Setting priorities for HTN reviews

Cochrane Hypertension priority-setting process

As a member of the Cochrane Circulation & Breathing Network, we are currently undertaking an exercise to identify those of our reviews which should prioritised for publication and updating as core titles within our portfolio.  

Benefits & rationale

The priority-setting exercises are designed to confirm that we are focussing our efforts on reviews which have been cited by our stakeholders (patients, carers, clinicians, and researchers) as being of the highest importance and that we are compliant with Cochrane requirements for priority-setting.

Cochrane Hypertension editorial and author teams are experiencing increasing workloads, sometimes resulting in publication delays.  Creating a portfolio of core titles will enable us to publish the highest priority titles in a more timely manner, ensuring that we are maintaining high quality and making the best use of our publically funded resources for the benefit of people making decisions about their healthcare.  

Steering Group members

  • Mohamed Ben-Eltriki
  • Alan Cassels
  • Juan Erviti
  • Balraj (Benji) Heran 
  • Ciprian Jauca
  • Carole Lunny 
  • Douglas M Salzwedel
  • Sara Tasnim
  • James (Jim) M Wright 
  • Janet Zhang

Phase 1: 

We mapped existing Cochrane Hypertension review titles to the top ten priorities identified by the Hypertension Canada Priority Setting Partnership Group (HCPSPG), which used the James Lind Alliance priority setting process. This process is recognized by the Cochrane Priority Setting Methods Group.  From this mapping, the Priority-Setting Steering Group selected a preliminary set of reviews to submit to Cochrane's priority reviews list.

Phase 2:

  1. We undertook a bilingual (English/Spanish) social media engagement campaign (#AskCochraneHTN) to solicit additional priorities from patients, carers and other stakeholders via an online questionnaire.  
  2. Respondents to the questionnaire provided input on their preferred hypertension topics.
  3. Topics ranking exercise (Spring/Summer 2021): members of the Steering Group and external stakeholders, including patients, carers and researchers ranked their top 10 priority topics from a draft list of 16 topics developed from the engagement campaign.
  4. Results of topic ranking exercise (September 2021): From the draft list of 16 priority topics, survey respondents chose the following eleven (two topics tied for tenth place) priority topics (presented in descending order from beginning with the highest priority topic:
    1. Which lifestyle habits or changes can modify blood pressure in people with hypertension?
    2. What's the best antihypertensive treatment to prevent cardiovascular disease and death?
    3. What are the harms and benefits of treating mild hypetension?
    4. What are the most common harms associated with long term use of antihypertensive drugs?
    5. What are the optimal threshold values and targets for starting and stopping antihypertensive drugs for people of different ages?
    6. What types of natural/alternative treatments or supplements are safe and effective for reducing blood pressure and the need for medication?
    7. Does treating stress, anxiety, or depression influence blood pressure and what's the optimal therapy?
    8. What are the best drug combinations for lowering blood pressure?
    9. What is the first drug that should be used to treat simple hypertension?
    10. Which hypertension management strategies are most effective for patients who also have other conditions?
    11. What are the best treatments for improving quality of life and daily functioning in elderly patients with hypertension?
  5. Review titles mapping exercise (November 2021): we are mapping our existing portfolio of Cochrane Hypertension review titles against the top priority topics selected in the ranking exercise.
  6. Review titles ranking exercise (November 2021): For each of the top priority topics, steering group members will view the mapping of existing review titles and rank the preferred review title for each of the priority topics, resulting in a new list of Cochrane Hypertension's priority reviews
  7. Portfolio update (Autumn 2021/Winter 2022): From the results of the engagement campaign, ranking and mapping exercises, the selected titles will comprise our updated portfolio of priority review titles.
  8. Website priority-setting update (Autumn 2021/Winter 2022): More detailed results of the consultation exercises will be published on this page and the ten Cochrane Hypertension priority review titles will be submitted to Cochrane's priority reviews list for their consideration.

Phase 3:

  1. Cochrane Hypertension will conduct a consultation event for patients, at which time we will solicit input on our existing priority titles and revise them as necessary to ensure that our priority titles align with priority topics identified in the earlier phases of our priority-setting exercise.
  2. Priority topics and titles will be revisited periodically as we continue to engage with our stakeholders