McMaster University

McMaster University

Faculty of
Health Sciences

Awareness program reduces heart disease in communities

Blood pressure reduction the key to improved outcomes

Published: June 8, 2010
Lisa Dolovich
Lisa Dolovich, Associate Professor, Department of Family Medicine

A community-based health promotion program significantly reduces heart disease and stroke in seniors, says McMaster research released today.

Principal investigator Janusz Kaczorowski told the Canadian Stroke Congress today the impact can be practically 10 per cent.

As part of the Cardiovascular Health Awareness Program (CHAP), family physicians in 20 mid-sized Ontario communities invited patients aged 65 and over to attend risk assessment sessions held at local pharmacies over a 10-week period.  More than 15,000 residents took part in the program delivered by over 500 peer volunteers.

"Volunteer-led risk assessments combined with health information and linkages to primary care providers and community resources led to an impressive nine percent reduction in their rates of hospitalization for stroke, heart attack, and congestive heart failure," said Kaczorowski.

The program was co-developed by professors Kaczorowski, Lisa Dolovich, and Larry Chambers from McMaster University and the Elisabeth Bruyere Research Institute.  Kaczorowski is now at the University of British Columbia and the Child and Family Research Institute.

The CHAP team randomly selected 39 communities and stratified them by location and population size. Twenty communities received CHAP. Nineteen communities served as controls and did not receive the program.

In the CHAP communities, more than 500 trained peer volunteers met with the residents to check blood pressure, review the warning signs of stroke and heart attack, look at risk factors, and promote blood pressure control and healthy living.

"CHAP is a unique, low cost way to activate community organizations, volunteers, health care providers, and the participants themselves," says Kaczorowski.

Pharmacists took part in the sessions as part of the primary care team to discuss concerns about blood pressure medications and recommendations on how to maximize the benefits of blood pressure lowering medications. "The CHAP system incorporated a mechanism for pharmacists to provide patient-focused care as part of the primary care team," stated Dolovich. "Pharmacists working as part of CHAP provide the kinds of care and services being adopted by many provinces across the country."

The program focused primarily on blood pressure reduction. "Controlling blood pressure is key to lowering rates of stroke and heart disease," says Kaczorowski. "We found that even small reductions can have a dramatic impact on the health of older adults."

According to the Canadian Heart and Stroke Foundation, one in five Canadian adults has high blood pressure.

With the largest cohort of baby boomers in Canada’s history entering their at-risk years, Kaczorowski says that the next steps will be to roll out the program across Canada.

The team received the Canadian Stroke Congress Chair’s Award for Impact, awarded to the research study presented at Congress which was judged to have the most impact on preventing or treating stroke.

"It’s never too late to reduce your risk of stroke, and this project is showing us how quickly the benefits of blood pressure management can accrue," says Canadian Stroke Network spokesperson Dr. Antoine Hakim.  "Good health isn’t just for the young; it’s a life-long pursuit."

He notes that simple solutions can lead to big results: "Here is a prevention strategy that doesn’t require large health expenditures but has significant impact on health outcomes. It’s worth pursuing this peer model with other at-risk populations such as youth and the Aboriginal population."

The 2010 Heart and Stroke Foundation report card recently warned that a ‘perfect storm’ of risk factors and demographic changes are creating an unprecedented burden on Canada’s fragmented cardiovascular care system.

"We currently have a patchwork quilt of prevention and treatment initiatives," says Heart and Stroke Foundation spokesperson Dr. Michael Hill.  "Community programs like CHAP are integral to helping individuals within at-risk populations understand and manage their health risks."

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