Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2006

Open Access 01-12-2006 | Research article

Methods underpinning national clinical guidelines for hypertension: describing the evidence shortfall

Authors: Fiona Campbell, Heather O Dickinson, Julia VF Cook, Fiona R Beyer, Martin Eccles, James M Mason

Published in: BMC Health Services Research | Issue 1/2006

Login to get access

Abstract

Background

To be useful, clinical practice guidelines need to be evidence based; otherwise they will not achieve the validity, reliability and credibility required for implementation.

Methods

This paper compares the methods used in gathering, analysing and linking of evidence to guideline recommendations in ten current hypertension guidelines.

Results

It found several guidelines had failed to implement methods of searching for the relevant literature, critical analysis and linking to recommendations that minimise the risk of bias in the interpretation of research evidence. The more rigorous guidelines showed discrepancies in recommendations and grading that reflected different approaches to the use of evidence in guideline development.

Conclusion

Clinical practice guidelines as a methodology are clearly still an evolving health care technology.
Literature
1.
Field MJ, Lohr KN, (eds): Institute of Medicine Committee on Clinical Practice Guidelines. Guidelines for clinical practice: from development to use. 1992, Washington DC, National Academy Press
2.
Dans PE: Credibility, cookbook medicine, and common sense: guidelines and the college. Annals of Internal Medicine. 1994, 120: 966-968.PubMedCrossRef
3.
Guidelines CCP: Clinical practice guidelines: directions for a new program. Edited by: Field MG LKN. 1990, Washington, National Academy Press, Institute of Medicine
4.
Eccles M, Freemantle N, Mason J: Developing cost effectiveness guidelines. BMJ. 1997, 27-27.
5.
Collaboration TAGREE: Development and validation of an interational appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Quality and Safety in Health Care. 2003, 12: 18-23. 10.1136/qhc.12.1.18.CrossRef
6.
Burgers J, Grol R, Klazinga N, Van Der Bij A, Makela M, Zaat J, Ollenschlager G, Grilli R, Slutsky JPNC, Bruun Madsen P, Durieus P, Brouwers M, Jackson R, Meulenberg F, Ten Have P, Fervers B, Grimshaw J, Burnand B, Miller J, Makela J, Dosquet P, Eccles M, Silagy C, Bowersox J, Irwin P, Dahlgren H, Atkins D: International comparison of 19 clinical guideline programmes - a survey of the AGREE Collaboration. Zeitschrift fur Arzliche Fortbildung und Qualitatssicherung. 2003, 97: 81-88.
7.
Choudhry NK, Stelfox HT, Detsky AS: Relationships between authors of clinical practice guidelines and the pharmaceutical industry. JAMA. 2002, 287: 612-617. 10.1001/jama.287.5.612.PubMedCrossRef
8.
Editorial: Just how tainted has medicine become?. The Lancet. 2002, 359: 1167-1167. 10.1016/S0140-6736(02)08198-9.
9.
WHO: The world health report 2002: reducing risks, promoting healthy life. 2002, Geneva
10.
Statistics ON: Key Health Statistics from General Practice 1998: analysis of morbidity and treatment data, including time trends, England and Wales. 2000, London, National Statistics
11.
Collaboration PS: Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002, 360: 1903-1913. 10.1016/S0140-6736(02)11911-8.CrossRef
12.
Primatesta P, Brookes M, Poulter NR: Improved hypertension management and control: results from the health survey for England 1998. Hypertension. 2001, 38: 827-832.PubMedCrossRef
13.
Task force for the Development of the 1999 Canadian recommendations for the management of hypertension: 1999 Canadian recommendations for the management of hypertension including case-based applications of the recommendations. Can Med Assoc J. 1999, 161: S1-S22.
14.
WHO: 1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. Guidelines Subcommittee. J Hypertens. 1999, 17: 151-183.
15.
16.
Improvement ICS: Hypertension diagnosis and treatment. 2003, ICSI, 1-46.
17.
Southern Africa Hypertension Society Hypertension Guideline Working Groups 2000 and 2003: South African Hypertension Guideline 2003 update. 2003, South Africa, Southern Africa Hypertension Society, i-32.
18.
Network SIG: Hypertension in older people. 2001, Edinburgh, SIGN, 1-50.
19.
Committee G: 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens. 2003, 21: 1011-1053.CrossRef
20.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JTJ, Roccella EJ, National Heart LBIJNCPDETHBP, National High Blood Pressure Education Program Coordinating Committee.: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003, 289: 2560-2572. 10.1001/jama.289.19.2560.PubMedCrossRef
21.
Williams B, Poulter N, Brown MJ, Davis M, McInnes GT, Poulter N, Potter JP: The BHS Guidelines Working Party Guidelines for Management of Hypertension: Report of the Fourth Working Party of the British Hypertension Society, 2004 - BHS IV. J Hum Hypertens. 2004, 18: 139-185. 10.1038/sj.jhh.1001683.PubMedCrossRef
22.
North of England Hypertension Guideline Development Group: Essential hypertension: managing adult patients in primary care. 2004, Newcastle, Centre for Health Services Research, University of Newcastle
23.
Atkins D, Eccles M, Flottorp S, Guyatt GH, Henry D, Hill S, Liberati A, O'Connell D, Oxman AD, Phillips B, Schunemann H, Tan-Torres Edejer T, Vist GE, Williams Jr JW, Group TGW: Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches The Grade Working Group. BMC Health Services Research. 2004, 4.
24.
Grilli R, Magrini N, Penna A, Mura G, Liberati A: Practice guidelines developed by specialty societies: the need for a critical appraisal. Lancet. 2000, 355: 103-106. 10.1016/S0140-6736(99)02171-6.PubMedCrossRef
25.
Thomson R, McElroy H, Sudlow M: Guidelines on anticoagulant treatment in atrial fibrillation in Great Britain: variation in content and implications for treatment. BMJ. 1998, 316: 509-513.PubMedPubMedCentralCrossRef
26.
Fretheim A, Williams JWJ, Oxman AD, Herrin J: The relation between methods and recommendations in clinical practice guidelines for hypertension and hyperlipidemia. J Fam Pract. 2002, 51: 963-968.PubMed
27.
McAlister FA, Zarnke KB, Campbell NR, Feldman RD, Levine M, Mahon J, Grover SA, Lewanczuk R, Leenen F, Tobe S, Lebel M, Stone J, Schiffrin EL, Rabkin SW, Ogilvie RI, Larochelle P, Jones C, Honos G, Fodor G, Burgess E, Hamet P, Herman R, Irvine J, Culleton B, Wright JM, Group. CHRW: The 2001 Canadian recommendations for the management of hypertension: Part two--Therapy. Can J Cardiol. 2002, 18: 625-641.PubMed
28.
29.
Eccles M, Freemantle N, Mason J: Using systematic reviews in clinical guideline development. Systematic Reviews in Health Care. Edited by: M E, G DS and DG A. 2001, BMJ publishing group, 400-409.CrossRef
30.
Cluzeau F, Littlejohns P, Grimshaw J, Feder G: Appraisal Instrument for Clinical Guidelines. 1997, London, St George's Hospital Medical School
31.
Savoie I, Kazanjian A, Bassett K: Do clinical practice guidelines reflect research evidence?. J health Serv Res Policy. 2000, 5: 76-82.PubMedCrossRef
32.
Raine R, Sanderson C, Black N: Developing clinical guidelines: a challenge to current methods. British Medical Journal. 2006, 331: 631-633.CrossRef
33.
Taylor R, Giles J: Cash interests taint drug advice. Nature. 2005, 437: 1070-1071. 10.1038/4371070a.PubMedCrossRef
34.
Mason J, Eccles M: Guideline recommendation an evidence grading (GREG): a new grading method for clinical guideline development groups. 2003, Newcastle upon Tyne, Centre for Health Services Research, University of Newcastle upon Tyne, Report 109.
35.
Silman AJ, Locke C, Mitchell P, Humpherson P: Evaluation of the effectiveness of a low sodium diet in the treatment of mild to moderate hypertension. Lancet. Edited by: Silman AJ. 1983, 1: 1179-1182. 10.1016/S0140-6736(83)92463-7.PubMedCrossRef
36.
Hooper L, Bartlett C, Davey Smith G, Ebrahim S: Systematic review of long term effects of advice to reduce dietary salt in adults. BMJ. 2002, 325: 628-636. 10.1136/bmj.325.7365.628.PubMedPubMedCentralCrossRef
37.
Fagerberg B, Andersson OK, Persson B, Hedner T: Reactivity to norepinehrine and effect of sodium on blood pressure during weight loss. Hypertension. 1985, 7: 586-592.PubMedCrossRef
38.
Midgley JP, Matthew AG, Greenwood CM, Logan AG: Effect of reduced dietary sodium on blood pressure: a meta-analysis of randomized controlled trials. JAMA. 1996, 275: 1590-1597. 10.1001/jama.275.20.1590.PubMedCrossRef
39.
Chalmers J, Morgan T, Doyle A, Dickson B, Hopper J, Mathews J, Matthews J, Moulds R, Myers J, Nowson C, Scoggins B, Stebbing M: Australian National Health and Medical Research Council dietary salt study in mild hypertension. J Hypertens. Edited by: Chalmers J. 1986, 4: S629-S637.
40.
Cutler JA, Follmann D, Allender PS: Randomized trials of sodium reduction: an overview. Am J Clin Nutr. 1997, 65: 643S-651S.PubMedCrossRef
41.
Australian National Health and Medical Research Council Dietary Salt Study Management Committee: Effects of replacing sodium intake in subjects on a low sodium diet: a crossover study. Clin Exp Hypertens. Edited by: Chalmers JP. 1989, A11: 1011-1024.
42.
Australian National Health and Medical Research Council Dietary Salt Study Management Committee: Fall in blood pressure with modest reduction in dietary salt intake in mild hypertension. Lancet. Edited by: Chalmers JP. 1989, 1: 399-402.
43.
Jula AM, Karanko HM: Effects on left-ventricular hypertrophy of long-term nonpharmacolgical treatment with sodium restriction in mild-to-moderate essential hypertension. Circulation. 1994, 89: 1023-1031.PubMedCrossRef
44.
Whelton PK, Appel LJ, Espeland MA, Applegate WB, Ettinger WH, Kostis JB, al : Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled Trial of Nonpharmacologic Interventions in the Elderly (TONE). JAMA. 1998, 279: 839-846. 10.1001/jama.279.11.839.PubMedCrossRef
45.
Appel LJ, Espeland MA, Easter L, Wilson AC, Folmar S, Lacy CR: Effects of reduced sodium intake on hypertension control in older individuals: results from the Trial of Nonpharmacologic Interventions in the Elderly (TONE). Arch Intern Med. 2001, 161: 685-693. 10.1001/archinte.161.5.685.PubMedCrossRef
46.
Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Group DASHSCR: Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med. 2001, 344: 3-10. 10.1056/NEJM200101043440101.PubMedCrossRef
47.
48.
Veterans Administration Cooperative Study Group on Antihypertensive Agents: Effects of treatment on morbidity in hypertension: II results in patients with diastolic blood pressure averaging 90 through 114 mm Hg. JAMA. 1970, 213: 1143-1152. 10.1001/jama.213.7.1143.CrossRef
49.
Messerli FH, Grossman E, Goldbourt U: Are beta-blockers efficacious as first-line therapy for hypertension in the elderly? A systematic review. JAMA. 1998, 279: 1903-1907. 10.1001/jama.279.23.1903.PubMedCrossRef
50.
Wright JM, C. L, G.K C: Systematic review of antihypertensive therapies. Canadian Medical Associataion Journal. 1999, 161.
51.
Collins R, Peto R, MacMahon S, Herbert P, Fiebach NH, Eberlein KA, Godwin J, Qizilbash N, Taylor JO, Hennekens CH: Blood pressure, stroke and coronary heart disease: Part 2, short-term reductions in blood pressure: overview of randomised drug trials in their epidemiology context. Lancet. 1990, 335: 827-838. 10.1016/0140-6736(90)90944-Z.PubMedCrossRef
52.
Insua JT, H.S. S, Lau T.Lau J.Reitman D.Pagano D.Chalmers T.C.: Drug Treatment of Hypertension in the Elderly. A Meta-Analysis. Ann Intern Med. 1994, 121: 355-362.PubMedCrossRef
53.
Psaty BM, Smith NL, Siscovick DS, Koepsell TD, Weiss NS, Heckbert SR, Lemaitre RN, Wagner EH, Furberg CD: Health outcomes associated with antihypertensive therapies used as first-line agents: a systematic review and meta-analysis. JAMA. 1997, 277: 739-745. 10.1001/jama.277.9.739.PubMedCrossRef
54.
Group HSCS: Effect of antihypertensive treatment on stroke recurrence. JAMA. 1974, 229: 409-418. 10.1001/jama.229.4.409.CrossRef
55.
Smith WM: Treatment of mild hypertension: results of a ten-year intervention trial. Circ Res. 1977, 40: 98-105.CrossRef
56.
Prepared for the Veterans Administration-National Heart LBISGETMH: Evaluation of drug treatment in mild hypertension: VA-NHLBI feasibility trial. Plan and preliminary results of a two-year feasibility trial for a multicenter intervention study to evaluate the benefits versus the disadvantages of treating mild hypertension. Ann N Y Acad Sci. 1978, 304: 267-288.CrossRef
57.
Hypertension Detection and Follow-up Program Cooperative Group: Five-year findings of the hypertension detection and follow-up program: I reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA. 1979, 242: 2562-2571. 10.1001/jama.242.23.2562.CrossRef
58.
Hypertension Detection and Follow-up Program Cooperative Group: Five-year findings of the Hypertension Detection and Follow-up Program: III reduction in stroke incidence among persons with high blood pressure. JAMA. 1982, 247: 633-638. 10.1001/jama.247.5.633.CrossRef
59.
Hypertension Detection and Follow-up Program Cooperative Group: Effect of stepped care treatment on the incidence of myocardial infarction and angina pectoris: 5-year findings of the Hypertension Detection and Follow-up Program. Hypertension. 1984, 6: I-198-I-206.
60.
Pearce KA, C.D F, J R: Does Antihypertenive Treatment of the Elderly prevent Cardiovascular Events or Prolong Life?: A Meta-analysis of Hypertension Treatment Trials. Arch Fam Med. 1995, 4: 943-950. 10.1001/archfami.4.11.943.PubMedCrossRef
61.
Gueyffier F, Boutitie F, Boissel JP, Pocock S, Coope J, Cutler J, Ekbom T, al : Effect of antihypertensive drug treatment on cardiovascular outcomes in women and men: a meta-analysis of individual patient data from randomized controlled trials. Ann Intern Med. 1997, 126: 761-767.PubMedCrossRef
62.
Australian National Blood Pressure Management Committee:: The Australian Therapeutic Trial in Mild Hypertension. Lancet. 1980, 1: 1261-1267.
63.
J.A S, J W, L T: Cardiovascular protection and blood pressure reduction: a meta-analysis. The Lancet. 2001, 358: 1305-1315. 10.1016/S0140-6736(01)06411-X.CrossRef
64.
European Working Party on High Blood Pressure in the Elderly (EWPHE): An international trial of antihypertensive therapy in elderly patients: objectives protocol and organization. Arch Int Pharmacodyn Ther. 1985, 275: 300-334.
65.
Staessen J, Bulpitt C, Clement D, de Leeuw P, Fagard R, Fletcher A, Forette F, Leonetti G, Nissinen A, O'Malley K, Tuomilehto J, Webster J, Williams BO: Relation between mortality and treated blood pressure in elderly patients with hypertension: report of the European Working Party on High Blood Pressure in the Elderly. BMJ. 1989, 298: 1552-1556.PubMedPubMedCentralCrossRef
66.
MacMahon S, Rodgers A: The Effects of Blood Pressure Reduction in Older Patients: an overview of Five Randomized Controlled Trials in Elderly Hypertensives. Clin Exp Hypertens. 1993, 15: 967-978.PubMedCrossRef
67.
Group IPPPSHC: Cardiovascular risk and risk factors in a randomized trial of treatment based on the beta-blocker oxprenolol: the International Prospective Primary Prevention Study in Hypertension (IPPPSH). J Hypertens. 1985, 3: 379-392.CrossRef
68.
Party MRCW: MRC trial of treatment of mild hypertension: principal results. BMJ. 1985, 291: 97-104.CrossRef
69.
70.
Helgeland A: Treatment of mild hypertension: a five year controlled drug trial: The Oslo Study. Am J Med. 1980, 69: 725-732. 10.1016/0002-9343(80)90438-6.PubMedCrossRef
71.
Hulley SB, Furberg CD, Gurland B, McDonald R, Perry HM, Schnaper HW: Systolic Hypertension in the Elderly Program (SHEP): antihypertensive efficacy of chlorthalidone. Am J Cardiol. 1985, 56: 913-920. 10.1016/0002-9149(85)90404-7.PubMedCrossRef
72.
Perry HM, McDonald RH, Hulley SB, Smith WM, Furberg CD, Greenlick MR: Systolic Hypertension in the Elderly Program. Pilot Study (SHEP-PS): morbidity and mortality experience. J Hypertens. 1986, 4: S21-S23.
73.
Perry HM, Smith WM, McDonald RH, Black D, Cutler JA, Furberg CD: Morbidity and mortality in the Systolic Hypertension in the Elderly Program (SHEP) Pilot Study. Stroke. 1989, 20: 4-13.PubMedCrossRef
74.
Wilhelmsen L, Berglund G, Elmfeldt D, Fitzsimons T, Holzgreve H, Hosie J, Hörnkvist PE, Pennert K, Tuomilehto J, Wedel H: Beta Blockers versus diuretics in hypertensive men: main results from the HAPPHY Trial. J Hypertens. 1987, 5: 561-572.PubMedCrossRef
75.
Wikstrand J, Warnold I, Olsson G, Tuomilehto J, Elmfeldt D, Berglund G: Primary prevention with Metoprolol in patients with hypertension: mortality results from the MAPHY study. JAMA. 1988, 259: 1976-1982. 10.1001/jama.259.13.1976.PubMedCrossRef
76.
Hansson L, Lindholm LH, Niskanen L, Lanke J, Hedner T, Niklason A, Luomanaki K, Dahlöf B, de Faire U, Morlin C, Karlberg BE, Wester PO, Bjorck JE: Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPPP) randomised trial. Lancet. Edited by: Hansson PL. 1999, 353: 611-616. 10.1016/S0140-6736(98)05012-0.PubMedCrossRef
77.
group TCAPPP: The Captopril Prevention Project: a prospective intervention trial of angiotensin converting enzyme inhibition in the treatment of hypertension. J Hypertens. 1990, 8: 985-990.CrossRef
78.
Perry HM, Davis BR, Price TR, Applegate WB, Fields WS, Guralnik JM, Kuller L, Pressel S, Stamler J, Probsfieldt JL: Effect of treating isolated systolic hypertension on the risk of developing various types and subtypes of stroke: the Systolic Hypertension in the Elderly Program (SHEP). JAMA. 2000, 284: 465-471. 10.1001/jama.284.4.465.PubMedCrossRef
79.
Group SHEPCR: Rationale and design of a randomized clinical trial on prevention of stroke in isolated systolic hypertension. J Clin Epidemiol. 1988, 41: 1197-1208. 10.1016/0895-4356(88)90024-8.CrossRef
80.
Group SHEPCR: Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension: final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA. 1991, 265: 3255-3264. 10.1001/jama.265.24.3255.CrossRef
81.
Vaccarino V, Berger AK, Abramson J, Black HR, Setaro JF, Davey JA, Krumholz HM: Pulse pressure and risk of cardiovascular events in the systolic hypertension in the elderly program. Am J Cardiol. 2001, 88: 980-986. 10.1016/S0002-9149(01)01974-9.PubMedCrossRef
82.
Dahlöf B, Lindholm LH, Hansson L, Scherstén B, Ekbom T, Wester P: Morbidity and mortality in the Swedish Trial in Old Patients With Hypertension (STOP-Hypertension). Lancet. 1991, 338: 1281-1285. 10.1016/0140-6736(91)92589-T.PubMedCrossRef
83.
Amery A, Birkenhager W, Bulpitt CJ, Clement D, de Leeuw P, Dollery CT: Syst-Eur: a multicenter trial on the treatment of isolated systolic hypertension in the elderly objectives, protocol, and organisation. Ageing. 1991, 3: 287-302.
84.
Staessen JA, Fagard R, Thijs L, Celis H, Arabidze GG, Birkenhager WH, Bulpitt CJ, de Leeuw P, Dollery CT, Fletcher AE, Forette F, Leonetti G, Nachev C, O'Brien ET, Rosenfeld J, Rodicio JL, Tuomilehto J, Zanchetti A: Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. Lancet. 1997, 350: 757-764. 10.1016/S0140-6736(97)05381-6.PubMedCrossRef
85.
Bulpitt CJ, Beckett NS, Fletcher AE, Thijs L, Staessen JA, Dumitrascu DL, Forette F, Leonetti G, Nachev C, Tuomilehto J, Fagard RH, investigators TSE: Withdrawal from treatment in the Syst-Eur Trial. J Hypertens. 2002, 20: 339-346. 10.1097/00004872-200202000-00026.PubMedCrossRef
86.
Staessen JA, Thijs L, Birkenhager WH, Bulpitt CJ, Fagard R: Update on the Systolic Hypertension in Europe (Syst-Eur) Trial. Hypertension. 1999, 33: 1476-1477.PubMedCrossRef
87.
Blood Pressure Lowering Treatment Trialists' Collaboration: Effects of different blood-pressure-lowering regimens on major cardiovascular events: Results of prospectively-designed overviews of randomised trials. Lancet. 2003, 362: 1527-1535. 10.1016/S0140-6736(03)14739-3.CrossRef
88.
Party MRCW: Medical Research Council Trial of treatment of hypertension in older adults: principal results. BMJ. 1992, 304: 405-412.CrossRef
89.
Dahlöf B, Hansson L, Lindholm LH, Schersten B, Wester PO, Ekbom T, Hedner T, de Faire U: STOP-Hypertension-2: a prospective intervention trial of newer versus older treatment alternatives in old patients with hypertension. Blood Press. 1993, 2: 136-141.PubMedCrossRef
90.
Hansson L, Lindholm LH, Ekbom T, Dahlöf B, Lanke J, Schersten B, Wester PO, Hedner T: Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity the Swedish Trial in Old Patients with Hypertension-2 study. Lancet. Edited by: Hansson PL. 1999, 354: 1751-1756. 10.1016/S0140-6736(99)10327-1.PubMedCrossRef
91.
Hansson L: Results of the STOP-Hypertension-2 trial. Blood Press. 2000, 9: 17-20. 10.1080/080370500439326.PubMedCrossRef
92.
Pahor M, Psaty BM, Alderman MH, Applegate WB, Williamson JD, Cavazzini C, Furberg CD: Health outcomes associated with calcium antagonists compared with other first-line antihypertensive therapies: a meta-analysis of randomised controlled trials. Lancet. 2000, 356: 1949-1954. 10.1016/S0140-6736(00)03306-7.PubMedCrossRef
93.
Staessen JA, Wang JG, Thijs L: Cardiovascular prevention and blood pressure reduction: A quantitative overview updated until 1 March 2003. J Hypertens. 2003, 21: 1055-1076. 10.1097/00004872-200306000-00002.PubMedCrossRef
94.
Kuwajima I, Kuramoto K, Ogihara T, Iimura O, Abe K, Saruta T, al : Tolerability and safety of a calcium channel blocker in comparison with a diuretic in the treatment of elderly patients with hypertension: Secondary analysis of the NICS-EH. Hypertens Res. 2001, 24: 475-480. 10.1291/hypres.24.475.PubMedCrossRef
95.
National Intervention Cooperative Study in Elderly Hypertensives Study Group: Randomized double-blind comparison of a calcium antagonist and a diuretic in elderly hypertensives. Hypertension. 1999, 34: 1129-1133.CrossRef
96.
Blood Pressure Lowering Treatment Trialists' Collaboration: Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials. Lancet. 2000, 356: 1955-1964. 10.1016/S0140-6736(00)03307-9.CrossRef
97.
Hansson L, Zanchetti A, Carruthers SG, Dahlöf B, Elmfeldt D, Julius S, Menard J, Rahn KH, Wedel H, Westerling S: Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet. 1998, 351: 1755-1762. 10.1016/S0140-6736(98)04311-6.PubMedCrossRef
98.
Group PATSC: Post-stroke antihypertensive treatment study: a preliminary result. Chin Med J (Engl). 1995, 108: 710-717.
99.
Davis BR, Cutler JA, Gordon DJ, Furberg CD, Wright JTJ, Cushman WC, Grimm RH, LaRosa J, Whelton PK, Perry HM, Alderman MH, Ford CE, Oparil S, Francis C, Proschan M, Pressel S, Hawkins CM: Rationale and design for the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Am J Hypertens. 1996, 9: 342-360. 10.1016/0895-7061(96)00037-4.PubMedCrossRef
100.
The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT): Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic. JAMA - Express. 2002, 288: 2981-2997.
101.
Borhani NO, Mercuri M, Borhani PA, Buckalew VM, Canossa-Terris M, Carr AA, Kappagoda MD, Rocco MV, Schnaper HW, Sowers JR, Bond MG: Final outcome results of the Multicenter Isradipine Diuretic Atherosclerosis Study (MIDAS). JAMA. 1996, 276: 785-791. 10.1001/jama.276.10.785.PubMedCrossRef
102.
Byington RP, Furberg CD, Craven TE, Pahor M, Sowers JR: Isradipine in prediabetic hypertensive subjects. Diabetes Care. 1998, 21: 2103-2110.PubMedCrossRef
103.
Rosei EA, Dal Palú C, Leonetti G, Magnani B, Pessina A, Zanchetti A: Clinical results of the Verapamil in Hypertension and Atherosclerosis Study. J Hypertens. 1997, 15: 1337-1344. 10.1097/00004872-199715110-00019.PubMedCrossRef
104.
Estacio RO, Jeffers BW, Hiatt WR, Biggerstaff SL, Gifford N, Schrier RW: The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. N Engl J Med. 1998, 338: 645-652. 10.1056/NEJM199803053381003.PubMedCrossRef
105.
Tatti P, Pahor M, Byington RP, Di M, Guarisco R, Strollo G: Outcome results of the Fosinopril versus Amlodipine Cardiovascular Events Randomized Trial (FACET) in patients with hypertension and NIDDM. Diabetes Care. 1998, 21: 597-603.PubMedCrossRef
106.
Group UKPDS: Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 39. BMJ. 1998, 317: 713-720.CrossRef
107.
The Heart Outcomes Prevention Evaluation Study Investigators: Effects of an angiotensin-converting-enzyme inhibitor, Ramipril, on cardiovascular events in high-risk patients. N Engl J Med. 2000, 342: 145-153. 10.1056/NEJM200001203420301.CrossRef
108.
Brown MJ, Palmer CR, Castaigne A, de Leeuw PW, Mancia G, Rosenthal T: Morbidity and mortality in patients randomised to double-blind treatment with a long-acting calcium-channel blocker or diuretic in the International Nifedipine GITS study: Intervention as a Goal in Hypertension Treatment (INSIGHT). Lancet. 2000, 356: 366-372. 10.1016/S0140-6736(00)02527-7.PubMedCrossRef
109.
Brown MJ, Palmer CR, Castaigne A, de Leeuw PW, Mancia G, Rosenthal T: Principal results from the International Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT). Eur Heart J. Edited by: Brown PMJ. 2001, 3: B20-B26.CrossRef
110.
Hansson L, Hedner T, Lund-Johansen P, Kjeldsen SE, Lindholm LH, Syvertsen JO, Lanke J, de Faire U, Dahlöf B, Karlberg BE: Randomised trial of effects of calcium antagonists compared with diuretics and beta-blockers on cardiovascular morbidity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study. Lancet. Edited by: Hansson PL. 2000, 356: 359-365. 10.1016/S0140-6736(00)02526-5.PubMedCrossRef
111.
Berl T, Hunsicker LG, Lewis JB, Pfeffer MA, Porush JG, Rouleau JL, Drury PL, Esmatjes E, Hricik D, Parikh CR, Raz I, Vanhille P, Wiegmann TB, Wolfe BM, Locatelli F, Goldhaber SZ, Lewis EJ, Irbesartan Diabetic Nephropathy Trial.Collaborative Study Group.: Cardiovascular outcomes in the Irbesartan Diabetic Nephropathy Trial of patients with type 2 diabetes and overt nephropathy. Ann Intern Med. 2003, 138: 542-549.PubMedCrossRef
112.
Group PROGRESSC: Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet. 2001, 358: 1033-1041. 10.1016/S0140-6736(01)06178-5.CrossRef
113.
Brenner BM, Cooper ME, de Zeeuw D, Keane WF, Mitch WE, Parving H, Remuzzi G, Snapinn SM, Zhang Z, Shahinfar S: Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. 2001, 345: 861-869. 10.1056/NEJMoa011161.PubMedCrossRef
114.
Zanchetti A, Bond MG, Hennig M, Neiss A, Mancia G, Dal Palu C, Hansson L, Magnani B, Rahn KH, Reid JL, Rodicio J, Safar M, Eckes L, Rizzini P, European Lacidipine Study on Atherosclerosis investigators.: Calcium antagonist lacidipine slows down progression of asymptomatic carotid atherosclerosis: principal results of the European Lacidipine Study on Atherosclerosis (ELSA), a randomized, double-blind, long-term trial. Circulation. 2002, 106: 2422-2427. 10.1161/01.CIR.0000039288.86470.DD.PubMedCrossRef
115.
Dahlöf B, Devereux RB, Kjeldsen SE, Julius S, Beevers G, de Faire U, Fyhrquist F, Ibsen H, Kristiansson K, Lederballe-Pedersen O, Lindholm LH, Nieminen M, Omvik S, Wedel H: Cardiovascular morbidity and mortality in the losartan intervention for endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet. Edited by: Dahlöf PB. 2002, 359: 995-1003. 10.1016/S0140-6736(02)08089-3.PubMedCrossRef
116.
Management Committee on behalf of the High Blood Pressure Research Council of Australia: Australian comparative outcome trial of angiotensin-converting enzyme inhibitor-and diuretic-based treatment of hypertension in the elderly (ANBP2): objectives and protocol. Clin Exp Pharmacol Physiol. 1997, 24: 188-192.CrossRef
117.
Wing LMH, Reid CM, Ryan P, Beilin LJ, Brown MA, Jennings GLR, Jonston CI, McNeil JJ, Macdonald GJ, Marley JE, TO M, West MJ: A comparison of outcomes with angiotensin-converting-enzyme inhibitors and diuretics for hypertrension in the elderly. N Engl J Med. 2003, 348: 583-592. 10.1056/NEJMoa021716.PubMedCrossRef
118.
Black HR, Elliott WJ, Neaton JD, Grandits G, Grambsch P, Grimm RH, Hansson L, Lacourciere Y, Muller J, Sleight P, Weber MA, White WB, Williams G, Wittes J, Zanchetti A, Fakouhi TD: Rationale and design for the controlled ONset Verapamil INvestigation of Cardiovascular Endpoints (CONVINCE) Trial. Control Clin Trials. 1998, 19: 370-390. 10.1016/S0197-2456(98)00013-0.PubMedCrossRef
119.
Black HR, Elliott WJ, Grandits G, Grambsch P, Lucente T, White WB, Neaton JD, Grimm RH, Hansson L, Lacourciere Y, Muller J, Sleight P, Weber MA, Williams G, Wittes J, Zanchetti A, Anders RJ: Principal results of the controlled onset verapamil investigation of cardiovascular end points (CONVINCE) trial. JAMA. 2003, 289: 2073-2082. 10.1001/jama.289.16.2073.PubMedCrossRef
120.
Lithell H, Hansson L, Skoog I, Elmfeldt D, Hofman A, Olofsson B, Trenkwalder P, Zanchetti A: The study on cognition and prognosis in the elderly (SCOPE): principal results of a randomized double-blind intervention trial. J Hypertens. 2003, 21: 875-886. 10.1097/00004872-200305000-00011.PubMedCrossRef
121.
Yui Y, Sumiyoshi T, Kodama K, Hirayama A, Nonogi H, Kanmatsuse K, Origasa H, Iimura O, Ishii M, Saruta T, Arakawa K, Hosoda S, Kawai C, for the Japanese Multicenter Investigation for Cardiovascular Diseases-B (JMIC-B) Study Group: Comparison of nifedipine retard with angiotensin converting enzyme inhibitors in Japanese hypertensive patients with coronary artery disease: the Japan Multicenter Investigation for Cardiovascular Diseases-B (JMIC-B) Randomized Trial. Hypertens Res. 2004, 27: 181-191. 10.1291/hypres.27.181.PubMedCrossRef
122.
Julius S, Kjeldsen SE, Weber M, Brunner HR, Ekman S, Hansson L, Hua T, Laragh J, McInnes GT, Mitchell L, Plat F, Schork A, Smith B, Zanchetti A, group* VALUE: Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet. 2004, 363: 2022-2031. 10.1016/S0140-6736(04)16451-9.PubMedCrossRef
123.
Kjeldsen SE, Julius S, Brunner H, Hansson L, Henis M, Ekman S, Laragh J, McInnes G, Smith B, Weber M, Zanchetti A: Characteristics of 15,314 hypertensive patients at high coronary risk. The VALUE trial. The Valsartan Antihypertensive Long-term Use Evaluation. Blood Press. 2001, 10: 83-91. 10.1080/08037050152112069.PubMedCrossRef
124.
Mann J, Julius S: The Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial of cardiovascular events in hypertension. Rationale and design. Blood Press. 1998, 7: 176-183. 10.1080/080370598437394.PubMedCrossRef
Metadata
Title
Methods underpinning national clinical guidelines for hypertension: describing the evidence shortfall
Authors
Fiona Campbell
Heather O Dickinson
Julia VF Cook
Fiona R Beyer
Martin Eccles
James M Mason
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2006
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-6-47

Other articles of this Issue 1/2006

BMC Health Services Research 1/2006 Go to the issue

Research article

The implementation of quality management systems in hospitals: a comparison between three countries

Research article

The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research

Research article

A comparison of career satisfaction amongst dental healthcare professionals across three health care systems: Comparison of data from the United Kingdom, New Zealand and Trinidad & Tobago

Study protocol

Protocol for stage 1 of the GaP study (Genetic testing acceptability for Paget's disease of bone): an interview study about genetic testing and preventive treatment: would relatives of people with Paget's disease want testing and treatment if they were available?

Research article

Hospitalizations during the last months of life of nursing home residents: a retrospective cohort study from Germany

Research article

Determinants of staff job satisfaction of caregivers in two nursing homes in Pennsylvania