Diabetes and Hypertension in Canada: New data from the Canadian Chronic Disease Surveillance System

Transcription

1 1 Diabetes and Hypertension in Canada: New data from the Canadian Chronic Disease Surveillance System Karen C. Roberts, Cynthia Robitaille, Sulan Dai, Paula Stewart, Glenn Robbins, Chris Waters, Bob McRae CPHA Centenary Conference Toronto, ON June 15, 2010

2 2 Objective Describe the patterns in diagnosed hypertension among Canadian adults with diagnosed diabetes using national health administrative data

3 3 Public Health Surveillance The tracking and forecasting of any health event or health determinant through: ongoing, systematic collection of best available data integration, analysis and interpretation of those data into surveillance products dissemination to those who need to know

4 Diabetes and Hypertension Hypertension (high blood pressure) is a major risk factor for the development of diabetes complications including: Cardiovascular disease (CVD), kidney disease, diabetic eye disease Up to 75% of diabetes complications have been attributed to hypertension* The 1st priority in the prevention of the complications of diabetes** is the reduction of CVD risk including: Blood pressure control, lifestyle modification, glycemic control *Sowers JR, Epstein M, Frohlich ED. Diabetes, hypertension, and cardiovascular disease: An update. Hypertension 2001;37: **CDA 2008 Clinical Practice Guidelines

5 5 Canadian Chronic Disease Surveillance System (CCDSS) Collaborative network of provincial/ territorial surveillance systems Formerly the National Diabetes Surveillance System (NDSS) Uses health administrative data: Insurance registry Hospital database Physician billing database

6 6 CCDSS: Data Sources Insurance Registry Hospital Database Physician Billing Database Unique ID Demographic Data Mortality Unique ID Disease Case Ascertainment Co-Morbidity Health Services Unique ID Disease Case Ascertainment Co-Morbidity Health Services

7 7 Methods Years: 2000/01 to 2006/07 Case Criteria: 1 or more Hospitalization 2 or more Physician OR Claims in 2 years ICD-9 / ICD-9-CM ICD-10-CA ICD-9 / ICD-9-CM Diabetes 250 E10-E Hypertension I10-I13, I Coverage: Males/Females, Ages 20+ Diabetes: all Provinces/Territories except NU Hypertension: all Provinces/Territories except NU & QC Excluded: Cases of pregnancy induced diabetes and hypertension

8 8 Prevalence of Diagnosed Diabetes and Hypertension, by Age, Canada,* 2006/ Total Hypertension:22.7% 60 Prevalence (%) Hypertension, Women Hypertension, Men Diabetes, Women Diabetes, Men >=85 Age Group Total Diabetes: 6.2% Source: Public Health Agency of Canada, using CCDSS data files contributed by provinces and territories as of September, *Data for Nunavut were unavailable for diabetes rates. Data for both Nunavut and Québec were unavailable for hypertension rates

9 9 Diagnosed Diabetes and Hypertension /07 Almost 2/3 of Canadian adults with diagnosed diabetes also had a diagnosis of hypertension More than 5% of Canadian adults were living with both diagnosed diabetes and hypertension 1.3 million Canadians

10 10 Prevalence of Diagnosed Hypertension Among People with Diagnosed Diabetes, by Age, Canada, 2006/ % 20.0% Prevalence (%) 15.0% 10.0% 5.0% 0.0% Only Diabetes 0.6% 0.9% 1.3% 1.9% 2.5% 3.1% 4.0% 4.8% 5.2% 5.2% 4.8% 4.2% 3.6% 3.1% 2.9% Diabetes + Hypertension 0.0% 0.1% 0.3% 0.6% 1.1% 2.1% 4.0% 7.1% 10.5% 14.3% 17.4% 19.2% 19.2% 15.7% 5.1% Age Group Source: Public Health Agency of Canada, using CCDSS data files contributed by provinces and territories as of September 2009 Data for Nunavut and Quebec were unavailable

11 11 Age-Standardized Prevalence* of Diagnosed Hypertension by Diabetes Status, 20+, Canada With Diabetes Prevalence (%) Without Diabetes / / / / / / /07 Women with Diabetes Men with Diabetes Women without Diabetes Men without Diabetes Fiscal Year Source: Public Health Agency of Canada, using CCDSS data files contributed by provinces and territories as of September, *Age-standardized to the 1991 Canadian population. Data for Nunavut and Québec were unavailable.

12 12 Age-Standardized All-Cause Mortality Rates,* by Disease Status, 20+, Canada, 2006/07 25 Mortality Rate (per 1,000) No Diabetes or Hypertension Hypertension only Diabetes only Both Diabetes and Hypertension Women Men Source: Public Health Agency of Canada, using CCDSS data files contributed by provinces and territories as of September, * Age-standardized to the 1991 Canadian population. Data for Nunavut and Québec were unavailable. The 95% Confidence Interval shows an estimated range of values which is likely to include the true mortality rate 19 times out of 20.

13 13 Conclusions The prevalence of hypertension in Canadians with diabetes is higher than in those without diabetes Overall the prevalence of hypertension is increasing, but it is increasing faster in those with diabetes This might be a result of better detection, screening and/or diabetes management Canadians with both diabetes and hypertension have higher all-cause mortality rates Treatment of hypertension has been associated with reductions in the rates of complication and mortality

14 14 Acknowledgements CCDSS Technical Support: Joellyn Ellison Hypertension in Canada, 2010 Editorial Board Hypertension Outcomes Surveillance Team CCDSS Science Committee CCDSS Technical Working Group Canadian Provincial and Territorial Ministries of Health PHAC Pan-Canadian Public Health Network Task Group on Surveillance of Chronic Disease and Injury

15 15 Contact Info Public Health Agency of Canada Centre for Chronic Disease Prevention & Control Chronic Disease Surveillance and Monitoring Division Karen C Roberts, Senior Epidemiologist T.: (613) E.: karen.c.roberts@phac-aspc.gc.ca Cynthia Robitaille, Epidemiologist T.: (613) E.: cynthia.robitaille@phac-aspc.gc.ca CCDSS Website: