Abstract

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Background
Keywords
Findings
Authors
What is already known on this subject?
What does this study add?

Background

In Canada, as elsewhere, control of hypertension in older persons who are using antihypertensive medication is more likely in men than in women. The reasons for the observed difference are not known.

Data and Methods

Data are from cycle 1 of the 2007 to 2009 Canadian Health Measures Survey (CHMS). The CHMS includes a comprehensive questionnaire, automated blood pressure (BP) measures, and a variety of biological and anthropometric assessments. Frequencies, means, cross-tabulations and multivariate models were produced to study differences between the sexes in hypertension control in a weighted sample representative of the household population aged 60 to 79.

Results

The prevalence of hypertension was nearly equal among older men (60%) and women (59%), and the percentage of those with hypertension who were receiving pharmaceutical treatment was not statistically different (84% and 89%, respectively). However, despite current treatment, hypertension was uncontrolled in a substantially higher percentage of women (30%) than men (17%). The difference persisted when age, socio-economic status, co-morbidity, category of medication, anthropometry, and other correlates of hypertension were taken into account.

Interpretation

The factors considered in the analysis do not account for the advantage to older men in hypertension control. The findings underscore the importance of efforts to control blood pressure in older women.

Keywords

Antihypertensive agents, high blood pressure, population surveillance, prevalence, sex factors

Findings

Hypertension is a major health risk factor, and its control is an important clinical concern. In Canada, among people younger than 60 who are using medication for hypertension, control is nearly equal between the sexes, at well over 90%. At older ages, however, control is more likely in men than in women — consistent with observations elsewhere. [Full Text]

Authors

Kathryn Wilkins was formerly with the Health Analysis Division at Statistics Canada, Ottawa, Ontario, K1A 0T6. Marianne Gee is with the Public Health Agency of Canada, Ottawa, Ontario. Norm Campbell is with the University of Calgary, Calgary, Alberta.

What is already known on this subject?

Hypertension is a major risk factor for heart and vascular disease and is an important cause of death around the world.
Hypertension is more common at older ages, and affects 6 in 10 people aged 60 to 79.
In a number of countries, including Canada, hypertension control is more successful in older men than in older women.

What does this study add?

Among people aged 60 to 79 who were using antihypertensive medication, the condition was controlled in a significantly higher percentage of men (83%) than women (70%).
In people with hypertension aged 60 to 79, antihypertensive use was similar in men (84%) and women (89%).
The number of medications used did not differ by sex, although women were more likely than men to be using thiazide diuretics (33% versus 19%).
Even when age, co-morbidity, type of medication used, body mass index and socio-demographic characteristics were taken into account, women aged 60 to 79 using antihypertensive medication had higher measured systolic blood pressure and pulse pressure than did men.