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Canada leads world in hypertension treatment, Statscan says

Two-thirds of Canadians with high blood pressure are being treated successfully for the condition, a level unmatched anywhere in the world, a new study shows.

"Sixty-six-per-cent treatment and control is a gold medal performance for Canada," said Norm Campbell, the Canada chair in hypertension prevention and control.

"The next best is 44 per cent in the U.S. so we're doing great."

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The research, published in Statistics Canada's Health Reports, shows that 80 per cent of people with hypertension are actually being treated with medication. That includes 66 per cent who have their blood pressure under control and another 14 per cent who have uncontrolled hypertension, despite treatment.

Seventeen per cent of Canadians who suffer from high blood pressure are not aware of their condition. Another four per cent are aware but are untreated.

Dr. Campbell said that, while the numbers are impressive, "we can still do a lot better."

Sheldon Tobe, a nephrologist and spokesman for the Heart and Stroke Foundation of Canada, agreed.

"We're not doing enough prevention," he said. "High blood pressure is an area where we have to pay a lot more attention, particularly when it comes to sodium reduction."

There are many factors that contribute to high blood pressure, including being overweight, a lack of physical activity, excessive sodium consumption and aging.

Hypertension, while it has few obvious symptoms, is a leading risk factor for heart disease, stroke, diabetes and kidney disease.

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The new study shows that 19 per cent of Canadian adults have high blood pressure, while another 20 per cent are considered pre-hypertensive, and 61 per cent have normal blood pressure.

In those over the age of 60, however, the results are notably different: 53 per cent have high blood pressure, 24 per cent are pre-hypertensive and only 23 per cent have normal blood pressure.

There are also some important gender differences. Men are less likely than women to take antihypertensive medication - 76 per cent v. 83 per cent.

However, among those taking prescription drugs to control their blood pressure, the percentage who were unable to control the condition was much higher among older women (19 per cent) than men (7 per cent.)

Blood pressure is determined using a sphygmomanometer, an instrument that measures the force of the blood against the blood vessel walls.

It is expressed in two numbers: Systolic pressure, the upper number, is the pressure when the heart contracts; diastolic pressure, the lower number, is the pressure when the heart is relaxed.

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A person is considered hypertensive with a blood-pressure reading of 140/90 millimetres of mercury (mmHg) or higher. Healthy adults should have a blood pressure in the range of 120/80 mmHg, although that target varies with age and other health conditions.

Chris Simpson, chief of cardiology at Queen's University and Kingston General Hospital, said that while the new data are encouraging, Canadians cannot afford to be complacent.

"We have a tsunami of risk factors coming in younger people - obesity, diabetes, inactivity, smoking, etc. The progress we have made risks being eclipsed in the future," he said.

Dr. Simpson noted, for example, that in the 20-to-39 age group there is already 2 per cent of the population with high blood pressure and 14.5 per cent pre-hypertensive. In the 40-to-59 age group, those numbers jump to 18.4-per-cent hypertensive and 23.4-per-cent pre-hypertensive.

"The message we need to deliver to younger people is that even if you don't have high blood pressure now, you need to make lifestyle adjustments now to avoid health problems in the future," he said.

To findings are based on a representative sample of 3,514 Canadians aged 20 to 79 who underwent a battery of medical tests between March, 2007, and February, 2009.

It is the first time since 1992 that Statistics Canada has directly measured the blood pressure of Canadians. At that time, only 13 per cent of those tested had their hypertension diagnosed and treated.

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About the Author
Public health reporter

André Picard is a health reporter and columnist at The Globe and Mail, where he has been a staff writer since 1987. He is also the author of three bestselling books.André has received much acclaim for his writing. More

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