Thank you for tagging me on this @AnastasiaSMihai & many thanks to @PadwalRaj, @feldman_ross & Dr. Tobe for their wisdom & leadership in on the @HTNCanada GLs.

Having been involved w/ the GLs for a decade, my reflections (FWIW): 1/7 (thread) https://twitter.com/AnastasiaSMihai/status/1361953513291485190

Completely agree that CHEP was a remarkable success b/c it was based on partnerships & a QI approach to a big public health concern. We need to return to strong parterships w/ primary care & community (non-MD, citizen) partners. We need to work in solidarity. 2/7

GLs have evolved to be very academically prestigious & exclusive. They have also contributed to some "academic tribalism" as we often contrast US v. Euro v. Canadian GLs. These academic debates don't lead to clear, simple messaging and don't help front line decision-making. 3/7

When CHEP launched in 1999, BP practice variation was massive and the need for simple guidance was significant. The knowledge needs now are more complex & nuanced. A re-think of how to approach these needs is req'd, emphasis on collaboration & creativity is needed. 4/7

Totally agree that digital health is an important part of the future of HTN care but ppl w HTN must always be partners in their care. We need to think carefully about how to include patient's practical wisdom & lived experience and how to avoid digital divides. 5/7

Healthy policy is critical to our blood pressure lowering strategy. Reducing income and health inequity, reducing structural oppressions must be considered as we discuss what "healthy communities & environments" should look like. 6/7

In summary: GLs have a role in supporting HTN decision-making but:
1) GLs must be inclusive & respect lived experience
2) Work hand in glove w/ policy that promote equitable, healthy environments
3) Be about care, not authors
4) Promote partnerships & solidarity in care
7/7