Background: Although brain and heart conditions share overlapping risk factors and commonly co-occur, current cardiac and neurologic clinical guidelines are typically produced within specialty silos. The objective of this guideline from a Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) panel is to expand on current cardiovascular guidelines to include evidence from the neurologic and mental health literature, with specific recommendations for providers managing comorbid brain and heart conditions.
Methods: The guideline development panel comprised an Executive Steering Committee; 10 expert subgroups to develop research questions and draft recommendations for specific brain - heart conditions; an Evidence Review Team to ensure the rigour and consistent application of the methodology; and an Implementation Committee to facilitate uptake of the recommendations by clinicians and into electronic medical records. The McMaster Evidence Review and Synthesis Team supported the literature searches and critical appraisal.
A panel of people with lived experience of specific conditions and caregivers provided input on patient values and perspectives throughout the guideline development process. Our consensus process followed the Appraisal of Guidelines for Research and Evaluation II framework.
It reflects an intent to bridge specialty silos and provide actionable recommendations for providers managing comorbidity.
A McMaster team supported literature searching and appraisal, while input from people with lived experience and caregivers informed patient values and perspectives throughout development.
An established evidence appraisal approach determined the level of evidence and strength of recommendations, aligned with Guidelines International Network principles on managing competing interests.
Additional targets include addressing cognitive impairment in hypertension, depression treatment in coronary artery disease, and dyslipidemia management in stroke.
The scope indicates potential variability in applicability across settings not elaborated in the source text.