GuidelineCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2025
Hypertension Canada guideline for the diagnosis and treatment of hypertension in adults in primary care.
Registry-linked trialAbstract readPractice Guideline
In one paragraph
Guideline in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07675551 (Peel Family Diabetes Prevention Program), which is not on this map. Cited by 25 papers, 3 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 3 pooled it
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Peel Family Diabetes Prevention Program (Peel FDPP): Family-Centred Health and Wellness Coaching Pilot Randomized Controlled Trial
Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Optimal hypertension screening frequency in adults: a systematic review.BMC primary care · 2026Pooled it
- Low-Dose Triple-Pill of Telmisartan, Amlodipine, and Indapamide for Initial Hypertension Treatment: A GRADE-Assessed Meta-analysis of Randomized Trials.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026Pooled it
- Revisiting Unattended Versus Attended Automated Office Blood Pressure Measurements: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2025Pooled it
- Article
- Optimizing cardiovascular pharmacotherapy in older adults with frailty.Nature reviews. Cardiology · 2026Review
- Management of hypertension in chronic kidney disease.Clinical medicine (London, England) · 2026Review
- Are Angiotensin-Converting Enzyme Inhibitors Effective in the Treatment of Hypertension in Black Patients?CJC open · 2026Review
- A HEARTS-based integrated model for noncommunicable disease control in primary health care in Peru.Lancet regional health. Americas · 2026Review
- Evaluation and Counseling of Living Kidney Donor Candidates.Journal of the American Society of Nephrology : JASN · 2026Review
- Rationale and design of a parallel randomised trial of a plant-based intensive lifestyle intervention for diabetes remission: The REmission of diabetes using a PlAnt-based weight loss InteRvention (REPAIR) trial.Diabetes, obesity & metabolism · 2026Article
- Response to letters about Hypertension Canada guideline.Canadian family physician Medecin de famille canadien · 2026Article
- All in on ARBs: Is it time to fold the ACEIs?Canadian family physician Medecin de famille canadien · 2026Review
- The Role of Mineralocorticoid Receptors in the Treatment of Primary Hypertension.Current hypertension reports · 2026Review
- Canadian Society of Nephrology Commentary on the 2025 Kidney Disease Improving Global Outcomes Clinical Practice Guidelines for Autosomal Dominant Polycystic Kidney Disease.Canadian journal of kidney health and disease · 2026Article
- Renal Denervation for Uncontrolled Hypertension: A Health Technology Assessment.Ontario health technology assessment series · 2026Article
- Article
- The Evolution of Hypertension Management in Canada: A Review of the Current Guidelines.Cureus · 2025Review
- Prognostic Impact of Different Definitions of White-Coat Hypertension.American journal of hypertension · 2025Article
- Blood pressure management in secondary prevention after myocardial infarction.Cardiovascular research · 2025Review
- Adapting hypertension guidelines for low-resource and rural settings: a global perspective.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Rémi GoupilDivision of Nephrology (Goupil), Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Que.; EPICORE (Tsuyuki), Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Department of Health Research Methods, Evidence, and Impact (Santesso), McMaster University, Hamilton, Ont.; Langstaff Medical Centre (Terenzi), Woodbridge, Ont.; Department of Family and Community Medicine (Habert), University of Toronto, Toronto, Ont.; Department of Family Medicine (Cheng), Faculty of Medicine and Health Sciences, McGill University, Montréal, Que.; Apothecare Pharmacy (Gysel), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Faculty of Nursing (Bruneau), Memorial University of Newfoundland, St. John's, NL; Division of Endocrinology and Metabolism (Leung), Department of Medicine, and Department of Community Health Sciences (Leung), Cumming School of Medicine, University of Calgary; Libin Cardiovascular Institute (Campbell), Department of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Lady Davis Institute for Medical Research (Schiffrin), Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Que.; Division of Nephrology (Hundemer), Department of Medicine, University of Ottawa; Inflammation and Chronic Disease Program (Hundemer), Ottawa Hospital Research Institute, Ottawa, Ont.
Ross T TsuyukiDivision of Nephrology (Goupil), Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Que.; EPICORE (Tsuyuki), Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Department of Health Research Methods, Evidence, and Impact (Santesso), McMaster University, Hamilton, Ont.; Langstaff Medical Centre (Terenzi), Woodbridge, Ont.; Department of Family and Community Medicine (Habert), University of Toronto, Toronto, Ont.; Department of Family Medicine (Cheng), Faculty of Medicine and Health Sciences, McGill University, Montréal, Que.; Apothecare Pharmacy (Gysel), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Faculty of Nursing (Bruneau), Memorial University of Newfoundland, St. John's, NL; Division of Endocrinology and Metabolism (Leung), Department of Medicine, and Department of Community Health Sciences (Leung), Cumming School of Medicine, University of Calgary; Libin Cardiovascular Institute (Campbell), Department of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Lady Davis Institute for Medical Research (Schiffrin), Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Que.; Division of Nephrology (Hundemer), Department of Medicine, University of Ottawa; Inflammation and Chronic Disease Program (Hundemer), Ottawa Hospital Research Institute, Ottawa, Ont.
Nancy SantessoDivision of Nephrology (Goupil), Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Que.; EPICORE (Tsuyuki), Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Department of Health Research Methods, Evidence, and Impact (Santesso), McMaster University, Hamilton, Ont.; Langstaff Medical Centre (Terenzi), Woodbridge, Ont.; Department of Family and Community Medicine (Habert), University of Toronto, Toronto, Ont.; Department of Family Medicine (Cheng), Faculty of Medicine and Health Sciences, McGill University, Montréal, Que.; Apothecare Pharmacy (Gysel), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Faculty of Nursing (Bruneau), Memorial University of Newfoundland, St. John's, NL; Division of Endocrinology and Metabolism (Leung), Department of Medicine, and Department of Community Health Sciences (Leung), Cumming School of Medicine, University of Calgary; Libin Cardiovascular Institute (Campbell), Department of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Lady Davis Institute for Medical Research (Schiffrin), Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Que.; Division of Nephrology (Hundemer), Department of Medicine, University of Ottawa; Inflammation and Chronic Disease Program (Hundemer), Ottawa Hospital Research Institute, Ottawa, Ont.
Kristin A TerenziDivision of Nephrology (Goupil), Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Que.; EPICORE (Tsuyuki), Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Department of Health Research Methods, Evidence, and Impact (Santesso), McMaster University, Hamilton, Ont.; Langstaff Medical Centre (Terenzi), Woodbridge, Ont.; Department of Family and Community Medicine (Habert), University of Toronto, Toronto, Ont.; Department of Family Medicine (Cheng), Faculty of Medicine and Health Sciences, McGill University, Montréal, Que.; Apothecare Pharmacy (Gysel), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Faculty of Nursing (Bruneau), Memorial University of Newfoundland, St. John's, NL; Division of Endocrinology and Metabolism (Leung), Department of Medicine, and Department of Community Health Sciences (Leung), Cumming School of Medicine, University of Calgary; Libin Cardiovascular Institute (Campbell), Department of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Lady Davis Institute for Medical Research (Schiffrin), Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Que.; Division of Nephrology (Hundemer), Department of Medicine, University of Ottawa; Inflammation and Chronic Disease Program (Hundemer), Ottawa Hospital Research Institute, Ottawa, Ont.
Jeffrey HabertDivision of Nephrology (Goupil), Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Que.; EPICORE (Tsuyuki), Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Department of Health Research Methods, Evidence, and Impact (Santesso), McMaster University, Hamilton, Ont.; Langstaff Medical Centre (Terenzi), Woodbridge, Ont.; Department of Family and Community Medicine (Habert), University of Toronto, Toronto, Ont.; Department of Family Medicine (Cheng), Faculty of Medicine and Health Sciences, McGill University, Montréal, Que.; Apothecare Pharmacy (Gysel), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Faculty of Nursing (Bruneau), Memorial University of Newfoundland, St. John's, NL; Division of Endocrinology and Metabolism (Leung), Department of Medicine, and Department of Community Health Sciences (Leung), Cumming School of Medicine, University of Calgary; Libin Cardiovascular Institute (Campbell), Department of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Lady Davis Institute for Medical Research (Schiffrin), Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Que.; Division of Nephrology (Hundemer), Department of Medicine, University of Ottawa; Inflammation and Chronic Disease Program (Hundemer), Ottawa Hospital Research Institute, Ottawa, Ont.
Gemma ChengDivision of Nephrology (Goupil), Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Que.; EPICORE (Tsuyuki), Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Department of Health Research Methods, Evidence, and Impact (Santesso), McMaster University, Hamilton, Ont.; Langstaff Medical Centre (Terenzi), Woodbridge, Ont.; Department of Family and Community Medicine (Habert), University of Toronto, Toronto, Ont.; Department of Family Medicine (Cheng), Faculty of Medicine and Health Sciences, McGill University, Montréal, Que.; Apothecare Pharmacy (Gysel), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Faculty of Nursing (Bruneau), Memorial University of Newfoundland, St. John's, NL; Division of Endocrinology and Metabolism (Leung), Department of Medicine, and Department of Community Health Sciences (Leung), Cumming School of Medicine, University of Calgary; Libin Cardiovascular Institute (Campbell), Department of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Lady Davis Institute for Medical Research (Schiffrin), Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Que.; Division of Nephrology (Hundemer), Department of Medicine, University of Ottawa; Inflammation and Chronic Disease Program (Hundemer), Ottawa Hospital Research Institute, Ottawa, Ont.
Stephanie C GyselDivision of Nephrology (Goupil), Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Que.; EPICORE (Tsuyuki), Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Department of Health Research Methods, Evidence, and Impact (Santesso), McMaster University, Hamilton, Ont.; Langstaff Medical Centre (Terenzi), Woodbridge, Ont.; Department of Family and Community Medicine (Habert), University of Toronto, Toronto, Ont.; Department of Family Medicine (Cheng), Faculty of Medicine and Health Sciences, McGill University, Montréal, Que.; Apothecare Pharmacy (Gysel), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Faculty of Nursing (Bruneau), Memorial University of Newfoundland, St. John's, NL; Division of Endocrinology and Metabolism (Leung), Department of Medicine, and Department of Community Health Sciences (Leung), Cumming School of Medicine, University of Calgary; Libin Cardiovascular Institute (Campbell), Department of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Lady Davis Institute for Medical Research (Schiffrin), Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Que.; Division of Nephrology (Hundemer), Department of Medicine, University of Ottawa; Inflammation and Chronic Disease Program (Hundemer), Ottawa Hospital Research Institute, Ottawa, Ont.
Jill BruneauDivision of Nephrology (Goupil), Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Que.; EPICORE (Tsuyuki), Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Department of Health Research Methods, Evidence, and Impact (Santesso), McMaster University, Hamilton, Ont.; Langstaff Medical Centre (Terenzi), Woodbridge, Ont.; Department of Family and Community Medicine (Habert), University of Toronto, Toronto, Ont.; Department of Family Medicine (Cheng), Faculty of Medicine and Health Sciences, McGill University, Montréal, Que.; Apothecare Pharmacy (Gysel), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Faculty of Nursing (Bruneau), Memorial University of Newfoundland, St. John's, NL; Division of Endocrinology and Metabolism (Leung), Department of Medicine, and Department of Community Health Sciences (Leung), Cumming School of Medicine, University of Calgary; Libin Cardiovascular Institute (Campbell), Department of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Lady Davis Institute for Medical Research (Schiffrin), Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Que.; Division of Nephrology (Hundemer), Department of Medicine, University of Ottawa; Inflammation and Chronic Disease Program (Hundemer), Ottawa Hospital Research Institute, Ottawa, Ont.
Alexander A LeungDivision of Nephrology (Goupil), Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Que.; EPICORE (Tsuyuki), Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Department of Health Research Methods, Evidence, and Impact (Santesso), McMaster University, Hamilton, Ont.; Langstaff Medical Centre (Terenzi), Woodbridge, Ont.; Department of Family and Community Medicine (Habert), University of Toronto, Toronto, Ont.; Department of Family Medicine (Cheng), Faculty of Medicine and Health Sciences, McGill University, Montréal, Que.; Apothecare Pharmacy (Gysel), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Faculty of Nursing (Bruneau), Memorial University of Newfoundland, St. John's, NL; Division of Endocrinology and Metabolism (Leung), Department of Medicine, and Department of Community Health Sciences (Leung), Cumming School of Medicine, University of Calgary; Libin Cardiovascular Institute (Campbell), Department of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Lady Davis Institute for Medical Research (Schiffrin), Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Que.; Division of Nephrology (Hundemer), Department of Medicine, University of Ottawa; Inflammation and Chronic Disease Program (Hundemer), Ottawa Hospital Research Institute, Ottawa, Ont.
Norman R C CampbellDivision of Nephrology (Goupil), Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Que.; EPICORE (Tsuyuki), Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Department of Health Research Methods, Evidence, and Impact (Santesso), McMaster University, Hamilton, Ont.; Langstaff Medical Centre (Terenzi), Woodbridge, Ont.; Department of Family and Community Medicine (Habert), University of Toronto, Toronto, Ont.; Department of Family Medicine (Cheng), Faculty of Medicine and Health Sciences, McGill University, Montréal, Que.; Apothecare Pharmacy (Gysel), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Faculty of Nursing (Bruneau), Memorial University of Newfoundland, St. John's, NL; Division of Endocrinology and Metabolism (Leung), Department of Medicine, and Department of Community Health Sciences (Leung), Cumming School of Medicine, University of Calgary; Libin Cardiovascular Institute (Campbell), Department of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Lady Davis Institute for Medical Research (Schiffrin), Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Que.; Division of Nephrology (Hundemer), Department of Medicine, University of Ottawa; Inflammation and Chronic Disease Program (Hundemer), Ottawa Hospital Research Institute, Ottawa, Ont.
Ernesto L SchiffrinDivision of Nephrology (Goupil), Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Que.; EPICORE (Tsuyuki), Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Department of Health Research Methods, Evidence, and Impact (Santesso), McMaster University, Hamilton, Ont.; Langstaff Medical Centre (Terenzi), Woodbridge, Ont.; Department of Family and Community Medicine (Habert), University of Toronto, Toronto, Ont.; Department of Family Medicine (Cheng), Faculty of Medicine and Health Sciences, McGill University, Montréal, Que.; Apothecare Pharmacy (Gysel), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Faculty of Nursing (Bruneau), Memorial University of Newfoundland, St. John's, NL; Division of Endocrinology and Metabolism (Leung), Department of Medicine, and Department of Community Health Sciences (Leung), Cumming School of Medicine, University of Calgary; Libin Cardiovascular Institute (Campbell), Department of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Lady Davis Institute for Medical Research (Schiffrin), Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Que.; Division of Nephrology (Hundemer), Department of Medicine, University of Ottawa; Inflammation and Chronic Disease Program (Hundemer), Ottawa Hospital Research Institute, Ottawa, Ont.
Gregory L HundemerDivision of Nephrology (Goupil), Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Que.; EPICORE (Tsuyuki), Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Department of Health Research Methods, Evidence, and Impact (Santesso), McMaster University, Hamilton, Ont.; Langstaff Medical Centre (Terenzi), Woodbridge, Ont.; Department of Family and Community Medicine (Habert), University of Toronto, Toronto, Ont.; Department of Family Medicine (Cheng), Faculty of Medicine and Health Sciences, McGill University, Montréal, Que.; Apothecare Pharmacy (Gysel), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.; Faculty of Nursing (Bruneau), Memorial University of Newfoundland, St. John's, NL; Division of Endocrinology and Metabolism (Leung), Department of Medicine, and Department of Community Health Sciences (Leung), Cumming School of Medicine, University of Calgary; Libin Cardiovascular Institute (Campbell), Department of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Lady Davis Institute for Medical Research (Schiffrin), Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Que.; Division of Nephrology (Hundemer), Department of Medicine, University of Ottawa; Inflammation and Chronic Disease Program (Hundemer), Ottawa Hospital Research Institute, Ottawa, Ont. ghundemer@toh.ca.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCanada has historically been among the world leaders in hypertension care, but hypertension treatment and control rates have regressed in recent years. This guideline is intended to provide pragmatic primary care-focused recommendations to improve hypertension management in adults at the population level.
methodsWe employed Grading of Recommendations Assessment, Development and Evaluation and ADAPTE frameworks in accordance with Appraisal of Guidelines for Research and Evaluation (AGREE II) quality and reporting standards to develop recommendations on managing hypertension for adults aged 18 years and older. We used the HEARTS framework - a model of care developed by the World Health Organization to improve hypertension control and reduce cardiovascular burden - to integrate these recommendations into streamlined, pragmatic, and evidence-based algorithms. The guideline committee predominantly comprised primary care providers and also included patient, methodology, and hypertension specialist representatives. Our process for managing competing interests adhered to Guidelines International Network principles. RECOMMENDATIONS: The 9 recommendations for managing hypertension in adults are grouped under the categories of diagnosis and treatment. Diagnostic recommendations include a standardized approach to measuring blood pressure (BP) and confirming hypertension, as well as providing a uniform definition for hypertension of BP ≥ 130/80 mm Hg. Treatment recommendations include targeting a systolic BP < 130 mm Hg, implementing healthy lifestyle changes, and providing stepwise guidance on optimal medication choices for patients requiring pharmacotherapy.
interpretationOur aim is to enhance the standard of hypertension care in the Canadian primary care setting. Accurate diagnosis and optimal treatment of hypertension can reduce adverse cardiovascular events and risk of death.
Indexed as
Antihypertensive AgentsHypertensionPrimary Health CareAdultBlood Pressure DeterminationCanadaHumansAntihypertensive Agents
Identifiers
What Socratic holds
Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390
Registered trials
NCT07675551ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.