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Bob Schwadron
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CANADIANS NOT RECEIVING TREATMENT FOR HIGH BLOOD PRESSURE
Many Canadians With Hypertension
Do Not Even Know They Have It,
American Journal of Hypertension Study Finds
NEW YORK, NY -- Nearly 3.5 million Canadians either do not know
they have high blood pressure or they are receiving poor medical
treatment, a landmark study in the October issue of the American Journal
of Hypertension reveals.
The study, involving more than 23,000 Canadians between the
ages of 18 and 74, indicates that 42 percent were unaware that they
had high blood pressure, 23 percent were treated and not controlled and
19 percent did not receive medical treatment. Only 16 percent were
receiving effective treatment.
*If we translate prevalence and proportion figures into estimated
population affected, we have about 4.1 million people aged 18 to 74
years in Canada who had hypertension and who were at increased risk
for coronary artery disease and stroke,* the authors said.
They note that about 960,000 people were treated and not
controlled; 757,000 were neither treated nor controlled and 1.7 million
Canadians did not even know they had high blood pressure.
*This study by Joffres et al points out that hypertension, which
can be easily recognized by a simple blood pressure measurement, is
poorly managed even in a country with a comprehensive health care
system,* says Michael Weber, MD, an editor of the American Journal of
Hypertension, the peer-reviewed journal of the American Society of
Hypertension.
*It is particularly distressing that many Canadian physicians,
despite knowing that their patients have hypertension, have elected
either not to treat patients adequately, or in some cases, not to even
inform them of their hypertension,* he continued. *This finding may
reflect a lack of information or follow-through on the part of responsible
physicians. Sadly, it may also reflect a health care system that claims to
provide universal health care but at the price of diminished quality.*
Hypertension, called the silent killer because it prematurely ages
the body's arteries often without warning, can lead to serious
complications including stroke, heart attack and kidney failure. With a
mortality rate of 38 percent, cardiovascular disease is the leading cause
of death in Canada.
The study was conducted in each of Canada's 10 provinces
between 1986 and 1992 and screened 23,116 randomly selected
Canadians -- 11,364 men and 11,752 women. High blood pressure for
the study was defined as greater than 140/90 mmHg.
Participants were interviewed at home for demographic and
lifestyle data, and their level of knowledge and awareness of
cardiovascular disease risk factors. Blood pressure was measured at
the beginning and end of the interview by a trained public health nurse.
About two weeks later the participants went to a clinic for two additional
blood pressure measurements.
Only two percent of the study participants never had their blood
pressure measured, according to the study. Joffres and colleagues
noted that most of the Canadian hypertensives were not from the older
age group.
In a separate analysis of the estimated population
extrapolation, they found that only 27 percent were in the 64 to 74 years age group, while 61 percent were in the middle age group, while only 12 percent
were in the 18 to 34 year age group.
*Even though prevalence of hypertension increases dramatically
with age, it is important to realize that the burden of hypertension is
occurring in the middle age group,* the authors said. *In terms of
prevention, it is important to note that about 254,000 Canadian men (64
percent) aged 18 to 34 years were not aware of their hypertension,
compared with only 15,000 Canadian women (19 percent), and this is
not only due to a lack in screening.*
The authors of the study, *Awareness, Treatment and Control of
Hypertension in Canada,* conclude that *despite a Canadian health care
system that is mostly free and provides relatively easy access, and in
which a great proportion of the population have had their blood pressure
measured in the last year, the prevalence of hypertension is still high,
with a low level of control, mainly in the young male population.*
Authors of the study are Michel R. Joffres, Dalhousie University,
Halifax, Nova Scotia; Parviz Ghadirian and Pavel Hamet, University
Center Hospital, Montreal; J. George Fodor, University of Ottawa Heart
Institute, Ottawa, Ontario; Andres Petrasovits, Cardiovascular Disease
Prevention Unit, Health Canada, Ottawa; and Arun Chockalingam,
Canadian Coalition for High Blood Pressure Prevention and Control,
Orleans, Ontario.
The American Society of Hypertension is the largest US
organization devoted exclusively to hypertension and related
cardiovascular diseases. The organization is committed to alerting
physicians, allied health professionals and the public about new medical
options, facts, research findings and treatment choices designed to
reduce the risk of cardiovascular disease.
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