Factors associated with lack of awareness and uncontrolled high blood pressure among Canadian adults with hypertension

Can J Cardiol. 2012 May;28(3):375-82. doi: 10.1016/j.cjca.2011.12.012. Epub 2012 Mar 7.

Abstract

Background: Approximately 17% of Canadians with high blood pressure were unaware of their condition, and of Canadians aware of having the condition, approximately 1 in 5 have uncontrolled high blood pressure despite high rates of pharmacotherapy. The objectives of the current study are to estimate the prevalence of resistant hypertension and examine factors associated with (1) lack of awareness and (2) uncontrolled hypertension despite pharmacotherapy.

Methods: Using the 2007-2009 Canadian Health Measures Survey (N = 3473, aged 20-79 years) and logistic regression, we quantified relationships between characteristics and (1) presence of hypertension, (2) lack of awareness (among those with hypertension), and (3) uncontrolled high blood pressure (among those treated for hypertension).

Results: Older age, lowest income, and less than high school education were associated with presence of hypertension. Men (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.1-2.2) and adults < 60 years (OR, 1.7; 95% CI, 1.1-2.6) were more likely than others to be unaware. Among those aged 60+ years, women were more likely than men to have uncontrolled high blood pressure (OR, 2.4; 95% CI, 1.1-5.2) despite treatment. Elevated systolic blood pressure was the issue in over 90% of women and 80% of men with uncontrolled hypertension. Depending on the definition employed, 4.4% (95% CI, 2.4-6.4) to 7.8% (95% CI, 6.0-9.6) of the population with hypertension had resistant hypertension.

Conclusions: Messaging or interventions encouraging screening may be helpful for all younger Canadian adults and men; programs encouraging blood pressure control may help older women.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Awareness
  • Blood Pressure Determination / methods
  • Canada / epidemiology
  • Confidence Intervals
  • Databases, Factual
  • Female
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice*
  • Health Surveys
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy*
  • Hypertension / epidemiology*
  • Male
  • Middle Aged
  • Needs Assessment
  • Odds Ratio
  • Prevalence
  • Risk Factors
  • Severity of Illness Index
  • Sex Distribution
  • Socioeconomic Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Antihypertensive Agents