University of Calgary

Research identifies Canadians who face greatest health risk from hypertension

UToday HomeMay 28, 2013

University of Calgary professors Hude Quan, left, and Norman Campbell studied the health of 3.5 million Canadians in six provinces to create a benchmark for current and future research. Photo by Lynda SeaUniversity of Calgary professors Hude Quan, left, and Norman Campbell studied the health of 3.5 million Canadians in six provinces to create a benchmark for current and future research. Photo by Lynda SeaA landmark research study that tracked 3.5 million Canadians with high blood pressure for up to 12 years has found that men, the elderly and people living in low-income or rural areas generally have poorer health outcomes than other segments of the population.

Anyone who lives with untreated high blood pressure faces increased risks from heart attack, heart failure and stroke, but now researchers have pinpointed the specific segments of the population at greatest risk of those health outcomes.

“Because the study is so large, and is based on health records from six provinces, it offers an accurate portrait of what is happening to Canadians with hypertension,” says Dr. Hude Quan, the lead author of the paper, and a member of the Libin Cardiovascular Institute of Alberta, which is supported by Alberta Health Services (AHS) and the University of Calgary.

“Until now we haven’t had benchmark information on the overall state of the population, but these findings will enable us to determine in the future whether our prevention and treatment approaches in addressing hypertension are having an impact,” says Quan, who is also a professor and co-chair of the Quality Improvement Committee of the AHS Cardiovascular Health and Stroke Strategic Clinical Network.


High blood pressure or hypertension – sometimes called a silent killer because it has no warning signs or symptoms – is a condition of increased force against the walls of the arteries as blood flows through them. If left untreated, it can seriously impact cardiovascular function, and lead to heart attack, heart failure and stroke.

Risk factors include age, family history, obesity, high salt intake, high fat intake, physical inactivity, smoking, alcohol intake, stress and diabetes.

“Although treatment and control of hypertension in Canada has improved over the last decade, at least one in five Canadians has high blood pressure,” says professor Norman Campbell, one of the study’s co-authors and a member of the Libin Cardiovascular Institute. “Globally, almost one in three has hypertension and it’s the leading cause of disability worldwide.”


The study, published this month by the Canadian Journal of Cardiology, found the mortality rate among hypertensive Canadians from all causes was 22.4 per 1,000 person years, meaning about 22 deaths would be expected among 1,000 hypertensive persons observed for one year.

The study included anonymized data from Alberta, British Columbia, Manitoba, Nova Scotia, Newfoundland and Labrador, and Ontario. Of the 3.5 million people included in the research study, 29.4 per cent were younger than 50, 35.6 per cent were aged 50-64, and 35 per cent were 65 or older. Males made up 48.2 per cent of the sample.

Researchers speculate that health outcomes could be poorer for the elderly due to what are called co-morbidities, or additional diseases or health conditions. Hypertensive men may fare worse than women because of negative lifestyle factors, such as smoking or alcohol consumption, and it’s well established that low-income populations generally have poorer overall health than those in higher socio-economic groups.

Campbell says one of the interesting findings in the paper is the apparent “sad reversal” that’s taken place among the rural population. “A generation ago it was the people who worked on farms who would be the healthiest, but now, with increased mechanization and poorer diets, they’re among the unhealthiest,” he says.


Gurmit Kaur Sarpal, a 63-year-old Calgarian, knows full well the importance of making lifestyle changes to help bring hypertension under control. Diagnosed with high blood pressure 20 years ago, Sarpal says she realized she had to do something to deal with the stress and depression she felt. She enrolled in an eight-week Better Choices, Better Health program offered by AHS, which teaches about the healthy benefits of lifestyle choices like diet, exercise and meditation.  

“I’m still on low doses of medication for high blood pressure, but I now have a much greater sense of well-being,” she says. “I’m eating better and I exercise at least twice a week.”


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