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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Article info
Publication history
Published online: August 15, 2015
Accepted:
July 17,
2015
Received:
June 6,
2015
Footnotes
See editorial by Campbell and Feldman, pages 609-611 of this issue.
See page 693 for disclosure information.
Identification
Copyright
© 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
