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Canadian Health Measures Survey: Blood pressure in adults
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Data from the Canadian Health Measure Survey (CHMS) indicate that nearly one-fifth (19%) of Canadians aged 20 to 79, roughly 4.6 million people, had hypertension. Another 20% had readings in the pre-hypertension range, and 61% had normal blood pressure.
These findings are based on data from direct, automated measures of blood pressure and self-reported use of blood pressure medication in cycle 1 of the CHMS, conducted from March 2007 through February 2009.
The CHMS, carried out in partnership with Health Canada and the Public Health Agency of Canada, is the most comprehensive survey involving direct physical measures ever carried out in Canada. The CHMS included a vast array of direct measures designed to assess fitness and activity levels, nutritional status, exposure to environmental contaminants, infectious disease status, oral health, lung capacity, heart rate, and blood pressure.
The CHMS provides data from which estimates of hypertension prevalence, awareness and control have been derived. The last such data from direct measures of blood pressure were based on surveys conducted in each province over the period 1985 to 1992.
About 80% of the 4.6 million adults with hypertension were being treated with antihypertensive drugs. In two-thirds (66%) of those with hypertension, medication was effective in controlling their blood pressure.
Among the remaining one-third (1.6 million) of adults with hypertension (who accounted for 6.6% of the adult population), the condition was uncontrolled, meaning that their blood pressure remained in the hypertensive range. Of those with uncontrolled hypertension, 4 in 10 were being treated with antihypertensive medication but their blood pressure remained elevated; 1 in 10 knew they had hypertension, but were not being treated with medication; and about half (762,000 people) were unaware of their condition.
Prevalence nearly the same in men and women
The prevalence of hypertension was nearly the same in both sexes: 19.7% in men and 19.0% in women. However, men were less likely than women to be aware of their condition.
The prevalence of high blood pressure increased sharply with age. At ages 20 to 39, about 2% of adults had hypertension. By ages 40 to 59, the percentage was 18%. And at ages 60 to 79, more than half (53%) had measured blood pressure in the hypertensive range, or were taking medication for it.
The percentages of adults with hypertension in whom the condition was controlled by medication were similar in both sexes: 67% in men and 65% in women. This was the case even though a lower percentage of men with hypertension were being treated with antihypertensive medication (76%) than were women (83%).
Among women with hypertension who were taking antihypertensive medication, 18% had blood pressure that remained out of control, compared with 10% among their male counterparts.
This gap in blood pressure control between the sexes occurred only at older ages. For example, among 60- to 69-year-olds who were using antihypertensive medication, the percentage not controlled was 19% for women, compared with 7% for men.
Note to readers
This article is based on data from cycle 1 of the Canadian Health Measures Survey (CHMS). The CHMS was conducted from March 2007 through February 2009 at 15 sites across the country. The survey used a mobile examination centre (a specially designed pair of trailers staffed by trained health professionals) to collect physical measures from a sample of about 5,600 Canadians aged 6 to 79 years.
In cycle 1 of the CHMS, blood pressure was directly measured for all respondents, 3,514 of whom were aged 20 to 79. The data were weighted to be representative of the 23.7 million adults in this age range.
Persons whose systolic blood pressure was 140 millimetres of mercury (mm Hg) or higher, or diastolic pressure was 90 mm Hg or higher, or who reported they had used medication for high blood pressure in the past month were classified as having hypertension.
Previous research has identified hypertension as a risk factor for cardiac, cerebrovascular and other vascular diseases. It is also a major cause of disability and death.
This study provides benchmark estimates of blood pressure levels in the adult population, and estimates of the prevalence of hypertension by sex and age group. Estimates of hypertension awareness, treatment and control are also reported.
One-fifth of adults in pre-hypertension range
A substantial percentage of adults had measured blood pressure that placed them in the pre-hypertensive range, defined according to internationally recognized standards as systolic blood pressure of 120 to 139 mm Hg, or diastolic blood pressure of 80 to 89 mm Hg. Pre-hypertension is associated with an increased risk of cardiovascular disease and is strongly predictive of hypertension.
About 20% people aged 20 to 79 had blood pressure in the pre-hypertension range. Pre-hypertension was more prevalent among men (25%) than among women (15%).
Three more waves of data from the CHMS will be released in 2010. Laboratory data reflecting cardiovascular health, chronic and infectious disease markers and nutrition will be released in the spring. They will be followed in the summer by data on environmental exposure measures, and in the fall, data on directly measured physical activity.
Definitions, data sources and methods: survey number 5071.
The article, "Blood pressure in Canadian adults," which is part of today's Health Reports online release, is now available (82-003-X, free). From the Key resource module of our website, choose Publications. For more information about this article, contact Kathryn Wilkins (613-951-1769: kathryn.wilkins@statcan.gc.ca), Health Analysis Division.
Today's online release also includes "Resting blood pressure and heart rate measurement in the Canadian Health Measures Survey, cycle 1." This article provides an overview of the blood pressure and heart rate collection method used for cycle 1 of the Canadian Health Measures Survey and information about methodological and analytical issues faced during the collection and analysis of these data. For more information, contact Jeanine Bustros (613-951-9476; jeanine.bustros@statcan.gc.ca), Physical Health Measures Division.
For more information about Health Reports, contact Christine Wright (613-951-1765; christine.wright@statcan.gc.ca), Health Analysis Division.
