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Canadian Journal of Cardiology

The Rise and Fall of Hypertension Control in Canada: The Beginning of the End or the End of the Beginning?

Published:February 16, 2021DOI:https://doi.org/10.1016/j.cjca.2021.02.008
      What a difference a decade makes. At the beginning of the 2010s we seemed well on the road to making hypertension the 21st century version of smallpox, a seemingly unstoppable disease eradicated by a concerted public health effort. Blood pressure (BP) control in Canada was approaching 70% rates, up from control rates in the teens 20 years earlier, increasing more than 4-fold.
      • Schiffrin E.L.
      • Campbell N.R.C.
      • Feldman R.F.
      • et al.
      Hypertension in Canada: past, present, and future.
      Furthermore, Canada was increasingly recognised for world-leading BP control rates driven in part by a very effective knowledge translation program: the Canadian Hypertension Education Program (CHEP), later the Hypertension Canada Guidelines.
      • Whelton P.K.
      The elusiveness of population-wide high blood pressure control.
      A decade later, BP control rates are declining in Canada, as is the effectiveness of those public health efforts that seemed to have been so effective at the beginning of this millennium.
      • Leung A.A.
      • Williams J.V.A.
      • McAlister F.A.
      • et al.
      Worsening hypertension awareness, treatment, and control rates in Canadian women between 2007 and 2017.
      In this brief commentary we would like to review the progress of the BP control effort, mostly focusing on the Canadian perspective, outline the basis of both successes and challenges inherent in those efforts and as we shift attention from away from COVID-19, and suggest a way forward to continue the progress against a disease that remains a leading determinant of premature death in North America and globally.
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