Awareness and misconception of hypertension in Canada: results of a national survey

The Canadian Heart Health Surveys were the last Canadian population-based physical measures surveys (conducted between 1988 and 1992) that determined that hypertension in Canada was poorly managed. Hypertension was undetected in almost one-half of all hypertensive Canadians surveyed, and only 13% of those with hypertension were treated and controlled to recommended blood pressure targets. The reasons for poor control are likely multifactorial; however, a lack of public awareness and understanding of hypertension may contribute to the epidemic of uncontrolled hypertension in Canada.

A national telephone survey was conducted comprising 1001 randomly selected men and women older than 40 years of age to determine the level of public awareness, understanding and misconception of hypertension in Canada. The survey was balanced for region, age and sex.

Thirty-four per cent of respondents had been diagnosed with high blood pressure or hypertension by a health care professional, but only 58% of respondents had ever discussed their blood pressure with a physician, and only 44% were able to identify their own blood pressure or differentiate blood pressure levels considered to be above or below recommended targets. Overall, respondents had a poor understanding of the consequences of high blood pressure or hypertension. The majority were unaware of the association between hypertension and heart disease (80%), heart attack (66%), kidney disease (98%), damage to blood vessels (95%) and premature death (74%). Respondents also had limited knowledge of lifestyle issues affecting hypertension, despite 44% indicating that they were overweight and 18% identifying themselves as smokers. Almost two-thirds (63%) thought hypertension had clearly identifiable signs or symptoms, although they believed that hypertension was not a serious medical condition. Most respondents (59%) falsely believed that they would not develop hypertension and 38% thought that they would be able to control hypertension without the aid of a physician if they did have hypertension.

While hypertension-related complications are preventable, lack of public awareness and misconceptions about hypertension and hypertensive complications are common and may, in part, be associated with ongoing inadequate Canadian awareness, treatment and control rates for hypertension. Increasing public awareness of hypertension using public education and health provider strategies should be a high national health priority.