Issue 106 Item 3 75% of Americans with High Blood Pressure are Not in Control!

Canada may be faring slightly worse than America in controlling the high blood pressure of its population, but both countries need improvement, according to researchers who compared data from the two countries. Dr. Michel R. Joffres of Dalhousie University in Halifax, Nova Scotia said "Given the quality and ease of access to our healthcare system, I did not expect Canada to be worse than the US in all the areas of hypertension: awareness, treatment level and overall control

Dr. Joffres’ team compared two studies, one Canadian and one from the US, both of which collected blood pressure information from several thousand people between the ages of 18 and 74 years old. Individuals with blood pressure of 140/90 mm Hg or higher and those on anti-hypertensive medication were considered to have hypertension.

According to the two studies, about one in five Canadians and Americans had hypertension. But compared with Americans, fewer Canadians had an optimal blood pressure, defined as less than 120/80 mm Hg. In addition, only 13% of Canadians with hypertension had the problem under control, compared with 25% of Americans.

The investigators also found that about half of diabetic study participants had hypertension. Only 9% of these patients in Canada had their blood pressured controlled compared with 36% in the US.

Dr. Joffres and colleagues point out that systolic blood pressure is especially important and can be a predictor of stroke, heart attack and death.

"We have almost neglected this important measure in the past…and have focused mainly on the diastolic blood pressure for defining hypertension and the level of control," Dr. Joffres said. "We still need to get this important message about systolic blood pressure control across to physicians and the public."

According to the researchers, the systolic but not the diastolic reading was high in 8% to 9% of individuals in both studies. The percentage of young Canadians with a high systolic reading was larger than that for young Americans.

Dr. Joffres noted that while the studies are a few years old, "unfortunately, we now have evidence that we have not improved in the last years, neither in Canada nor the US." Am J Hypertens 2001;14:1099-1105