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Canadian Journal of Cardiology

Epidemiology of Hypertension in Canada: An Update

Published:August 15, 2015DOI:https://doi.org/10.1016/j.cjca.2015.07.734

      Abstract

      Background

      High blood pressure (BP) is the leading cause of death and disability in the world. The objective of this analysis was to perform a detailed update of the epidemiology of hypertension in Canada.

      Methods

      Five population-based data sources were analyzed. We used the Canadian Health Measures Survey to determine the latest directly measured prevalence, awareness, and control estimates (2012-2013); the National Population Health Survey, and Canadian Community Health Survey to assess crude and age-standardized self-reported prevalence (1994-2013); the Canadian Chronic Disease Surveillance System to assess administrative data–ascertained prevalence and mortality trends (1998-2010); and Intercontinental Medical Statistics Health data to examine antihypertensive drug–prescribing trends and costs (2007-2014).

      Results

      In 2012-2013, the prevalence of hypertension (defined as drug treatment for high BP or BP ≥ 140/90 mm Hg) in Canadian adults was 22.6%, and the proportion of disease controlled was 68.1%. In Canadians with diabetes, the prevalence (defined as drug treatment or BP ≥ 130/80 mm Hg) was 67.1%, and 60.1% of cases were controlled. Self-reported hypertension prevalence has increased by approximately 2-fold over nearly 2 decades. Age-standardized mortality rates are falling in hypertensive Canadians (from 9.4 to 7.9 deaths per 1000 individuals), but to a lesser extent than in nonhypertensive individuals. Total antihypertensive drug prescription volume has increased steadily since 2007 amid falling drug costs.

      Conclusions

      Hypertension prevalence in Canada continues to rise. Increased use of antihypertensive drugs and improvements in control are apparent. Coordinated efforts to further improve the treatment and control of hypertension in Canada are needed.

      Résumé

      Introduction

      L’hypertension est la principale cause de décès et d’incapacité dans le monde. L’objectif de cette analyse était de réaliser une mise à jour approfondie de l’épidémiologie de l’hypertension au Canada.

      Méthodes

      Cinq sources de données de la population générale ont été analysées. Nous avons utilisé l’Enquête canadienne sur les mesures de la santé pour déterminer les plus récentes mesures directes de la prévalence, la sensibilisation et les estimations de la maîtrise (2012-2013); l’Enquête nationale sur la santé de la population et l’Enquête sur la santé dans les collectivités canadiennes pour évaluer la prévalence autodéclarée brute et standardisée selon l’âge (1994-2013); le Système canadien de surveillance des maladies chroniques pour évaluer les données administratives – la vérification de la prévalence et des tendances de la mortalité (1998-2010); et les données de l’Intercontinental Medical Statistics Health pour examiner les médicaments antihypertenseurs — les tendances et les coûts des ordonnances (2007-2014).

      Résultats

      En 2012-2013, la prévalence de l’hypertension (définie par le traitement pharmacologique de l'hypertension ou de la pression artérielle [PA] ≥ 140/90 mm Hg) chez les adultes canadiens était de 22,6 %, puis le pourcentage de maîtrise de la maladie était de 68,1 %. Chez les Canadiens souffrant de diabète, la prévalence (définie par le traitement pharmacologique ou la PA ≥ 130/80 mm Hg) était de 67,1 %, puis le pourcentage des cas qui maîtrisait la maladie était de 60,1 %. La prévalence de l’hypertension autodéclarée a approximativement doublé depuis près de 2 décennies. Les taux de mortalité standardisée selon l’âge diminuent chez les Canadiens hypertendus (de 9,4 à 7,9 décès par 1 000 individus), mais dans une proportion moindre que chez les individus non hypertendus. Le volume total d’ordonnances de médicaments antihypertenseurs a augmenté de manière constante depuis 2007, au moment de la baisse des coûts des médicaments.

      Conclusions

      La prévalence de l’hypertension au Canada continue de s’accroître. L’augmentation de l’utilisation des médicaments antihypertenseurs et les améliorations concernant la maîtrise sont évidentes. Il est nécessaire de coordonner les efforts pour améliorer davantage le traitement et la maîtrise de l’hypertension au Canada.
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