Chronic disease management is becoming an increasingly central part of care team practice, particularly in primary care settings. Scientific evidence continues to grow, recommendations are evolving, therapeutic options are expanding, and patient profiles are becoming more complex.
In this context, the challenge is no longer simply having access to clinical information, but being able to use it effectively when it matters most. Healthcare professionals need high-performing, up-to-date, and clinically relevant tools that support personalized and reliable interventions. This is why Vigilance Santé works to integrate the most recent guidelines into its platforms, bringing clinical information closer to everyday decision-making.
This article provides an overview of recent guideline updates evaluated by our team of pharmacists. It focuses on three common conditions in primary care: hypertension, COPD (chronic obstructive pulmonary disease), and obesity.
The most recent Hypertension Canada guidelines, published in May 2025, are specifically intended for primary care professionals. They aim to improve the management of hypertension in adults by offering a simplified approach.
This update was prompted in part by a concerning trend: despite historically strong results, hypertension control is declining in Canada. Identified contributing factors include the complexity of previous recommendations and the difficulty of applying them in routine practice.
To address this, the guide focuses on simplified recommendations that can be applied directly in primary care. It also provides an algorithm that helps guide clinicians from diagnosis through to treatment adjustment.
One of the major changes pertains to the definition of hypertension itself, now established as blood pressure (BP) ≥ 130/80 mmHg when measured under optimal conditions using a device validated for accuracy. This revision is based on data linking BP values of ≥ 130–139/85–89 mmHg to a higher cardiovascular risk compared with lower values.
Pharmacotherapy is recommended when BP is ≥ 140/90 mmHg in adults, or when systolic blood pressure (SBP) is 130–139 mmHg in patients at high risk of cardiovascular disease. The preferred initial treatment consists of a low-dose combination of two agents from among the following three classes:
angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs);
thiazide or thiazide-like diuretics;
long-acting dihydropyridine calcium channel blockers.
This strategy helps achieve better blood pressure control more quickly and limits therapeutic inertia. Ideally, treatment should be provided as a single-pill combination. To facilitate management, the authors suggest the irbesartan/hydrochlorothiazide combination as initial therapy, particularly because it is available as a single-pill formulation and is accessible through several generic versions in Canada.
The therapeutic target has also been simplified for practice, with the adoption of a single SBP target of < 130 mmHg for most patients.
It should be noted that the Hypertension Canada guidelines have been structured in two parts. While this first section is intended for primary care professionals, recommendations addressing more complex situations will be published progressively, topic by topic.
Hypertension Canada offers a professional certification program designed to help healthcare professionals feel more confident in managing hypertension. At the time of writing, this program was being updated to integrate the 2025 guidelines. Stay informed by regularly consulting Hypertension Canada’s social media channels and website.
The management of chronic obstructive pulmonary disease (COPD) is based in part on recommendations from GOLD, the Global Initiative for Chronic Obstructive Lung Disease, which are updated annually. This update frequency makes GOLD a particularly relevant reference, as it rapidly incorporates new scientific evidence, whether related to pharmacotherapy or management strategies.
The 2026 edition represents a major update, with the addition of more than 300 new references. The full guide remains highly detailed, and an abridged version is also available to support use in clinical settings where time is limited.
Among the major changes is a revision of the ABE assessment tool. Already used in recent years, this tool helps clinicians choose initial treatment by categorizing patients according to their exacerbation history and symptoms.
In the 2026 update, the presence of a single moderate or severe exacerbation in the past year is now sufficient to classify a patient in Group E. This revision is based on new data showing that a single moderate exacerbation before the initiation of maintenance therapy is associated with an increased risk of future events. As a result, the lower intervention threshold supports earlier treatment intensification. For these patients, a combination of a long-acting muscarinic antagonist (LAMA) and a long-acting beta2-agonist (LABA) is recommended from the outset, with the addition of an inhaled corticosteroid (ICS) to be considered if blood eosinophils are ≥ 300 cells/µL.
A new section on disease activity has been introduced in this edition. The guide defines a state of “low activity” as the absence of exacerbations, worsening symptoms, and accelerated decline in lung function.
However, the goal of disease control, corresponding to this low-activity state with minimal impact on the patient, may remain difficult to achieve in individuals with advanced lung impairment and a high symptom burden.
In this context, targeting disease activity from the early stages could help slow disease progression and limit structural damage, with the potential to reduce the risk of symptoms and disability associated with COPD.
With the emergence of biologic therapies in the COPD treatment arsenal, mepolizumab has been added to the 2026 report as a therapeutic option for patients with blood eosinophil levels ≥ 300 cells/µL who remain uncontrolled despite triple inhaled therapy (LAMA + LABA + ICS). A new table summarizing the evidence supporting the use of biologic agents has also been added. It should be noted that, at the time of writing, mepolizumab did not yet have an official indication in Canada for the treatment of COPD.
These elements represent only a snapshot of what is new in the 2026 version. To review all updates, consult the list of key changes.
Despite persistent stigma, obesity is now recognized as a chronic disease by the World Health Organization.
To support healthcare professionals, the Obesity Canada guidelines, developed in collaboration with the Canadian Association of Bariatric Physicians and Surgeons, cover a wide range of aspects related to obesity management. The 2025 update to the pharmacotherapy chapter reflects the rapid evolution of this field in recent years, with the integration of new therapeutic options that not only enable greater weight loss, but also significantly improve several comorbidities.
Treatment selection is based on an individualized approach, taking into account factors such as comorbidities, tolerability, patient preferences, and issues related to access and cost. The guide also emphasizes the chronic nature of treatment: medications should be considered for long-term use, as discontinuation is frequently associated with weight regain.
In this context, the role of primary care professionals is central, both in supporting decision-making and ensuring close follow-up. Optimizing adherence, managing adverse effects, and adjusting treatment based on clinical evolution are all integral parts of this management approach.
Discover Obesity Canada’s podcast for healthcare professionals, featuring discussions on current issues in obesity management.
At Vigilance Santé, we recognize that chronic disease management is at the heart of practice for healthcare teams across Canada, and we develop technology solutions designed to make it easier.
To ensure clinicians have access to clear, up-to-date guidance that can be applied directly in practice, our teams design tools built on both the quality and currency of the content, as well as performance.
Whether through the implementation of the Chroma module in RxConsultAction or the Intervention Opportunities tool integrated into RxVigilance, our goal is to integrate clinical information directly into professionals’ workflow.
Fill out the form below to access a document presenting both products.
The rapid evolution of chronic disease guidelines represents a challenge for clinicians. Yet it is precisely in this context that adapted, integrated tools, offering simplified access to relevant information, help support optimal practice.
At Vigilance Santé, we believe that the combination of rigorous content and integrated technology solutions makes it possible to meet this need.