Antihypertensive medication use and blood pressure control: a community-based cross-sectional survey (ON-BP).
BACKGROUND
The Ontario Blood Pressure (ON-BP) survey reported high treatment and control rates for hypertension in the province of Ontario, Canada, in a survey performed in 2006. This study examined patterns of utilization of antihypertensive drug classes and their impact on blood pressure (BP) control.


METHODS
Cross-sectional, population-based survey of adults, 20-79 years of age (population 7,996,653). Responses are weighted to the Ontario hypertensive population of 1,498,045.


RESULTS
Of all hypertensives, 51 and 49% were on monotherapy vs. 2+ drug therapy with similar control rates (86 vs. 80%, respectively). In those on monotherapy a renin-angiotensin system (RAS) blocker was the most commonly used drug class (62%) and use of other drug classes was only approximately 10%. In those on 2+ therapy, a RAS blocker was also the most common class (80%), followed by a diuretic (67%). In diabetics with hypertension 46 and 54% were on monotherapy vs. 2+ drug therapy with significantly higher control rates on monotherapy (90 vs. 46%). RAS blocker was also the most common drug class (85 and 80%, respectively), but in those on 2+ drugs only 45% were on a diuretic. Control rates did not differ by type of drug treatment in the overall hypertensive population and those with a comorbidity, but were low in diabetics on 2+ therapy and particularly in those on a calcium channel blocker (CCB) or diuretic.


CONCLUSIONS
High treatment and control rates of hypertension in Ontario are associated with high utilization of RAS blockers. Diabetics on 2+ therapy are the least effectively controlled, possibly reflecting the limited use of diuretics.
McInnis
Natalie H
NH
University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Fodor
George
G
Moy Lum-Kwong
Margaret
M
Leenen
Frans H H
FH
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D015220:Calcium Channels / Q000494:pharmacology / Q000627:therapeutic use; D055812:Community-Based Participatory Research; D003430:Cross-Sectional Studies; D004232:Diuretics / Q000494:pharmacology / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008875:Middle Aged; D009864:Ontario; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012084:Renin-Angiotensin System / Q000502:physiology
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D015220:Calcium Channels; D004232:Diuretics