Setting priorities for HTN reviews

Cochrane Hypertension priority-setting process

We have completed 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 were designed to confirm that we focus our efforts on reviews which have been cited by Cochrane Hypertension 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
  • Juan Erviti
  • Balraj (Benji) Heran 
  • Ciprian Jauca
  • Carole Lunny 
  • Douglas M Salzwedel
  • Sara Tasnim
  • James (Jim) M Wright 
  • Janet Zhang

Phase 1 - Preliminary mapping of review titles:

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 - Bilingual survey and topics ranking:

Bilingual survey: we undertook a social media engagement campaign (#AskCochraneHTN) in both English and Spanish to solicit additional priorities from patients, carers and other stakeholders via an online questionnaire.Respondents to the questionnaire provided input on their preferred hypertension topics.

Topics ranking exercise: 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. 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 hypertension?
  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 older patients with hypertension?

Phase 3 - Final mapping, ranking and publication of core portfolio of review titles:

Review titles mapping exercise:  we mapped our existing portfolio of Cochrane Hypertension review titles against the top priority topics selected in the ranking exercise.

Review titles ranking exercise: for each of the top priority topics, steering group members ranked their preferred review title(s) for each of the priority topics, resulting in a new list of Cochrane Hypertension's priority reviews

Core portfolio of priority reviews: we are pleased to present the below Cochrane Hypertension core portfolio resulting from our priority-setting engagement campaign, ranking, and mapping exercises:

  1. A001 Pharmacotherapy for hypertension in adults 60 years or older
  2. A056 Pharmacotherapy for mild hypertension
  3. A145 Blood pressure targets for hypertension in older adults
  4. A178 First-line drug classes for hypertension in adults: A network meta-analysis
  5. A035 Relaxation therapies for the management of primary hypertension in adults
  6. A081 Pharmacotherapy for hypertension in adults aged 18 to 59
  7. A128 First-line combination therapy versus first-line monotherapy for primary hypertension
  8. A149 Combination therapy for hypertension
  9. A157 Withdrawal of antihypertensive drugs in older people
  10. A095 Long-term effects of weight-reducing diets for hypertension
  11. A098 Walking for hypertension
  12. A057 Effect of early treatment with anti-hypertensive drugs on short and long-term mortality in patients with an acute cardiovascular event
  13. A090 Blood pressure targets for people with hypertension in diabetes mellitus
  14. A014 Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol and triglyceride
  15. A136 Vitamin D supplementation for treatment of essential hypertension
  16. A062 Garlic for the prevention of cardiovascular morbidity and mortality in hypertensive patients
  17. A088 First-line drugs inhibiting the renin angiotensin system versus other first-line antihypertensive drug classes for hypertension
  18. A011 First-line diuretics versus other classes of antihypertensive drugs for hypertension
  19. A034 Statins for preventing major vascular events in people with hypertension
  20. A129 Blood pressure targets for the treatment of people with hypertension and cardiovascular disease
  21. A029 Blood pressure targets in adults with hypertension
  22. A038 Combined calcium, magnesium, and potassium supplementation for the management of primary hypertension in adults
  23. A091 Blood pressure targets for people with hypertension in chronic renal disease