Abstract
The last Canadian survey that accurately assessed hypertension treatment and control is over 12 years old. The survey indicated that only 13% of adults with hypertension were treated and controlled. Statistics Canada has announced a new survey that will measure health risks in 2007–2008. A committee of hypertension and survey experts was formed to provide recommendations to ensure the survey would address the minimum surveillance needs of the hypertension community. The committee made several innovative recommendations to improve the reproducibility and standardization of blood pressure assessment. In particular, it was recommended to adopt oscillometric measurement and to have measurements conducted in the absence of study personnel. Continued use of standard Canadian survey questions to assess awareness and treatment of hypertension was recommended to allow comparison with prior surveys. It was also recommended that Canada adopt a specific question on lifestyle changes. The new survey will allow the Canadian hypertension community, and in particular the Canadian Hypertension Education Program, to evaluate the effectiveness of current programs for prevention, treatment and control of hypertension and to revise our strategies based on the results.
MeSH terms: Hypertension, blood pressure, population surveillance, public health, surveys, blood pressure determination, sphygmomanometers
Résmé
La dernière enquête à avoir évalué de façon précise le traitement et le contrôle de l’hypertension au Canada date de 12 ans. Cette enquête a révélé que seulement 13 % des adultes hypertendus étaient à la fois traités et contrôlés. Statistique Canada a annoncé une nouvelle enquête mesurant les facteurs de risques pour la santé en 2007–2008. On a constitué un comité de spécialistes de l’hypertension et des enquêtes de santé, que l’on a chargé de formuler des recommandations pour que l’enquête comporte un minimum de données critiques de surveillance pour la communauté médicale qui s’intéresse à l’hypertension. Le comité a fait plusieurs recommandations novatrices en vue d’améliorer la reproductibilité et la standardisation de la prise de pression artérielle. L’une de ces recommandations est d’adopter les mesures oscillométriques de la pression artérielle et de prendre ces mesures en l’absence des chercheurs associés à l’étude. L’utilisation de questions types tirées d’enquêtes précédentes est recommandée afin de permettre la comparaison avec les données antérieures. Il est également recommandé que le Canada adopte des questions spécifiques sur le changement des modes de vie. La nouvelle enquête permettra à la communauté intéressée par l’hypertension, tout particulièrement au Programme canadien d’éducation sur l’hypertension, d’évaluer l’efficacité des programmes actuels de prévention, de traitement et de contrôle de l’hypertension, et de revoir nos stratégies à la lumière des résultats.
Footnotes
For an Expert Committee of the Canadian Hypertension Society, the Canadian Coalition for High Blood Pressure Prevention and Control and the Heart and Stroke Foundation of Canada
References
- 1.World Health Organization. The World Health Report 2002. Geneva, Switzerland: World Health Organization; 2002. [Google Scholar]
- 2.Joffres MR, Hamet P, MacLean DR, Gilbert JL, Fodor JG. Distribution of blood pressure and hypertension in Canada and the United States. AJH. 2001;14:1099–105. doi: 10.1016/s0895-7061(01)02211-7. [DOI] [PubMed] [Google Scholar]
- 3.Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment and control of hypertension in the United States, 1988–2000. JAMA. 2003;290:199–206. doi: 10.1001/jama.290.2.199. [DOI] [PubMed] [Google Scholar]
- 4.Zarnke KB, Campbell NRC, McAlister FA, Levine M f t C. Hypertension Recommendations Working Group. A novel process for updating recommendations for managing hypertension: Rationale and methods. Can J Cardiol. 2000;16:1094–102. [PubMed] [Google Scholar]
- 5.Campbell NRC, Nagpal S, Drouin D. Implementing hypertension recommendations. Can J Cardiol. 2001;17:851–53. [PubMed] [Google Scholar]
- 6.A Report of an Expert Committee . Minimum Standards for Assessing Blood Pressure in Surveys. 2004. [Google Scholar]
- 7.Joffres MR, Ghadirian P, Fodor JG, Petrasovits A, Chockalingam A, Hamet P. Awareness, treatment, and control of hypertension in Canada. Am J Hypertens. 1997;10:1097–102. doi: 10.1016/S0895-7061(97)00224-0. [DOI] [PubMed] [Google Scholar]
- 8.Campbell NRC, McKay DW. Accurate blood pressure measurement. Why does it matter? CMAJ. 1999;161:277–78. [PMC free article] [PubMed] [Google Scholar]
- 9.Birkett NJ, Donner AP, Maynard MD. Assessing hypertension control in the community: The need for follow-up measurements to ensure clinical relevance. CMAJ. 1987;136:595–600. [PMC free article] [PubMed] [Google Scholar]
- 10.O’Brien E, Petrie J, Little WA, de Swiet M, Padfield PL, Altman D, et al. The British Hypertension Society Protocol for the evaluation of blood pressure measuring devices. J Hypertens. 1993;11:S43–S63. doi: 10.1097/00004872-199306000-00013. [DOI] [PubMed] [Google Scholar]
- 11.O’Brien E, Pickering T, Asmar R, Myers M, Parati G, Staessen J, et al. on behalf of the Working Group on Blood Pressure Monitoring of the European Society of Hypertension. International protocol for validation of blood pressure measuring devices in adults. Blood Press Monit. 2002;7:3–17. doi: 10.1097/00126097-200202000-00002. [DOI] [PubMed] [Google Scholar]
- 12.American National Standard for Electronic or Automated Sphygmomanometers . ANSI/AAMI SP10-2002. Arlington, VA: Association for the Advancement of Medical Instrumentation; 2003. [Google Scholar]
- 13.Hemmelgard B, Zarnke K, Campbell NRC, Feldman R, McKay DW, McAlister F, et al. for the Canadian Hypertension Education Program. The 2004 Canadian recommendations for the management of hypertension. Part I - Blood pressure measurement, diagnosis and assessment of risk. Can J Cardiol. 2004;20(1):31–40. [PubMed] [Google Scholar]
- 14.Wolf-Maier K, Cooper RS, Banegas JR, Giampaoli S, Hense HW, Joffres M, et al. Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA. 2003;289:2363–69. doi: 10.1001/jama.289.18.2363. [DOI] [PubMed] [Google Scholar]
- 15.Wolf-Maier K, Cooper RS, Kramer H, Banegas JR, Giampaoli S, Joffres MR, et al. Hypertension treatment and control in five european countries, Canada, and the United States. Hypertension. 2004;43:1–8. doi: 10.1161/01.HYP.0000103630.72812.10. [DOI] [PubMed] [Google Scholar]
- 16.Pan A H I. Working meeting on blood pressure measurement: suggestions for measuring blood pressure to use in population surveys. Pan Am J Public Health. 2003;14:300–2. doi: 10.1590/S1020-49892003001000003. [DOI] [PubMed] [Google Scholar]