Treatment and awareness of hypertension in Canada have improved significantly in the last 25 years for community-dwelling adults, states an article in CMAJ (Canadian Medical Association Journal).
High blood pressure (hypertension) is a risk factor for vascular disease and mortality in developed countries but if managed properly, it is the most important modifiable risk factor. Recent studies in Canada have indicated improvements in the prescribing rates of drugs to treat hypertension and consequent decreases in cardiovascular events related to high blood pressure.
A team of researchers looked at the measurement of blood pressure in people aged 20 to 79 not living in institutions who participated in either of two national health surveys. The analysis showed decreases in the number of hypertensive Canadians between 1992 and 2009 who were not being treated or not receiving adequate treatment to control their blood pressure. As well, the percentage of people who were unaware of their condition had dropped from 43% to 17%. Systolic blood pressure levels were lower in people with treated hypertension and in people without high blood pressure in 2009 compared to 1992.
"The management of hypertension among community-dwelling Canadian adults appears to have improved over the past two decades," writes Dr. Finlay McAlister, University of Alberta, with coauthors. "Notably, the rates of awareness, treatment and control documented in the ON-BP and the CHMS [surveys] are higher than those recently reported from physical measures surveys done in the United States and elsewhere during the same periods."
People with high blood pressure and heart disease or cardiovascular or cerebrovascular disease were more likely to have their blood pressure under control. "This is encouraging, as it suggests that either Canadian physicians appropriately target more intensive therapy to patients at higher risk or that patients at higher risk are more compliant with their therapy," state the authors.
"However, despite marked improvements in rates for the control of hypertension over the past two decades, one-third of community-dwelling Canadian adults with hypertension still have blood pressures that are higher than the currently recommended targets, and cardiovascular disease remains the most common cause of premature death and disability in Canada," the authors conclude, stating we need to further improve management of hypertension.
The study was conducted by researchers from the University of Alberta, Statistics Canada, Simon Fraser University, The University of Ottawa Heart Institute, the Public Health Agency of Canada, the Children's Hospital of Eastern Ontario Research Institute and the University of Calgary.
- McAlister, Finlay A., Wilkins, Kathryn, Joffres, Michel, Leenen, Frans H.H., Fodor, George, Gee, Marianne, Tremblay, Mark S., Walker, Robin, Johansen, Helen, Campbell, Norm. Changes in the rates of awareness, treatment and control of hypertension in Canada over the past two decades. CMAJ, 2011; DOI: 10.1503/cmaj.101767
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