Health leaders are advocating for the restoration of Canada’s hypertension control program

An impassioned call for the re-establishment of the Canadian health coalition focused on hypertension prevention and control appears as an editorial in Canadian Journal of Cardiology, published by Elsevier. “We need a national hypertension control program to prevent death and disability,” according to prominent health care leaders.

Lead editorial author Norm RK Campbell, MD, Department of Medicine, University of Calgary, explains, “Hypertension is a leading cause of death and disability in Canada; globally causes aone in five deaths (19.2%). However, it is possible to reduce this significantly. Throughout my career in health care, I have worked to control hypertension in our population. What was achieved in Canada was highly unique; Canada was the most successful country in controlling hypertension by a large margin and one of the best in prevention.”

The editorial describes the essential role that Canadian coalitions have in the prevention and control of hypertension. In Canada, health care delivery is a provincial and territorial responsibility, while the federal government sets and administers national standards for the health care system through the Canada Health Act, as well as many nutrition policies. Given the burden of disease associated with high blood pressure, the Canadian federal and provincial governments published a hypertension strategy in 1986, calling for a coalition of government and non-government organizations to oversee the implementation of the strategy.

Professor Campbell says, “In recent years, I have seen the Canadian hypertension control coalition and program fall apart while other countries build much better national hypertension control programs. As a result, hypertension control in Canada has declined over the past decade. Prevention and control of hypertension on a population scale are proven methods to prevent death and disability, as well as to reduce health care costs. We need to restore our national program to save lives.”

Ross Tsuyuki, PharmD, President, Hypertension Canada, agrees with Professor Campbell’s assessment and says, “Hypertension Canada is deeply concerned about the deterioration of blood pressure control that is leading to increased mortality and disability in Canadians. Canada has become complacent. Hypertension Canada is committed to helping rebuild a coalition to bring stakeholders, such as health care providers and governments, to the table to solve this problem.”

Patrice Lindsey, RN, PhD, Lead, PWLE and Stroke Engagement Strategy at the Heart and Stroke Foundation of Canada, adds, “Heart & Stroke recognizes high blood pressure as a leading risk factor for stroke and a major risk factor for heart disease. We strongly support initiatives that will lead to measurable increases in the diagnosis, treatment and control of high blood pressure and lead to reductions in death and hospitalization due to cardiovascular disease. These measures will improve outcomes and quality of life for people affected by high blood pressure.

Prevention of high blood pressure can happen at different levels.

• Through various public health interventions, such as promoting healthy diets, regular physical activity, reducing alcohol consumption and maintaining a healthy body weight and composition.
• Through clinical interventions such as healthy lifestyle advice and drug treatment.

Professor Campbell: “A healthy lifestyle is difficult for people to implement in our unhealthy environment; they take time and a lot of support. Drug treatment is very effective and fast and can save money or be cost effective. Unfortunately, our clinical interventions are in decline.”

The global model for preventing non-communicable diseases (NCDs) – which account for about 90% of deaths and 85% of disability in Canada – and strengthening primary care is the World Health Organization’s (WHO) HEARTS initiative. HEARTS uses hypertension control as an ‘entry point’ for CVD prevention and control in primary care.

Professor Campbell: “Although many public health professionals focus clinical interventions on infections such as Covid-19, influenza and the RS virus, the real issue affecting death and disability in Canada is the prevention and control of non-communicable diseases. HEARTS is an established global model that Canada can use to rebuild primary care to reduce mortality and prevent noncommunicable diseases.”

Professor Campbell concludes, “Winston Churchill said, ‘Never let a good crisis go to waste.’ In Canada, we have an opportunity to build a much stronger collaborative federal health system focused on global best practices to prevent and control our leading causes of death and disability, improve quality of life and save health care costs. It doesn’t require a lot of innovation or intelligence, but it does require a strong ability to collaborate with the current global best practice that is WHO HEARTS.”