Changes in the rates of awareness, treatment and control of hypertension in Canada over the past two decades
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Key result
The rate of hypertension control among community-dwelling Canadian adults improved significantly from 13.2% in 1992 to 64.6% in 2009.
Population
28,352 community-dwelling adults aged 20 years or older in Canada across three population-based surveys…
Design
Cross-sectional
Authors
Discussion
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Implication
Documents substantial gains in Canadian hypertension control; leaves open whether trends persisted post-2009 or generalize elsewhere.
Study Design
Type
Cross-Sectional (n=28,352)
Multicenter
Yes
Structured PICO
P
Population
28,352 community-dwelling adults aged 20 years or older in Canada across three population-based surveys (CHHS 1986-1992 n=22,314; ON-BP 2006 n=2,551; CHMS 2007-2009 n=3,487). Excluded pregnant women and people living in long-term care facilities.
O
Outcome
Trends in the prevalence of hypertension and in control rates in Canada between 1992 and 2009
Main Result
Absolute Event Rate: 64.6% vs 13.2%
p-value: p=<0.001
Between 1992 and 2009, the prevalence of hypertension in Canada remained stable, but rates of awareness, treatment, and control improved markedly, with control rates increasing from 13.2% to 64.6%.
Limitations
- Awareness rates may be overestimated because taking antihypertensive medication was part of the case definition
- Measuring blood pressure only once during surveys tends to underestimate control rates and overestimate prevalence compared with 24-hour ambulatory monitoring
- People with isolated office hypertension may have been misclassified as having uncontrolled hypertension
- People with masked hypertension may have been misclassified as having controlled hypertension
- Required statistical adjustment to compare automated BpTRU measurements with manual mercury sphygmomanometer readings
- Overestimation of awareness due to case definition including 'regularly taking antihypertensive medication'
- Single blood pressure measurement may underestimate control and overestimate prevalence compared to 24-hour ambulatory monitoring
- Potential misclassification of isolated office hypertension or masked hypertension
- Need to adjust BpTRU measurements to estimate equivalent manual readings
Cite This Study
McAlister et al. (2011) conducted a cross-sectional in Hypertension (n=28,352). Hypertension management in 2009 (CHMS) vs. Hypertension management in 1992 (CHHS) was evaluated on Hypertension control rate (p=<0.001). The rate of hypertension control among community-dwelling Canadian adults improved significantly from 13.2% in 1992 to 64.6% in 2009.
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