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Canadian Journal of Cardiology

Worsening Hypertension Awareness, Treatment, and Control Rates in Canadian Women Between 2007 and 2017

Published:April 13, 2020DOI:https://doi.org/10.1016/j.cjca.2020.02.092

      Abstract

      Background

      Hypertension continues to be the leading cause of preventable death and disability. The objective of this study was to examine hypertension prevalence, awareness, treatment, and control for women and men in Canada over the last decade.

      Methods

      A nationally representative, cross-sectional study was conducted using the Canadian Health Measures Survey (2007-2017). Using blood pressure readings from each respondent, along with a self-reported history of high blood pressure and active medications, the rates of hypertension prevalence, awareness, treatment, and control were calculated for women and men.

      Results

      A total of 5,794,641 people were identified to have hypertension from 2007 to 2017, representing 23.1% (95% confidence interval [CI], 21.9%-24.2%) of the Canadian adult population with no appreciable change in prevalence over the decade. Overall awareness, treatment, and control were 83.5% (95% CI, 81.5%-85.4%), 78.9% (95% CI, 76.2%-81.6%), and 65.4% (95% CI, 62.4%-68.4%), respectively, with no significant changes in men from 2007 to 2017. Conversely, in women, substantial deteriorations in awareness (72.2% [95% CI, 64.1%-80.2%] in 2016-2017 vs 85.0% [95% CI, 82.4%-87.7%] in 2007-2015), treatment (65.2% [95% CI, 57.6%-72.8%] vs 82.2% [95% CI, 79.4%-85.1%]), and control (49.2% [95% CI, 39.7%-58.7%] vs 67.0% [95% CI, 63.9%-70.1%]) were found.

      Conclusions

      After plateauing early in the 2000s, Canadian hypertension treatment and control rates have declined in the past decade, largely in women. Renewed collaborative efforts by key stakeholders are urgently needed to address this increase in preventable risk for cardiovascular disease.

      Résumé

      Contexte

      L'hypertension reste la principale cause de décès et d'invalidité évitables. L'objectif de cette étude était d'examiner la prévalence de l'hypertension, la sensibilisation, le traitement et le contrôle de l'hypertension chez les femmes et les hommes au Canada au cours de la dernière décennie.

      Méthodes

      Une étude transversale représentative, à l'échelle nationale, a été réalisée à l'aide de l'Enquête canadienne sur les mesures de la santé (2007-2017). Au travers des lectures de la pression artérielle de chaque répondant, ainsi que des antécédents autodéclarés d'hypertension et de médicamentation en cours, les taux de prévalence de l'hypertension, de sensibilisation, de traitement et de contrôle ont été calculés pour les femmes et les hommes.

      Résultats

      Un total de 5 794 641 personnes ont été identifiées comme souffrant d'hypertension entre 2007 et 2017, ce qui représente 23,1 % (intervalle de confiance [IC] à 95 %, 21,9 %-24,2 %) de la population adulte canadienne, sans changement notable de la prévalence au cours de la décennie. Dans l'ensemble, la sensibilisation, le traitement et le contrôle étaient respectivement de 83,5 % (IC à 95 %, 81,5 %-85,4 %), 78,9 % (IC à 95 %, 76,2 %-81,6 %) et 65,4 % (IC à 95 %, 62,4 %-68,4 %), sans changement significatif chez les hommes de 2007 à 2017. À l'inverse, chez les femmes, des détériorations importantes de la sensibilisation (72,2 % [IC à 95 %, 64,1 %-80,2 %] en 2016-2017 vs 85,0 % [IC à 95 %, 82,4 %-87,7 %] en 2007-2015), du traitement (65,2 % [IC à 95 %, 57,6 %-72,8 %] contre 82,2 % [IC à 95 %, 79,4 %-85,1 %]), et le contrôle (49,2 % [IC à 95 %, 39,7 %-58,7 %] contre 67,0 % [IC à 95 %, 63,9 %-70,1 %]) ont été constatées.

      Conclusions

      Après avoir plafonné au début des années 2000, les taux de traitement et de contrôle de l'hypertension au Canada ont diminué au cours de la dernière décennie, principalement chez les femmes. Il est urgent de renouveler les efforts de collaboration des principales parties prenantes pour faire face à cette augmentation du risque évitable de maladie cardiovasculaire.
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