Epidemiology of Hypertension in Canada: An Update

Padwal, Raj; Bienek, Asako; McAlister, Finlay A.; Campbell, Norm R.C.

doi:10.1016/j.cjca.2015.07.734

Cited by 130 publications

(96 citation statements)

References 47 publications

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“…17 Similarly, in the most recent analysis of five population-based data sources that included the Canadian Health Measures Survey to determine the latest directly measured prevalence, awareness and control estimates in 2012-2013, Padwal et al 18 reported control rates of >68% among all hypertensive adults; this rate is significantly higher than corresponding control rates in China and the United States (~10% and 53%, respectively). [18][19][20][21] These national-level geographic differences mask an even worse picture of hypertension prevalence, treatment and control for many population groups and communities at the sub-national level. For example, the United States National Health and Nutrition Examination Survey (for non-institutionalized adults aged >18 years) in 2011-2014 showed a national hypertension prevalence of 29% but a much higher prevalence in non-Hispanic Blacks (41.2%).…”

Section: Inaugural Elijah Saunders Memorial Lecture -Mensahmentioning

confidence: 97%

The Inaugural Elijah B. Saunders Memorial Lecture: The Global Consequences of Hypertension and Related Disparities

Mensah¹

2016

Ethn Dis

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<p>This inaugural memorial lecture provides an opportunity to celebrate the life of Elijah B. Saunders, MD, FACC and pays tribute to his pioneering spirit in the quest to advance health equity in the prevention and control of hypertension and cardiovascular diseases. It also enables an assessment of the state of the global burden of hypertension and related disparities. Despite the remarkable biomedical research progress made over the last half-century, hypertension remains the leading risk factor for global disease burden and the major preventable contributor to cardiovascular and all-cause mortality. Additionally, disparities in hypertension-related morbidity and mortality remain pervasive worldwide. National hypertension control rates showing progress often mask important suboptimal treatment and control in population groups defined by sex, race, ethnicity, geography, and social and environmental determinants. Within these groups, many hypertension-related disparities remain largely unchanged while other gaps have widened. In essence, current research has been relatively ineffective in guiding largescale, sustained elimination of hypertension-related disparities. An important explanation for these observations may be the significant advances made in observational epidemiological research, especially in improved surveillance and data collection that document the extent of disparities in marked contrast to the relative paucity of interventional disparities research. The paucity of these interventional research studies remains a continuing challenge. The time has come for renewed efforts in building strategic partnerships that leverage transdisciplinary, multi-sectoral expertise to provide global leadership in interventional implementation research for hypertension control and elimination of related disparities. Developing an appropriately skilled implementation research workforce will be crucial. The National Heart, Lung, and Blood Institute and its biomedical research funding partners remain committed to a strategic agenda of implementation research, training, and education for the prevention and control of hypertension and elimination of related disparities. <em>Ethn Dis. </em>2016;26(3):461-468; doi:10.18865/ed.26.3.461 </p>

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Section: Inaugural Elijah Saunders Memorial Lecture -Mensahmentioning

confidence: 97%

The Inaugural Elijah B. Saunders Memorial Lecture: The Global Consequences of Hypertension and Related Disparities

Mensah¹

2016

Ethn Dis

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“…При этом достижение контроля над АГ по-прежне-му является трудновыполнимой задачей. Среди па-циентов с АГ целевых значений АД достигают толь-ко 60% жителей Канады [8], 53% -США [9] и 45% -50% -в странах Европейского Союза [10].…”

Section: том 4 №4 / 2017unclassified

Risk Profile and Antihypertensive Treatment Efficacy in Patients Referred to the Cardiological Centre: Post-Hoc Analysis

Ionov¹,

Емельянов²,

Rotar³

et al. 2017

Transl. med. (Print)

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РезюмеАктуальность: Артериальная гипертензия (АГ) остается основным фактором риска сердечно-сосудистой заболеваемости и смертности. Эффективность лечения различна в регионах и зависит от типа лечебного учреждения. Интерес представляет оценка особенностей терапии АГ при оказании специализированной кардиологической амбулаторно-поликлинической помощи. Цель: Проанализировать сопутствующую АГ патологию, факторы сердечно-сосудистого риска и определить особенности антигипертензивной терапии среди амбулаторных пациентов федерального кардиологического центра. Материалы и методы: Проведен ретроспективный анализ 100 случайно выбранных электронных медицинских карт пациентов, проконсультированных в Национальном медицинском исследовательском центре им. В. А. Алмазова (ранее Северо-Западный федеральный медицинский исследовательский центр им. В. А. Алмазова) по поводу сердечно-сосудистых заболеваний в период 2010-2013 гг. Представительную выборку составили мужчины (n=44) и женщины (n=56) в возрасте от 23 до 88 лет (59±13 лет). АГ определялась при уровне систолического АД (САД) ≥ 140 мм рт.ст., диастолического АД (ДАД) ≥ 90 мм рт.ст., или если пациент получал антигипертензивную терапию (АГТ). Под эффективностью лечения понимали достижение целевого уровня АД на фоне АГТ, а под контролируемой АГ -целевые уровни АД среди всех гипертензивных пациентов. Оценивался тип АГТ и рекомендуемые группы препаратов. Результаты: Среди амбулаторных пациентов кардиологического центра АГ в подавляющем количестве случаев была сопряжена с другими сердечно-сосудистыми заболеваниями. Встречаемость курения была минимальна, ожирение и сахарный диабет чаще диагностировался у пациентов с АГ. Средние уровни САД и ДАД были 143±23 мм рт. ст. и 87±11 мм рт. ст., соответственно. АГТ была назначена всем пациентам с АГ (n=82), принимали ее 62% (n=51) пациентов, при этом женщины оказались более приверженными к рекомендациям врача (р = 0,026). Эффективность лечения наблюдалась в (n=40) 78% случаях, а контроль АГ -в (n=53) 65%. Большинству пациентов была назначена комбинированная терапия (n=65) 79%, чаще -трехкомпонентная (n=32, 48,5%). Основные антигипертензивные препараты -бета-адреноблокаторы, ингибиторы АПФ и диуретики. Заключение: Наблюдается строгая ассоциация АГ с явными сердечно-сосудистыми заболеваниями, ожирением и сахарным диабетом. Большинство пациентов достигает адекватного контроля АД, при этом его вероятность выше у молодых, регулярно принимающих комбинированную терапию пациенток с сопутствующей хронической сердечной недостаточностью.Ключевые слова: артериальная гипертензия, специализированный центр, антигипертензивные препараты, эффективность, приверженность.

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“…The 4 most important modifiable risk factors for cardiovascular disease are hypertension, dyslipidemia, diabetes, and smoking 2,3. These risk factors are highly prevalent in Canadians – 23% have hypertension, 45% have dyslipidemia, 9% have diabetes, and 18% smoke 4–6…”

Section: Introductionmentioning

confidence: 99%

“…For example, 37% of Canadians with hypertension and 81% of Canadians with dyslipidemia are not controlled to target levels 4,7. These care-gaps reflect a lost opportunity to improve health, prevent premature death and disability, and reduce unnecessary health care expenditures.…”

Section: Introductionmentioning

confidence: 99%

Worksite-based cardiovascular risk screening and management: a feasibility study

Padwal¹,

Rashead²,

Snider³

et al. 2017

VHRM

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BackgroundEstablished cardiovascular risk factors are highly prevalent and contribute substantially to cardiovascular morbidity and mortality because they remain uncontrolled in many Canadians. Worksite-based cardiovascular risk factor screening and management represent a largely untapped strategy for optimizing risk factor control.MethodsIn a 2-phase collaborative demonstration project between Alberta Health Services (AHS) and the Alberta Newsprint Company (ANC), ANC employees were offered cardiovascular risk factor screening and management. Screening was performed at the worksite by AHS nurses, who collected baseline history, performed automated blood pressure measurement and point-of-care testing for lipids and A1c, and calculated 10-year Framingham risk. Employees with a Framingham risk score of ≥10% and uncontrolled blood pressure, dyslipidemia, or smoking were offered 6 months of pharmacist case management to optimize their risk factor control.ResultsIn total, 87 of 190 (46%) employees volunteered to undergo cardiovascular risk factor screening. Mean age was 44.5±11.9 years, 73 (83.9%) were male, 14 (16.1%) had hypertension, 4 (4.6%) had diabetes, 12 (13.8%) were current smokers, and 9 (10%) had dyslipidemia. Of 36 employees with an estimated Framingham risk score of ≥10%, 21 (58%) agreed to receive case management and 15 (42%) attended baseline and 6-month follow-up case management visits. Statistically significant reductions in left arm systolic blood pressure (−8.0±12.4 mmHg; p=0.03) and triglyceride levels (−0.8±1.4 mmol/L; p=0.04) occurred following case management.ConclusionThese findings demonstrate the feasibility and usefulness of collaborative, worksite-based cardiovascular risk factor screening and management. Expansion of this type of partnership in a cost-effective manner is warranted.

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Epidemiology of Hypertension in Canada: An Update

Cited by 130 publications

References 47 publications

The Inaugural Elijah B. Saunders Memorial Lecture: The Global Consequences of Hypertension and Related Disparities

The Inaugural Elijah B. Saunders Memorial Lecture: The Global Consequences of Hypertension and Related Disparities

Risk Profile and Antihypertensive Treatment Efficacy in Patients Referred to the Cardiological Centre: Post-Hoc Analysis

Worksite-based cardiovascular risk screening and management: a feasibility study

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