The Impact of Cardiovascular Risk-Factor Profiles on Blood Pressure Control Rates in Adults From Canada and the United States
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Background It is unclear whether blood pressure control varies across the spectrum of atherosclerotic risk.Methods We used data from nonpregnant adults who had fasted laboratory samples drawn for the 2007-2009 cycle of the Canadian Health Measures Survey (CHMS) or the 2005-2008 US National Health and Nutrition Examination Survey (NHANES).Results The 1692 CHMS subjects and 3541 NHANES participants were demographically similar (aged a mean of 45 years), although NHANES participants exhibited higher obesity rates (33.8% vs. 22.2%, P < 0.001). Over 80% of CHMS and NHANES subjects with hypertension had at least 1 other cardiovascular risk factor. As the number of atherosclerotic risk factors increased, hypertension prevalence increased, but blood pressure control rates improved (from 48% among hypertensives with no other risk factors in CHMS to 77% among those with 3 or more risk factors, and from 35% to 53% in NHANES). However, the converse was not true: The distribution of Framingham risk scores for those subjects with "controlled hypertension" was nearly identical to the distribution among those adults with uncontrolled hypertension in both CHMS and NHANES and substantially higher than scores in normotensive subjects.Conclusions Although control of blood pressure was better in patients with multiple atherosclerotic risk factors, hypertensives with controlled blood pressures exhibited risk-factor profiles similar to those of participants with uncontrolled blood pressures. This suggests the need, in educational messaging and therapy decision making, for an increased focus on total atherosclerotic risk rather than just blood pressure control.
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In the United States, Canada, and Finland, over 80% of people with hypertension have other cardiovascular risks and/or evidence of blood pressure-related damage (heart disease, stroke, and/or kidney damage).
“In the United States, Canada, and Finland, over 80% of people with hypertension have other cardiovascular risks and/or evidence of blood pressure-related damage (heart disease, stroke, and/or kidney damage).”
From São Paulo call to action for the prevention and control of high blood pressure: 2020 (2019) · cites this paper as [35]
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- Authors
- McAlister, F. A., Robitaille, C., Gillespie, C., Yuan, K., Rao, D. P., Grover, S., Dai, S., Johansen, H., Joffres, M., Loustalot, F., & Campbell, N.
- Affiliations
- University of Alberta (CA)
- Public Health Agency of Canada (CA)
- Centers for Disease Control and Prevention (US)
- McGill University (CA)
- University of Ottawa (CA)
- Simon Fraser University (CA)
- University of Calgary (CA)
- Corresponding author
- McAlister, Finlay A.
- ORCID
- Venue
- Canadian Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2013-05
- Volume
- 29
- Issue
- 5
- Pages
- 598-605
- ISSN
- 0828-282X (ISSN-L)
- PMC
- PMC4494043
- OpenAlex
- W2051696650
- Cited by
- 25
- References
- 35
- Citations by year
- 2022: 1 · 2021: 4 · 2020: 3 · 2019: 2 · 2017: 1 · 2016: 1 · 2015: 4 · 2014: 5 · 2013: 4
- FWCI
- 3.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Canadian Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Public Health Agency of Canada
- National Institutes of Health (CC999999)
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Keywords
- blood pressure control, hypertension, cardiovascular risk factors, atherosclerosis risk, Framingham risk score, multiple risk factors, hypertension prevalence, Canadian Health Measures Survey, NHANES, obesity
- MeSH terms
- Adult, Blood Pressure, Canada, Cardiovascular Diseases, Female, Health Surveys, Humans, Hypertension, Male, Middle Aged, Nutrition Surveys, Obesity, Risk Factors, United States, Prevalence, Atherosclerosis
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