months?

Like, are you pretty happy with a $20 blood pressure machine someone buys on Amazon?

Dr. Rémi Goupil

Well, that's a major problem right now is that most machines that are sold online, they're not validated. So that means that we don't know if they're accurate. It's a different story in machines bought in pharmacies.

Most of them, over 90% in Canada, they're validated. So we know that they are accurate against standardized measurements. Research creates standardized measurements.

So the device on Amazon, just to say, it could be accurate or not. We just don't know for now. And we're doing studies on that.

Hopefully, we'll try to shed some light on this. But we always measure blood pressure at the clinic and we try to have their patients measure blood pressure at home because it makes them aware of their blood pressures. It makes them aware that their treatment is working and all that.

And we compare the two. And when there's a big difference between the two, we sometimes ask the patients to bring the machine in so we can test it against our machine. So this gives us a good indication.

Or just tell them to test it against the machine at the pharmacy. Or even sometimes we do ABPMs to see what's the difference in measurements. But I think it's very important for patients to get involved in their care and measure blood pressure at home.

And another new thing with the guidelines is we designed some with patient partners, some patient guidelines, which really tells them what they should know about hypertension, how they can help with their treatment or diagnosis and all that. And it really revolves around what they can do in their daily life to lower the blood pressure, but also what's important for them to know, their number, what's their blood pressure. And it can only be measured at home.

So this is some of the tools we're hoping that will be picked up by patients so they can help and join us in their care for their high blood pressure.

Dr. Blair Bigham

I want to talk more specifically about the actual treatment algorithm once the diagnosis is made and you've tried some lifestyle modifications, they haven't been successful. What is first line, second line, third line for people with hypertension? And at what point should a family doctor say this isn't working and refer on or go down other diagnostic pathways?

Dr. Greg Hundemer

Yeah, so this is a bit of a new change for the Hypertension Canada guidelines in terms of first-line agents. We are recommending combination therapy. Since the prior guidelines came out, there's been a growing evidence base supporting low-dose combination therapy as first-line treatment for hypertension.

So this means combining, it's still one pill ideally, but you combine two medications at lower doses than you usually use in combination. And there's a number of benefits to that. So number one, it's been shown to lower blood pressure more effectively than a single agent.

You can actually reduce side effects because you're giving two medications at a lower dose and because each one's at a lower dose, generally, you can get less side effects. As we show in the guidelines, it's actually quite a bit cheaper. These are large, the ones we recommend are all generics and they're actually cheaper than the individual drugs themselves.

And it's very well proven that these patients not only get better blood pressure reduction, they're actually more likely to be adherent and actually remain adherent over the course of time with combination therapy. So that's why we recommend starting with combination therapy.

Dr. Mojola Omole

Sorry, Greg, don't interrupt. Why are they more adherent with a combination therapy?

Dr. Greg Hundemer

Yeah, it's a good question. I think one of the big theories is that polypharmacy plays a role and that when you have patients on more and more pills, it's hard for them to be consistent with it, especially when they might be taken different times a day. One might be once a day, one might be twice a day.

Combining them all into like the more we can reduce pill burden, the better. And I think that's part of why people are more adherent to it. In terms of going beyond that with the algorithm, you'll see our algorithms now are very much, we actually recommend specific medications and we actually base this on, if any of you are familiar with the HEARTS program, the HEARTS is a World Health Organization approved approach to combating hypertension across the world.

And it's been successfully implemented in a number of countries across the world. Where you give very directive stepwise algorithms. We actually specify certain medications and we actually provide the reasoning why we chose the medications we did and that they're effective. But in Canada, they're cost effective as well, especially used at the population level and ones with the least amount of side effects.

And so that's why we start with this combination pill. Step one, up titrate the combination pill is step two. And we add, we kind of lay out what the third and fourth agents are.

Now we do recognize that, and we kind of comment on this, is that there are certain clues where you may think about secondary causes of hypertension, whether that's something like primary aldosteronism or renal arteriostenosis. When you see clues like that, that's probably kind of a clue to maybe refer to a hypertension specialist or endocrinologist or whatever you think is appropriate. We also kind of outline with it, once you hit that fourth step and you're still not under control, you probably should be referring them to a specialist at that point.

So that's part, that's kind of built into the pathway. But for most patients, I think this is a kind of a proper stepwise approach that's very evidence based, but also very cost effective.

Dr. Blair Bigham

So I'm starting with an ARB plus either a thiazide or calcium channel blocker, up titrating. And then a couple months later, I'm adding either whichever I didn't have before the calcium channel blocker or the thiazide. And then I'm going to spironolactone.

And they're still hypertensive. Now I'm going to send them to a specialist. Are there any red flags that somebody can be on the lookout for where it might be secondary hypertension before they get to that?

You know, it sounds like a one year process just to find out, oh, your blood pressure is still 160 on 105. Are there any red flags where you wouldn't bother going through that slow up titration and adding pill by pill where you would just say, oh, you know what, this is weird. This is special hypertension.

It's secondary. I'm going to go ahead and start a different workup. What are the red flags we can be on the lookout for?

Dr. Rémi Goupil

So I think the major one is hypokalemia. So if your patient has low potassium level and hypertension, you need to think primary aldosteronism. So this is the first clue, which is not often happens in primary aldo, but it's certainly a clue that this patient may have primary aldo.

So low potassium level. And also when the blood pressure rapidly goes up, when there's an accelerated course of high blood pressure. So this tends to point out to secondary causes.

And then if you have symptoms suggestive of corticosteroid excess or things like that, it can give you clues for secondary hypertension.

Dr. Blair Bigham

Greg, any other tips?

Dr. Greg Hundemer

So I think those are all correct. I mean, somebody who comes in with very severe hypertension out of nowhere, it makes me think that there's something odd going on there. And to look for secondary causes, very young patients without a history, that really clues you in.

If somebody's kidney function goes way down, if they start an ACE or an ARB, it should clue you in to maybe renal arsenosis. So there's a number of those clues that you need to be on the lookout for. So these algorithms are not to take away from clinical discretion.

You still need to use your clinical discretion and realize when you have those red herring cases where there's something else going on here. They're not to be followed blindly, these algorithms. So you do need to use clinical discretion and try to identify those secondary causes because clearly you have to treat those secondary, like whatever the pathway is that's causing, that's driving their hypertension.

That's really what you need to target rather than just use this kind of standard formula for medication choices.

Dr. Blair Bigham

I do want to encourage people to actually go to the guideline, look at the algorithm, and we'll have that in the show notes so that people can get there quickly. But talk to me about drug classes for that first step and second step.

Dr. Greg Hundemer

Yeah, so good question. So the combination pills that are available in generic form, they're mostly ARBs and thiazides are the most common that we see. There are ACE inhibitors and thiazides as well.

Because of the better side effect profile with ARBs compared to ACE inhibitors in terms of like cough and risk for angioedema and things like that, we felt it was more appropriate to put ARBs and thiazide together. Now, it is worth noting that most of the thiazide that are available is hydrochlorothiazide. Thiazide-like diuretics, which are longer acting and some people think may be better though.

Some of the data brings that into question—that maybe there's actually no difference in terms of cardiovascular risk. So that's why our recommended combination is irbesartan and hydrochlorothiazide. Many people actually like to use a combination of amlodipine and telmisartan, which is available as well.

But as we outlined in the guideline, when we actually look at individual costs, it's over twice as expensive. When we think about if this is taken up across the whole country here, it may be actually a lot of cost when you think it's over double the price of irbesartan and HCTZ, which is how we landed on that.

Dr. Mojola Omole

I just had a quick question for you, because I do a lot of work with Black population and I know that there's a different response to certain medications like ACE and ARB, if I'm correct. Do physicians, are there any other groups that maybe certain classes of drugs do not work as effectively in? And was that taken also into consideration with the guidelines?

Dr. Rémi Goupil

I'll let you have that one, Greg.

Dr. Greg Hundemer

Yeah, it's a good question. There's actually, it's an area of debate because there was a lot of literature in the past that certain agents would be preferred in Black populations. There's actually been some evidence since that time that maybe that's actually not correct and that maybe the response is similar between the three agents.

So I would say that's an area of debate. And there's some of the evidence that used to be out there regarding that has actually gone away. And so there is good evidence that patients that are Black may actually benefit equally to the common first-line medication.

So I think that has been disproven a little bit and that some of the evidence has suggested that maybe they actually respond similarly across the different medication classes that we traditionally use.

Dr. Mojola Omole

All right, if a family doctor, nurse practitioner, or other primary care provider just has to remember one or two things from this episode, what should the key takeaways be for them?

Dr. Rémi Goupil

So first thing is when you measure blood pressure, make sure you measure it correctly. And you need to take the time to measure blood pressure in the correct way, especially if you want to implement what is proposed in the guidelines. So that's the first step.

And then when you treat hypertension, make sure you try to achieve a systolic blood pressure below 130. And the first step will always be lifestyle modification. And lots of patients will also require specific drugs.

And I think that we wanted to make it as simple as possible. And one of the ways to do that would be to implement the algorithm that we propose for the treatment with the sequence of medication. It's really like a plug and play.

You can use it for almost all patients. It should pretty much work to get the blood pressure down.

Dr. Blair Bigham

Fantastic. Thank you so much for joining us today. This has been super helpful and you brought a lot of clarity to this.

And it sounds like the new guidelines have been really purposefully developed to be digestible and implemented with some ease by people on the front lines. So thank you.

Dr. Greg Hundemer

Thank you for having us.

Dr. Mojola Omole

Thank you, guys.

Dr. Rémi Goupil 

Thanks.

Dr. Blair Bigham

Thanks. Dr. Rémi Goupil is a nephrologist and clinician researcher at the Sacré-Cœur Hospital in Montreal. Dr. Hundemer is a nephrologist and clinician scientist at the Ottawa Hospital and University of Ottawa. All right, Jola, what are your thoughts?

Dr. Mojola Omole

For me, that was just a really straightforward, I love a good algorithm. So for me, that was just music to my ears that it was so straightforward.

Even that I think that if I had a patient in the hospital who postoperatively or in the hospital had hypertension, I even would feel comfortable to be able to look at the guidelines in terms of management.

Dr. Blair Bigham

Absolutely. We have to give kudos to the way they've even just done the graphic design on this guideline. And you've got to go to the show notes and download this thing.

It's very, very straightforward. It's easy to interpret. Only nine recommendations?

I mean, come on, we can all handle that. It just seems like they've really prioritized making the right thing to do the easy thing to do. I also really appreciate having struggled with this a little bit, that they're very, very clear on what they recommend your first line, second line, third line to be.

It's not like, oh, pick one of these four classes of drugs, each of which have their own four choices. They've been really, really straightforward. And for somebody like me, who is maybe not starting hypertension treatment very often, it encourages me to do it when I do need to.

But that's just me. Do you think that if you had someone who probably was never going to follow up or didn't have a family doctor, would you feel comfortable starting something?

Dr. Mojola Omole

Yeah, 100%. I would feel comfortable starting something. My only problem is just following up on the medication.

And so that's just the gray areas. There is part of surgery that's episodic. And so being able to follow up with the patient in terms of adjusting, that's my only hesitation in terms of starting something.

But for sure, I would feel comfortable starting something.

Dr. Blair Bigham

What did you think when you heard that some of the evidence has changed around Black populations in first line?

Dr. Mojola Omole

This was something that was even up until a few months ago, was something that had been circulating. So it's good to know that there's some evidence to refute that that was the issue in terms of certain medications in Black population. So I look forward to their more deeper dive, the one that they're doing.

Dr. Blair Bigham

The other thing that I found really surprising was this talk about checking your blood pressure at home. You know, emerg docs hate this. People come in, oh, I checked my blood pressure, it was high.

So I checked it again, it was higher. And they come in and their blood pressure is normal. And we're like, okay, you can go home now.

But it was interesting to sort of hear that some machines are better than others. Some that you maybe buy in a drugstore are validated.

Dr. Mojola Omole

I buy everything off Amazon.

Dr. Blair Bigham

Who doesn't these days? And so, yeah, this is interesting that there may be a whole bunch of sort of crummy machines out there that are maybe informing people incorrectly. Whereas, I don't even know if they'd be more expensive.

Whereas, if you buy it at a pharmacy, at least you know that there's something behind that. Although, I don't know. I wonder if that's true as well.

I'm sure some pharmacies buy, I don't know, I mean, I'm interested in this.

We should investigate.

Dr. Mojola Omole

Anyways, this is, bottom line, it's a great set of guidelines that will continue to keep Canada as, you know, one of the top countries in terms of blood pressure control, which has a lot of effects on other diseases downstream. So this is great.

Dr. Blair Bigham

Absolutely. Hopefully, this reverses that downward trend of getting people's pressure under control.

Dr. Mojola Omole

That's it for this episode of the CMAJ Podcast. The link to the study is in the show notes. Please rate, share, review the podcast.

The podcast is produced for CMAJ by Neil Morrison at PodCraft Productions. Catherine Varner is our deputy editor at the CMAJ and senior editor of the podcast. I'm Mojola Omole.

Dr. Blair Bigham

And I'm Blair Bigham. Until next time, be well.