Antihypertensive medication use by recently diagnosed hypertensive Canadians

The Canadian Hypertension Education Program (CHEP) was initiated in 1999 to improve hypertension management in Canada. The objective of the present study was to compare antihypertensive pharmacotherapy in Canada before and after the CHEP.

Data were obtained from the longitudinal National Population Health Surveys, which consisted of five cycles at two-year intervals from 1994 to 2002. Recent hypertensive respondents 20 years of age and older were identified the first time hypertension was reported or treated, and were included in a study population of 1453 newly diagnosed hypertensive patients. Persistence with medication use was assessed in the cycle after the first report of hypertension.

Antihypertensive medication use within two years of hypertension diagnosis increased with age, from 35% in patients 20 to 39 years of age, to 72.1% in those 80 years of age and older. Antihypertensive medication use increased after the CHEP (from 49.2% to 53.8% of the population), as did the use of multiple antihypertensive medications (from 7.5% to 10.6%). The most commonly used antihypertensive medication for men was angiotensin-converting enzyme inhibitors (beta-blockers were second), but the most common medication for women was diuretics. The overall persistence rate for antihypertensive medication use was 73.2% over two years, which had increased after the CHEP (from 70.4% to 75.4%).

The implementation of the CHEP was followed by increased antihypertensive medication use, increased use of multiple antihypertensive medications and improved persistence with medication use. Although causality cannot be established with the design of the present study, improved hypertension management in Canada is heartening. Sex-related differences were observed in prescribed medications, even though clinical guidelines do not differentiate between sexes.