Take urgent action diagnosing, treating, and controlling hypertension in older women

Increased blood pressure is a leading risk of death, accounting for half of all cardiovascular disease {CVD). Hypertension is both highly preventable and controllable. Up to 80% of hypertension is directly, through excess sodium and deficient potassium, or indirectly, through obesity, related to diet. Preventing hypertension by healthy dietary policies (eg, reducing dietary salt) is highly cost-effective. Canada has been a global leader in controlling hypertension,7 with the world's highest reported national rate of control since 2006.8 Unfortunately, since 2011, the hypertension control rate in older women has become lower than in older men, in contrast to nearly all other countries,9-12 and there are disturbing tendencies in decreasing rates of hypertension awareness, treatment, and control in older Canadian women. Most disturbing, after decades of decline, are increases in the CVD death rates in Canada since 2010. Some of the increases in CVD deaths are related to the increasing age of the population. The rest of the increase in CVD deaths is likely attributable to the well established modifiable causes of CVD not being effectively prevented and controlled (eg, hypertension, poor diet, obesity, etc).13 There has also been a rapid increase in disability-adjusted life-years owing to CVD since 2010, which will result in a considerable decline in quality of life for Canadians. Declining rates of hypertension control in women older than 60 years of age explains some of the increases in CVD, but the rate of CVD is also increasing in men, highlighting the need to control hypertension and other vascular risk factors in both sexes.