Abstract

BackgroundIt is unclear whether certain medical conditions may be associated with blood pressure (BP) treatment and control.MethodsUsing the Canadian Health Measures Survey (2007-2019), BP was assessed according to the presence of selected comorbidities, including prior heart attack or stroke, dyslipidemia, chronic kidney disease, diabetes mellitus, obstructive sleep apnea, and overweight or obesity.ResultsA total of 5,841,453 people, representing 23.0% (95% CI 21.7-24.2%) of Canadian adults, were hypertensive. The adjusted odds of having hypertension treated and controlled was higher in people with a prior heart attack or stroke (aOR 3.15; 95% CI 2.31-4.31), dyslipidemia (aOR 2.51; 95% CI 1.96-3.21), obstructive sleep apnea (aOR 1.95; 95% CI 1.19-3.21), overweight or obesity (aOR 1.51; 95% CI 1.18-1.94), chronic kidney disease (aOR 1.49; 95%CI 1.13-1.95), or diabetes (aOR 1.44; 95% CI 1.12-1.86), compared to when these conditions were absent. Individuals without any of these comorbidities were less likely to have their BP treated and controlled (aOR 0.34; 95% CI 0.25-0.48). Moreover, treatment and control was low among many people without prior heart attack or stroke, even with moderate (aOR 0.25; 95%CI 0.17-0.37) to high Framingham risk (aOR 0.10; 95% CI 0.06-0.16).ConclusionsLarge differences in BP control exist across comorbidity profiles and the greatest gaps are seen in individuals without recognized comorbidities, even those that have moderate to high Framingham risk. Efforts to optimize BP control and narrow care gaps, especially in individuals without recognized comorbidities, are necessary to reduce the burden of cardiovascular disease and premature death in Canada.