Prevalence and management of hypertension in primary care practices with electronic medical records: a report from the Canadian Primary Care Sentinel Surveillance Network

BACKGROUND: Most epidemiologic reports on hypertension in Canada are based on data from surveys or on administrative data. We report on the prevalence and management of hypertension based on data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), which consists of validated, national, point-of-care data from primary care practices. METHODS: We included CPCSSN data as of Dec. 31, 2012, for patients 18 years and older who had at least 1 clinical encounter during the previous 2 years with one of the 444 family physicians and nurse-practitioners who participate in the CPCSSN. We calculated the prevalence of hypertension, the proportion of patients who achieved blood pressure targets, the number of encounters with primary care providers, comorbidities and pharmacologic management. RESULTS: Of the 250 346 patients who met the eligibility criteria, 57 180 (22.8%) had a diagnosis of hypertension. Of the 44 981 patients for whom blood pressure data were available, 35 094 (78.0%) had achieved both targets for systolic (≤□140 mm Hg) and diastolic (≤□90 mm Hg) pressure. Compared with patients who did not have a hypertension diagnosis, those with hypertension were significantly more likely to have a comorbidity and visited their primary care provider more often. Among the patients with hypertension, 12.1% were not taking antihypertensive medications; nearly two-thirds (61.7%) had their condition controlled with 1 or 2 drugs. INTERPRETATION: The prevalence of hypertension based on CPCSSN data was similar to estimates from the Canadian Health Measures Survey. Although achievement of blood pressure targets was high, patients with hypertension had more comorbidities and saw their primary care provider more often than those without hypertension.