Study reveals high blood pressure a growing public health concern in Canada

According to a study published recently in the Canadian Journal of Cardiology, a growing number of Canadians, especially women, are unaware that they have high blood pressure, and they aren’t getting the treatment they need to control the condition.

The study’s lead, Dr. Alexander Leung, MD, an endocrinologist and epidemiologist in the Libin Cardiovascular Institute and the O’Brien Institute for Public Health, within the University of Calgary’s Cumming School of Medicine (CSM), says Canada can’t be complacent when it comes to its national approach to high blood pressure (hypertension).

“High blood pressure is the leading cause of preventable heart attacks, strokes and premature death in Canada and around the world, so this is a real concern,” says Leung an assistant professor in the departments of Medicine and Community Health Sciences at the CSM. 

Canada has been a world leader in hypertension care, outperforming other Western countries over many years, but the country’s ranking has fallen in the past decade.

From 1990 to 2007, hypertension management improved in Canada thanks to strong public funding, a co-ordinated national strategic plan and collaboration among national hypertension organizations on guideline implementation and evaluation. However, in recent years, several factors have adversely impacted hypertension care in Canada, including declining federal government support for surveillance and implementation; a refocusing of non-governmental organizations away from implementing hypertension recommendations; and declining industry support as patented drugs were replaced by generics.

This study was based on data collected during a national survey conducted by Statistics Canada from 2007 to 2017. The data included face-to-face interviews and direct blood pressure measurements. 

'This is a matter of life and death'

Nearly a quarter of Canadian adults, about 5.8 million people, suffer from hypertension. While the number of people with high blood pressure has remained stable over 10 years, the study found a significant drop in the percentage of people aware of their high blood pressure, those treated with medications and those whose hypertension is controlled. For the first time in decades, less than 75 per cent of people with high blood pressure were treated and fewer than 60 per cent were controlled.

“This means that hundreds of thousands of people living with high blood pressure do not even know they have a problem, a large number are not receiving adequate treatment, and, as a result, many people are suffering from preventable deaths and disability from heart attacks and strokes,” says Leung, noting that disability and death from cardiovascular disease has risen in Canada at a corresponding rate. 

Leung is particularly concerned that women were impacted much more than men. Despite men and women having similar prevalence in hypertension, less than two-thirds of women with high blood pressure were treated and less than half were controlled, while 79 per cent of men with hypertension were treated and 67 per cent were controlled.

Leung hopes his study serves as a warning that high blood pressure is a major public health threat in Canada.

“We should not be complacent about national blood pressure control, but urgently re-engage the public, doctors, and policy-makers in government about the importance of blood pressure treatment and control for people of all ages and genders,” says Leung. “This is a matter of life and death.”

According to Leung, maintaining a healthy body weight, exercising regularly, and eating plenty of fruits and vegetables are examples of some practical ways that may help prevent high blood pressure in many people.