Half the population of Canada could suffer from hypertension — according to the results of a new study published in the American Journal of Hypertension — and many may not know it. The study also shows that many others with serious hypertension are not addressing it.
Hypertension is a major cause of disease burden worldwide, and is one of the most important modifiable cardiovascular risk factors for coronary artery disease, stroke, heart failure and end-stage renal disease. High blood pressure also increases all-cause mortality.
Determining the prevalence and severity of hypertension in the public is essential because of the "silent" nature of the condition. It is also important for healthcare providers and health organizations to indentify people unaware of the existence of hypertension.
For this study, researchers created a mobile hypertension awareness campaign to determine prevalence and types of hypertension, increase awareness of high blood pressure and to indentify reasons why patients do not adhere to therapy. To do this, they set up mobile clinics at shopping malls, hospitals, workplaces and community centers with the tools and staff to measure blood pressure in the public. Participants were all volunteers.
For this study, researchers defined prehypertension as 121/81 to 139/89 mm Hg, hypertension as ≥140/90 mm Hg. They defined hypertensive urgency as a B/P ≥180/110 mm Hg without signs of organ damage and a hypertensive emergency as a reading of ≥180/110 mm Hg and signs of organ damage.
More than 1,000 people volunteered for blood pressure readings from July 2014 to May 2016. Of the 1,097 participants, half were normotensive or prehypertensive, and the other half had high blood pressure.
Two percent of participants presented with a hypertensive urgency or emergency. The researchers working the clinic asked these participants if they had a prescription for an antihypertensive and presented three possible options:
- No, the participant had never been prescribed an antihypertensive
- Yes, they have antihypertensive medication and take it regularly
- Yes, they have antihypertensive medication but do not take it regularly
Four of the participants with urgency/emergency levels of blood pressure had never received a prescription for an antihypertensive, and another four said they have such a medication and take it regularly. Fourteen of those with seriously high blood pressure said they have a prescription for antihypertensive medication but do not take it regularly.
Most of those with urgent/emergent hypertension said they had no idea their blood pressure was so high. In fact, they reported their health as normal.
Workers recording blood pressures advised those presenting with a hypertensive crisis to go immediately to the nearest emergency department. About one-quarter of those with a hypertensive urgency/emergency dismissed the results and the advice.
The researchers asked hypertensive participants why they stopped taking their antihypertensive medication. Participants said they experienced side effects, forgot to fill the prescription, felt fine without the medication, dismissed the significance of their blood pressure readings, or tried to control hypertension through lifestyle, nutrition and behavior changes.
Public awareness is better in the United States. About 29 percent of adults in the United States suffer from high blood pressure, according to the Centers for Disease Control and Prevention (CDC), and about 54 percent have their hypertension under control.
