Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: a cross-sectional study

Abstract

ObjectiveComparison of recent national survey data on prevalence, awareness, treatment and control of hypertension in England, the USA and Canada, and correlation of these parameters with each country stroke and ischaemic heart disease (IHD) mortality.DesignNon-institutionalised population surveys.Setting and participantsEngland (2006 n=6873), the USA (2007–2010 n=10 003) and Canada (2007–2009 n=3485) aged 20–79 years.OutcomesStroke and IHD mortality rates were plotted against countries’ specific prevalence data.ResultsMean systolic blood pressure (SBP) was higher in England than in the USA and Canada in all age–gender groups. Mean diastolic blood pressure (DBP) was similar in the three countries before age 50 and then fell more rapidly in the USA, being the lowest in the USA. Only 34% had a BP under 140/90 mm Hg in England, compared with 50% in the USA and 66% in Canada. Prehypertension and stages 1 and 2 hypertension prevalence figures were the highest in England. Hypertension prevalence (≥140 mm Hg SBP and/or ≥90 mm Hg DBP) was lower in Canada (19·5%) than in the USA (29%) and England (30%). Hypertension awareness was higher in the USA (81%) and Canada (83%) than in England (65%). England also had lower levels of hypertension treatment (51%; USA 74%; Canada 80%) and control (<140/90 mm Hg; 27%; the USA 53%; Canada 66%). Canada had the lowest stroke and IHD mortality rates, England the highest and the rates were inversely related to the mean SBP in each country and strongly related to the blood pressure indicators, the strongest relationship being between low hypertension awareness and stroke mortality.ConclusionsWhile the current prevention efforts in England should result in future-improved figures, especially at younger ages, these data still show important gaps in the management of hypertension in these countries, with consequences on stroke and IHD mortality.

Educational Interventions May Promote Better Blood Pressure Control in Russia

“…Of note, 45.9% of the patients from the Ivanovo region achieved the recommended blood pressure targets of less than 140/90 mmHg. These findings were consistent with those from a recent observational study, which collected data from the general practice in Italy in 2012-2013, which reported that about 60% of patients achieved the recommended blood pressure target [9], as well as in other recent report from European countries [10][11][12]. It should be also noted that among various factors potentially involved for the achievement of BP control in this population, medical education (mostly including advices on alcohol consumption, smoking cessation and weight reduction) represents the most relevant one, whereas presence of antihypertensive drug therapies seems to have relatively limited impact on the achievement of blood pressure goals.…”

Medium-term effects of dietary nitrate supplementation on systolic and diastolic blood pressure in adults

“…A correct anti-hypertensive drug therapy combined with dietary and lifestyle modifications 30 attenuate the adverse effects of BP on cardiovascular health; however adequate and sustained 31 control of BP using these combined approaches is only achieved in ~60-70% of hypertensive 32 patients [3]. Therefore, the primary prevention of hypertension becomes a priority to 33 minimise the population burden of hypertension and nutritional and lifestyle approaches are 34 unanimously recognised as fundamental components of primary prevention programmes [4].…”

Association between self-reported health and sociodemographic characteristics with cardiovascular diseases in adults

“…However, it was lower than that found in a study conducted in Florianopolis with adults aged 20 to 50, in which the prevalence reached 40.1% (20) . Internationally, it appears that the prevalence of hypertension in Canada was 19.5%, lower than in the US (29%) and England (30%) (21) . It should be noted that in 2000, the prevalence of hypertension in the world population was 25% and the estimate for 2025 is 29% (22) .…”