Changes in the rates of awareness, treatment and control of hypertension in Canada over the past two decades

McAlister, Finlay A.; Wilkins, Kathryn; Joffres, Michel; Leenen, Frans H. H.; Fodor, George; Gee, Marianne E.; Tremblay, Mark S.; Walker, Robin; Johansen, Helen; Campbell, Norm R.C.

doi:10.1503/cmaj.101767

Cited by 232 publications

(206 citation statements)

References 31 publications

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“…Hypertension is highly prevalent, and although rates of detection and control of hypertension are improving in many countries, uncontrolled hypertension remains common [1] and medication and lifestyle adherence remains low. Nonadherence leads to substantial avoidable healthcare costs [2] because of inefficiencies in care delivery, discarded medications, and expenditures related to preventable hypertensionrelated sequelae [3].…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Study of Patient Perspectives about Hypertension

et al. 2013

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To understand hypertensive patients' perspectives regarding blood pressure and hypertension treatment, this qualitative study applied semistructured interviews of hypertensive patients. Participants were recruited from two hypertension clinics at the University of Alberta in Edmonton, Canada. To be eligible for inclusion, patients had to be aged 18 years or older, diagnosed with hypertension by a healthcare provider, and currently taking an antihypertensive medication. Participants were stratified in the analysis according to blood pressure control. Twenty-six patients (mean age 57; 62% female) were interviewed, of which 42% were on target and 58% were not. Three underlying themes emerged from the interviews: (a) knowledge of blood pressure relating to diagnosis and management and control of hypertension, (b) integration of hypertension management into daily routine, and (c) feelings and beliefs of wellness. None of the above themes were associated with better control. Knowledge gaps were found, which emphasize the need for further patient education and physician training. Feelings and beliefs of wellness, and not knowledge, were important factors in home assessment of blood pressure. The absence of connections between control of hypertension and the identified domains indicates that current approaches could benefit from the development of a more personalized approach for education and communication.

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Section: Introductionmentioning

confidence: 99%

A Qualitative Study of Patient Perspectives about Hypertension

et al. 2013

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“…Although the prevalence of hypertension is on the rise in Canada, studies have shown that its incidence is declining and that more patients are receiving the appropriate treatment to control their blood pressure. 27,28 In addition, implementation of specific guidelines on carotid revascularization, anticoagulation for atrial fibrillation, and an emphasis on early evaluation times and neuroimaging may also improve secondary stroke prevention. 29,30 In Canada, rates of anticoagulation for stroke prevention in context of atrial fibrillation have increased in the past decade with a concomitant decrease in stroke rates.…”

Section: Discussionmentioning

confidence: 99%

Shifting Trend of Transient Ischemic Attack Admission and Prognosis in Canada

Lindsay

Fang

et al. 2016

Can. J. Neurol. Sci.

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Background: Stroke is often preceded by transient symptoms. Although global stroke rates have been shown to be declining, previous studies have reported inconsistent temporal trends of transient ischemic attacks (TIA). The objective of the current study is to report the temporal trends of TIA admissions and outcomes in Canada over the last 11 years. Methods: We conducted a complete population cohort study using a national administrative database to study the temporal trend of age-and sex-adjusted TIA admission rates in Canada from 2003 to 2013. We also determined the rates of TIA and stroke diagnoses in the emergency department in the province of Ontario during the same period. We used multivariable analyses to study discharge location after acute hospitalization as well as 90-day stroke and/or TIA readmission rates. Results: Of 425,799 admissions to an acute care hospital for all stroke and TIA, 71,443 (16.8%) were TIA. The age-and sex-standardized rates of TIA admission decreased significantly during the study period from 30.0 to 20.6 per 100,000 (p < 0.0001). In Ontario, decreasing TIA admissions is mirrored by decreasing rates of TIA directly discharged from the emergency department (55.1 to 46.8 per 100,000, p = 0.002). The odds of 90-day readmission rates for stroke or TIA are also decreasing (adjusted odds ratio, 0.97; 95% confidence interval, 0.96-0.99). Conclusions: We show that TIA admission rates have declined in the past 11 years in Canada, reflecting improved vascular risk reduction and stroke care. Future studies to confirm our findings on improved stroke or TIA recurrence rates are necessary. ICT, 71,443 (16,8%) étaient pour une ICT. Les taux d'hospitalisation pour une ICT, standardisés pour l'âge et le sexe, ont diminué significativement pendant la période de l'étude, soit de 30,0 à 20,6 par 100,000 (p < 0,0001). En Ontario, la diminution des hospitalisations pour une ICT se reflète dans la diminution des taux d'ICT au moment du congé directement du département des urgences (55,1 à 46,8 par 100,000; p = 0,002). Les taux de réhospitalisation pour AVC ou ICT au cours des 90 jours suivant l'événement initial diminuent également (RC 0,97 ; intervalle de confiance à 95% de 0,96 à 0,99). Conclusions: Nous démontrons que les taux d'hospitalisation pour ICT ont diminué au Canada au cours des 11 dernières années, reflétant une diminution du risque vasculaire ainsi qu'une amélioration du traitement de l'AVC. Des études ultérieures seront nécessaires afin de confirmer nos constatations sur les taux de récurrence de l'AVC ou de l'ICT.

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“…1,2 Recently, McAlister and colleagues reported that 20% of Canadians have hypertension and 35% of adults with hypertension fail to keep their blood pressure below recommended targets despite taking antihypertensive medication. 3,4 Awareness and management of hypertension in Canada has improved substantially over the past 20 Background: Hypertension is a major risk factor for cardiovascular morbidity and mortality. Despite this fact and the development of effective antihypertensive drug therapy, hypertension is often poorly controlled.…”

Section: Introductionmentioning

confidence: 99%

“…3 While health care professionals in Canada have made strides toward reducing the prevalence of hypertension, there is still room for improvement. Proper detection and management of hypertension and other cardiovascular risk factors have enormous potential to reduce the burden of CVD among Canadians.…”

Section: Introductionmentioning

confidence: 99%

The MyHealthCheckup Study: Training Graduate Students to Implement Cardiovascular Risk Screening Programs in Community Pharmacies

et al. 2012

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Results:Among the 238 patients who participated (57% female, mean age 60.6 years), 67% had a body mass index (BMI) greater than 25 kg/m 2 , 52% had abdominal obesity, 58% reported insufficient physical activity and 14% were smokers. A total of 120 patients (51%) were taking antihypertensive medication, yet 63 (53%) had blood pressure readings above currently accepted targets. Higher BMI and physical inactivity were associated with increased rates of poorly controlled hypertension. ABSTRACT Conclusion:The screening program identified individuals with modifiable cardiovascular risk factors and poorly controlled hypertension. The intervention program was well received by participants and the majority provided contact information for future cardiovascular screening clinics. These findings support the feasibility of screening programs run by graduate students in the pharmacy setting. Can Pharm J 2012;145:268-275.

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Changes in the rates of awareness, treatment and control of hypertension in Canada over the past two decades

Cited by 232 publications

References 31 publications

A Qualitative Study of Patient Perspectives about Hypertension

A Qualitative Study of Patient Perspectives about Hypertension

Shifting Trend of Transient Ischemic Attack Admission and Prognosis in Canada

The MyHealthCheckup Study: Training Graduate Students to Implement Cardiovascular Risk Screening Programs in Community Pharmacies

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