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CMAJ. Jun 1, 1992; 146(11): 1997–2005.
PMCID: PMC1490336

Prevalence, control and awareness of high blood pressure among Canadian adults. Canadian Heart Health Surveys Research Group.


OBJECTIVE: To estimate the prevalence and distribution of elevated blood pressure (BP) among Canadian adults and to determine the level of control, treatment, awareness and prevalence of other risk factors among adults with high BP. DESIGN: Population-based cross-sectional surveys. SETTING: Nine Canadian provinces, from 1986 to 1990. PARTICIPANTS: A probability sample of 26,293 men and women aged 18 to 74 years was selected from the health insurance registers in each province. For 20,582 subjects, BP was measured at least twice. Nurses administered a standard questionnaire and recorded two BP measurements using a standardized technique. Two further BP readings, anthropometric measurements and a blood specimen for lipid analysis were obtained from those subjects who attended a clinic. OUTCOME MEASURES: Mean values of systolic and diastolic BP, prevalence of elevated BP using different criteria, and prevalence of smoking, elevated blood cholesterol, body mass index, physical activity and presence of diabetes by high BP status are reported. MAIN RESULTS: Sixteen percent of men and 13% of women had diastolic BP of 90 mm Hg or greater or were on treatment (or both). About 26% of these subjects were unaware of their hypertension, 42% were being treated and their condition controlled, 16% were treated and not controlled, and 16% were neither treated nor controlled. Use of non-pharmacologic treatment of high BP with or without medication was low (22%). Hypertensive subjects showed a higher prevalence of elevated total cholesterol, high body mass index, diabetes and sedentary lifestyle than normotensive subjects. Most people with elevated BP were in the 90 to 95 mm Hg range for diastolic pressure and 140 to 160 mm Hg range for systolic pressure. Prevalence of high isolated systolic BP sharply increased in men (40%) and women (49%) 65 to 74 years old. CONCLUSIONS: The relatively low level of control of elevated BP calls for population and individual strategies, stressing a non-pharmacologic approach and addressing isolated systolic hypertension in the elderly.

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  • Yano K, McGee D, Reed DM. The impact of elevated blood pressure upon 10-year mortality among Japanese men in Hawaii: the Honolulu Heart Program. J Chronic Dis. 1983;36(8):569–579. [PubMed]
  • Levy D, Wilson PW, Anderson KM, Castelli WP. Stratifying the patient at risk from coronary disease: new insights from the Framingham Heart Study. Am Heart J. 1990 Mar;119(3 Pt 2):712–717. [PubMed]
  • Wolf PA, D'Agostino RB, Belanger AJ, Kannel WB. Probability of stroke: a risk profile from the Framingham Study. Stroke. 1991 Mar;22(3):312–318. [PubMed]
  • Stamler J, Wentworth D, Neaton JD. Prevalence and prognostic significance of hypercholesterolemia in men with hypertension. Prospective data on the primary screenees of the Multiple Risk Factor Intervention Trial. Am J Med. 1986 Feb 14;80(2A):33–39. [PubMed]
  • Stemmermann GN, Hayashi T, Resch JA, Chung CS, Reed DM, Rhoads GG. Risk factors related to ischemic and hemorrhagic cerebrovascular disease at autopsy: the Honolulu Heart Study. Stroke. 1984 Jan-Feb;15(1):23–28. [PubMed]
  • Luepker RV, Jacobs DR, Jr, Folsom AR, Gillum RF, Frantz ID, Jr, Gomez O, Blackburn H. Cardiovascular risk factor change--1973-74 to 1980-82: the Minnesota Heart Survey. J Clin Epidemiol. 1988;41(9):825–833. [PubMed]
  • Sprafka JM, Burke GL, Folsom AR, Luepker RV, Blackburn H. Continued decline in cardiovascular disease risk factors: results of the Minnesota Heart Survey, 1980-1982 and 1985-1987. Am J Epidemiol. 1990 Sep;132(3):489–500. [PubMed]
  • Dagenais GR, Robitaille NM, Lupien PJ, Christen A, Gingras S, Moorjani S, Meyer F, Rochon J. First coronary heart disease event rates in relation to major risk factors: Quebec cardiovascular study. Can J Cardiol. 1990 Sep;6(7):274–280. [PubMed]
  • Johansen H, Semenciw R, Morrison H, Mao Y, Verdier P, Smith ME, Wigle DT. Important risk factors for death in adults: a 10-year follow-up of the Nutrition Canada survey cohort. CMAJ. 1987 Apr 15;136(8):823–828. [PMC free article] [PubMed]
  • Rabkin SW, Mathewson AL, Tate RB. Predicting risk of ischemic heart disease and cerebrovascular disease from systolic and diastolic blood pressures. Ann Intern Med. 1978 Mar;88(3):342–345. [PubMed]
  • Kannel WB, Gordon T, Schwartz MJ. Systolic versus diastolic blood pressure and risk of coronary heart disease. The Framingham study. Am J Cardiol. 1971 Apr;27(4):335–346. [PubMed]
  • Lichtenstein MJ, Shipley MJ, Rose G. Systolic and diastolic blood pressures as predictors of coronary heart disease mortality in the Whitehall study. Br Med J (Clin Res Ed) 1985 Jul 27;291(6490):243–245. [PMC free article] [PubMed]
  • Shaper AG, Pocock SJ, Walker M, Phillips AN, Whitehead TP, Macfarlane PW. Risk factors for ischaemic heart disease: the prospective phase of the British Regional Heart Study. J Epidemiol Community Health. 1985 Sep;39(3):197–209. [PMC free article] [PubMed]
  • van der Giezen AM, Schopman-Geurts van Kessel JG, Schouten EG, Slotboom BJ, Kok FJ, Collette HJ. Systolic blood pressure and cardiovascular mortality among 13,740 Dutch women. Prev Med. 1990 Jul;19(4):456–465. [PubMed]
  • Harmsen P, Rosengren A, Tsipogianni A, Wilhelmsen L. Risk factors for stroke in middle-aged men in Göteborg, Sweden. Stroke. 1990 Feb;21(2):223–229. [PubMed]
  • MacLean CJ, Reed DM. Predictors of atherosclerosis in the Honolulu Heart Program. II. Adjustment for autopsy bias. Am J Epidemiol. 1987 Aug;126(2):226–236. [PubMed]
  • Reed D, Yano K. Predictors of arteriographically defined coronary stenosis in the Honolulu Heart Program. Comparisons of cohort and arteriography series analyses. Am J Epidemiol. 1991 Jul 15;134(2):111–122. [PubMed]
  • Cornoni-Huntley J, LaCroix AZ, Havlik RJ. Race and sex differentials in the impact of hypertension in the United States. The National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Arch Intern Med. 1989 Apr;149(4):780–788. [PubMed]
  • Havlik RJ, LaCroix AZ, Kleinman JC, Ingram DD, Harris T, Cornoni-Huntley J. Antihypertensive drug therapy and survival by treatment status in a national survey. Hypertension. 1989 May;13(5 Suppl):I28–I32. [PubMed]
  • Sytkowski PA, Kannel WB, D'Agostino RB. Changes in risk factors and the decline in mortality from cardiovascular disease. The Framingham Heart Study. N Engl J Med. 1990 Jun 7;322(23):1635–1641. [PubMed]
  • MacMahon S. Antihypertensive drug treatment: the potential, expected and observed effects on vascular disease. J Hypertens Suppl. 1990 Dec;8(7):S239–S244. [PubMed]
  • MacMahon S, Peto R, Cutler J, Collins R, Sorlie P, Neaton J, Abbott R, Godwin J, Dyer A, Stamler J. Blood pressure, stroke, and coronary heart disease. Part 1, Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet. 1990 Mar 31;335(8692):765–774. [PubMed]
  • Joffres MR, Reed DM, Yano K. Relationship of magnesium intake and other dietary factors to blood pressure: the Honolulu heart study. Am J Clin Nutr. 1987 Feb;45(2):469–475. [PubMed]
  • Moulopoulos SD, Adamopoulos PN, Diamantopoulos EI, Nanas SN, Anthopoulos LN, Iliadi-Alexandrou M. Coronary heart disease risk factors in a random sample of Athenian adults. The Athens Study. Am J Epidemiol. 1987 Nov;126(5):882–892. [PubMed]
  • Sprafka JM, Folsom AR, Burke GL, Edlavitch SA. Prevalence of cardiovascular disease risk factors in blacks and whites: the Minnesota Heart Survey. Am J Public Health. 1988 Dec;78(12):1546–1549. [PMC free article] [PubMed]
  • Hebert PR, Fiebach NH, Eberlein KA, Taylor JO, Hennekens CH. The community-based randomized trials of pharmacologic treatment of mild-to-moderate hypertension. Am J Epidemiol. 1988 Mar;127(3):581–590. [PubMed]
  • Holme I, Helgeland A, Hjermann I, Leren P, Mogensen SB. Correlates of blood pressure change in middle-aged male mild hypertensives: results from the untreated control group in the Oslo hypertension trial. The Oslo Study. Am J Epidemiol. 1988 Apr;127(4):742–752. [PubMed]
  • Struyvenberg A. Hypertensie-consensus in Nederland. Ned Tijdschr Geneeskd. 1990 Oct 27;134(43):2086–2093. [PubMed]
  • Black HR, Unger D, Burlando A, Wright JC, Pressel SL, Allen R, McDonald RH, Surath H. Systolic Hypertension in the Elderly Program (SHEP). Part 6: Baseline physical examination findings. Hypertension. 1991 Mar;17(3 Suppl):II77–I101. [PubMed]
  • Labarthe DR, Blaufox MD, Smith WM, Lacy CR, Schnaper H, LaBaw F, Mascioli S, Davey J, Lakatos E. Systolic Hypertension in the Elderly Program (SHEP). Part 5: Baseline blood pressure and pulse rate measurements. Hypertension. 1991 Mar;17(3 Suppl):II62–II76. [PubMed]
  • Larochelle P, Bass MJ, Birkett NJ, De Champlain J, Myers MG. Recommendations from the Consensus Conference on Hypertension in the Elderly. CMAJ. 1986 Oct 1;135(7):741–745. [PMC free article] [PubMed]
  • Langer RD, Ganiats TG, Barrett-Connor E. Factors associated with paradoxical survival at higher blood pressures in the very old. Am J Epidemiol. 1991 Jul 1;134(1):29–38. [PubMed]
  • Taylor JO, Cornoni-Huntley J, Curb JD, Manton KG, Ostfeld AM, Scherr P, Wallace RB. Blood pressure and mortality risk in the elderly. Am J Epidemiol. 1991 Sep 1;134(5):489–501. [PubMed]
  • Myers MG, Carruthers SG, Leenen FH, Haynes RB. Recommendations from the Canadian Hypertension Society Consensus Conference on the Pharmacologic Treatment of Hypertension. CMAJ. 1989 May 15;140(10):1141–1146. [PMC free article] [PubMed]
  • Anderson KM, Odell PM, Wilson PW, Kannel WB. Cardiovascular disease risk profiles. Am Heart J. 1991 Jan;121(1 Pt 2):293–298. [PubMed]
  • Laurenzi M, Mancini M, Menotti A, Stamler J, Stamler R, Trevisan M, Zanchetti A. Multiple risk factors in hypertension: results from the Gubbio study. J Hypertens Suppl. 1990 Mar;8(1):S7–12. [PubMed]
  • Wolf PA, D'Agostino RB, Belanger AJ, Kannel WB. Probability of stroke: a risk profile from the Framingham Study. Stroke. 1991 Mar;22(3):312–318. [PubMed]
  • Kannel WB, Zhang T, Garrison RJ. Is obesity-related hypertension less of a cardiovascular risk? The Framingham Study. Am Heart J. 1990 Nov;120(5):1195–1201. [PubMed]
  • Phillips A, Shaper AG. Relative weight and major ischaemic heart disease events in hypertensive men. Lancet. 1989 May 6;1(8645):1005–1008. [PubMed]
  • Assmann G, Schulte H. Diabetes mellitus and hypertension in the elderly: concomitant hyperlipidemia and coronary heart disease risk. Am J Cardiol. 1989 May 2;63(16):33H–37H. [PubMed]
  • Ford ES, DeStefano F. Risk factors for mortality from all causes and from coronary heart disease among persons with diabetes. Findings from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Am J Epidemiol. 1991 Jun 15;133(12):1220–1230. [PubMed]
  • Hamet P, Kalant N, Ross SA, Wilson TW, Leenen FH, Haynes RB. Recommendations from the Canadian Hypertension Society Consensus Conference on Hypertension and Diabetes. CMAJ. 1988 Dec 1;139(11):1059–1062. [PMC free article] [PubMed]

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