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The management of hypertension has improved markedly in Ontario, Canada, although its prevalence is still high among older people. This is the finding of a community-based, cross-sectional study by Leenen and colleagues that used direct observation. In 2006, 21% of 2551 adult Ontario residents participating in the study had hypertension, defined as systolic blood pressure of 140 mm Hg or more, diastolic pressure of 90 mm Hg or more, or treatment with an antihypertensive medication. Of these individuals, 66% had their blood pressure treated and controlled. In comparison, between 1986 and 1992, 22% of adult Canadians had hypertension, but only 16% of them had their blood pressure treated and controlled.
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More news about hypertension
The prevalence of hypertension in adults in Ontario has increased from 153 per 1000 in 1995 to 245 per 1000 in 2005, a relative increase of 60%, as found by Tu and colleagues, who studied a population-based cohort using linked administrative and billing data. This increase is higher than that projected from global estimates published in 2000.
In another study, Tu and colleagues report that mortality among adults with hypertension decreased by 15.5% between 1995 and 2005. They speculate that this is partly because of improved detection and control of blood pressure. This decrease in mortality is one reason for the observed increase in the prevalence of hypertension in this population.
Stun guns and the heart
Stun guns deliver a short electrical pulse of high-voltage current to incapacitate the target. But do they stimulate the heart? Nanthakumar and colleagues review the literature and find some evidence that suggests they may.
In our lead editorial, Stanbrook wryly observes that users of tasers have medicalized their use.
Student elective in Africa
Altruistic humanitarians, adventurers, earnest apprentices, full-fledged doctors, profligate gadflies or just a curiosity — this is how you may be perceived in Africa. That is if you are a medical student on an elective. Einterz offers advice to students.
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How to manage stroke
New recommendations for managing stroke come from the Canadian Stroke Strategy. This review hopes to address the large variations in the way stroke is managed in Canada. The authors make 24 recommendations about increasing public awareness and responsiveness, educating patients and family, preventing stroke, managing acute stroke and rehabilitating patients.
See page 1418
Practice
In What is your call? Fanella and Aoki present the case of a 10-year-old boy with dermatomyositis who fell off a trampoline and fractured two small bones in his ankle. A day later he developed pain, redness and swelling of 3 joints along with nausea, vomiting and malaise (page 1427).
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Copyright 1995-2008, Canadian Medical Association. All rights reserved. ISSN 1488-2329
(e) 0820-3946 (p)
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association. |
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