Report from the Canadian Chronic Disease Surveillance System: Hypertension in Canada, 2010

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Glossary

Age-Standardized: Rates are adjusted for changes in the age structure of the population over time. Refer to the National Diabetes Surveillance System Methods Documentation²⁵ for more information.

All-Cause Mortality: Mortality rate due to any cause of death.

Confidence Interval: A 95% confidence interval is a range of values around the estimate that has a 95% probability of including the true value. The size of the confidence interval relates to the precision of the estimate.

Crude Rate: Total number of events relative to the population size without any adjustment or standardization.

Diagnosed Hypertension: The CCDSS summarized data about residents of Canada who have used the Canadian health care system. In the CCDSS, to meet the case criteria for hypertension, an insured individual, aged 20 years and older, must have either one inpatient hospital separation with an ICD-9 or ICD-9-CM code of 401-405 (hypertension) or equivalent ICD-10-CA code of I10-I13 and I15, selected from all available diagnostic codes in the hospital file, or two or more physician claims with a relevant ICD-9 code of 401-405 (hypertension) within two years, selected from the first diagnosis field available on the claim.

Diagnosed Diabetes: The CCDSS summarized data about residents of Canada who have used the Canadian health care system. In the CCDSS, to meet the case criteria for diabetes, an insured individual, aged one year and older, must have either one inpatient hospital separation with an ICD-9 or ICD-9-CM code of 250 (diabetes mellitus) or equivalent ICD-10-CA code of E10 to E14, selected from all diagnostic codes in the hospital file, or two or more physician claims with the relevant ICD-9 code of 250 within two years, selected from the first diagnosis field available on the claim.

False-Negatives: Individuals who have not met the CCDSS case criteria, but who have hypertension. The potential proportion of false negatives was indicated by the CCDSS hypertension validation studies.^{10 11 12 13}

False-Positives: Individuals who have met the CCDSS case criteria, but who do not have hypertension. The potential proportion of false positives was indicated by the CCDSS hypertension validation studies.^{10 11 12 13}

Incidence: The number of individuals newly diagnosed with hypertension during the fiscal year.

Incidence Rate: The proportion of individuals newly diagnosed with hypertension among those at risk during the fiscal year.

Prevalence: The number of individuals that met the case criteria for diagnosed hypertension at a given point in time.

Prevalence Rate: The proportion of individuals that met the case criteria for diagnosed hypertension at a given point in time.

Acknowledgements

Editorial Board Members

• Christina Bancej, Public Health Agency of Canada
• Claudia Blais, Institut national de santé publique du Québec
• Norm Campbell, University of Calgary
• Sulan Dai, Public Health Agency of Canada
• Susan Quach, Public Health Agency of Canada
• Hude Quan, University of Calgary
• Kim Reimer, British Columbia Ministry of Healthy Living and Sport
• Cynthia Robitaille, Public Health Agency of Canada
• Mark Smith, Manitoba Centre for Health Policy
• Paula Stewart, Public Health Agency of Canada
• Karen Tu, Institute for Clinical Evaluative Sciences
• Robin Walker, University of Calgary

External Reviewers

• J. George Fodor, University of Ottawa Heart Institute
• Michel Joffres, Simon Fraser University

Internal Reviewers

• Oliver Baclic, Public Health Agency of Canada
• Howard Morrison, Public Health Agency of Canada
• Andreas Wielgosz, Public Health Agency of Canada

Canadian Chronic Disease Surveillance System Scientifc Committee

• Shazhan Ahmed, British Columbia Children’s Hospital
• Christina Bancej, Public Health Agency of Canada
• Paul Belanger, Institute of Nutrition Metabolism and Diabetes, Canadian Institutes of Health Research
• Gillian Booth, St. Michael’s Hospital, University of Toronto
• Jill Casey, Nova Scotia Department of Health
• Kayla Collins, Newfoundland and Labrador Centre for Health Information
• Valérie Émond, Institut national de santé publique du Québec
• Linda S. Geiss, Division of Diabetes Translation, Centers for Disease Control and Prevention
• Hasan Hutchinson, CIHR Institute of Nutrition, Metabolism and Diabetes, Simon Fraser University
• Jan Hux, Institute for Clinical Evaluative Sciences
• Jeffrey Johnson, School of Public Health, University of Alberta
• Isabelle Larocque, Institut national de santé publique du Québec
• Anthony Leamon, Population Health, Department of Health and Social Services, Government of the Northwest Territories
• Lisa Lix, School of Public Health, University of Saskatchewan
• Jenny Mackey, Prince Edward Island Department of Health
• William Osei, Population Health Branch, Saskatchewan Health
• Joan Porter, Public Health Agency of Canada
• Rolf Puchtinger, Chronic Disease Branch, Manitoba Health
• Indra Pulcins, Canadian Institute for Health Information
• Kim Reimer, British Columbia Ministry of Healthy Living and Sport
• Glenn Robbins, Public Health Agency of Canada
• Chris Robinson, Public Health Agency of Canada
• Mark Smith, Manitoba Centre for Health Policy
• Larry Svenson, Public Health Surveillance and Environmental Health, Alberta Health and Wellness
• Ellen Toth, Department of Medicine, University of Alberta
• Linda Van Til, Research Directorate, Veteran Affairs Canada
• Karen Tu, Institute for Clinical Evaluative Sciences
• Chris Waters, Public Health Agency of Canada
• Jean-François Yale, McGill Nutrition and Food Science Centre, McGill University

Canadian Chronic Disease Surveillance System Technical Working Group

• Fred Ackah, Alberta Health and Wellness Organization
• Connie Cheverie, Prince Edward Island Department of Health
• Joellyn Ellison, Public Health Agency of Canada
• Bao Gang Fei, New Brunswick Department of Health
• Wendy Fonseca-Holt, Chronic Disease Branch, Manitoba Health
• Janice Hawkey, Saskatchewan Health
• Alexander Kopp, Institute for Clinical and Evaluative Services
• Anthony Leamon, Population Health, Department of Health and Social Services, Government of the Northwest Territories
• Lidia Loukine, Public Health Agency of Canada
• Pat McCrea, British Columbia Ministry of Healthy Living and Sport
• Bob McRae, Public Health Agency of Canada
• Robin Read, Diabetes Care Program of Nova Scotia
• Louis Rochette, Institut national de santé publique du Québec
• Khokan Sikdar, Newfoundland and Labrador Centre for Health Information
• Mike Tribes, Government of Yukon, Health and Social Services
• Paul Tchouaff, Department of Health and Social Services, Health Information and Research, Iqualuit, Nunavut

The CCDSS is guided by the Public Health Agency of Canada Public Health Network’s Task Group on Surveillance of Chronic Disease and Injury with the following members:

• Alberta Health and Wellness
• British Columbia Ministry of Healthy Living and Sport
• Canadian Institute of Health Information
• Canadian Institutes of Health Research/Institute of Nutrition, Metabolism and Diabetes
• Government of Nunavut
• Government of Yukon
• Health Canada, First Nations and Inuit Health Branch
• Institut national de santé publique du Québec
• Manitoba Health
• New Brunswick Department of Health
• Newfoundland and Labrador Centre for Health Information
• Northwest Territories Department of Health and Social Services
• Nova Scotia Department of Health
• Ontario Ministry of Health and Long Term Care and Ministry of Health Promotion
• Prince Edward Island Department of Health
• Saskatchewan Ministry of Health
• Statistics Canada

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¹⁰ Lix L, Yogendran M, Burchill C, Metge C, McKeen N, Moore D, Bond R. Defining and validating chronic diseases: an administrative data approach. Winnipeg, Manitoba Centre for Health Policy, July 2006.
¹¹ Quan H, Li B, Saunders LD, Parsons GA, Nilsson CI, Alibhai A, et al. Assessing validity of ICD-9-CM and ICD-10 administrative data in recording clinical conditions in a unique dually coded database. Health Serv Res. 2008 Aug; 43 (4):1424-41.
¹² Quan H, Khan N, Hemmelgarn BR, Tu K, Chen G, Campbell N, et al. Validation of a case definition to define hypertension using administrative data. Hypertension. 2009 Dec; 54 (6):1423-8.
¹³ Tu K, Campbell NRC, Chen ZL, Cauch-Dudek KJ, McAlister FA. Accuracy of administrative databases in identifying patients with hypertension. Open Med. 2007 Apr 14;1 (1): E3-5.
²⁵ Public Health Agency of Canada. National Diabetes Surveillance System Methods Documentation, 2008. Ottawa: Public Health Agency of Canada; 2009 April. 40p. Available from: www.phac-aspc.gc.ca/ccdpc-cpcmc/ndss-snsd/english/diabetes_data/00-06/pdf/method_v208-eng.pdf (pdf)

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