Objective: Comparison of recent national survey data
on prevalence, awareness, treatment and control of
hypertension in England, the USA and Canada, and
correlation of these parameters with each country
stroke and ischaemic heart disease (IHD) mortality.
Design: Non-institutionalised population surveys.
Setting and participants: England (2006 n=6873),
the USA (2007–2010 n=10 003) and Canada (2007–
2009 n=3485) aged 20–79 years.
Outcomes: Stroke and IHD mortality rates were
plotted against countries’ specific prevalence data.
Results: Mean systolic blood pressure (SBP) was
higher in England than in the USA and Canada in all
age–gender groups. Mean diastolic blood pressure
(DBP) was similar in the three countries before age 50
and then fell more rapidly in the USA, being the lowest
in the USA. Only 34% had a BP under 140/90 mm Hg
in England, compared with 50% in the USA and
66% in Canada. Prehypertension and stages 1 and 2
hypertension prevalence figures were the highest in
England. Hypertension prevalence (≥140 mm Hg SBP
and/or ≥90 mm Hg DBP) was lower in Canada
(19·5%) than in the USA (29%) and England (30%).
Hypertension awareness was higher in the USA (81%)
and Canada (83%) than in England (65%). England
also had lower levels of hypertension treatment (51%;
USA 74%; Canada 80%) and control (<140/90 mm Hg;
27%; the USA 53%; Canada 66%). Canada had the
lowest stroke and IHD mortality rates, England
the highest and the rates were inversely related to the
mean SBP in each country and strongly related to the
blood pressure indicators, the strongest relationship
being between low hypertension awareness and stroke
mortality.
Conclusions: While the current prevention efforts in
England should result in future-improved figures,
especially at younger ages, these data still show
important gaps in the management of hypertension in
these countries, with consequences on stroke and IHD
mortality