Quality Standard Details
Hypertension: Care in the Community for Adults
- Publication Date
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2024-February-01
- Status
- Published
- Topic Area
- Cardiac Cardiovascular
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Hypertension is a common condition that affects nearly 25% of adult Canadians. In Ontario, 26% of people aged 18 years and older (or more than 3 million adults) and 66% of people aged 65 years and older had a diagnosis of hypertension in 2021. Hypertension is the most common modifiable risk factor for death or disability, and it can lead to cardiovascular morbidity, chronic kidney disease, complications affecting numerous organ systems (including the brain, heart, eyes, kidneys, and peripheral vasculature), and death.
Common risk factors for developing hypertension include increasing age, obesity, smoking, alcohol use, a family history of hypertension, and conditions such as diabetes or high cholesterol.
Hypertension disproportionately affects people from Black, Indigenous, South Asian, and Francophone populations; people from older age groups; women aged 65 years and older; and people living in rural and remote settings. Cardiovascular health risk was exacerbated by the health care, social, and economic restrictions of the COVID-19 pandemic (e.g., unforeseen effects on the continuity of care, adherence to medications and recommended health behaviour changes, decreased physical activity, loss of income, social isolation, and increased frequency of depression and anxiety).
This quality standard addresses care for adults aged 18 years or older who have been diagnosed with hypertension or who are at risk of developing hypertension. The quality standard focuses on the prevention, assessment, diagnosis, and management of hypertension in primary care, and in long-term care and other home and community care settings.
Quality Standard in Brief
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Quality Statement 1: Culturally Responsive Care
People with hypertension or at risk for hypertension (and their families and care partners) receive care from health care teams in a health care system that is culturally responsive and free from discrimination and racism. Health care teams work to build trust, address misconceptions about hypertension, remove barriers to accessing care, and provide equitable care.
Quality Statement 2: Accurate Measurement of Blood Pressure
People receive automated office blood pressure measurement when in-office blood pressure measurement is performed.
Quality Statement 3: Out-of-Office Assessment to Confirm a Diagnosis
People with a high in-office blood pressure measurement receive ambulatory blood pressure monitoring to confirm a diagnosis of hypertension. Home blood pressure monitoring can be used if ambulatory blood pressure monitoring is not tolerated or not readily available, or if the patient prefers home monitoring.
Quality Statement 4: Health Behaviour Changes
People with hypertension or at risk for hypertension (and their families and care partners) receive information and supports for health behaviour changes that can reduce their blood pressure and risk of cardiovascular disease, including physical exercise, alcohol consumption, diet, sodium and potassium intake, smoking cessation, and stress and weight management.
Quality Statement 5: Care Planning and Self-Management
People with hypertension (and their families and care partners) collaborate with their clinicians and use shared decision-making to create a care plan that includes a target blood pressure range, goals for health behaviour change, medication selection and adherence, recommended diagnostic testing, management of concurrent conditions, and when to follow up.
Quality Statement 6: Monitoring and Follow-Up After a Confirmed Diagnosis
People with hypertension who are actively modifying their health behaviours but not taking blood pressure medication are assessed by their clinician every 3 to 6 months. Shorter intervals (every 1 to 2 months) may be needed for people with higher blood pressure. People who have been prescribed blood pressure medication are assessed every 1 to 2 months until their target blood pressure has been met on 2 consecutive visits, and then every 3 to 6 months.
Quality Statement 7: Improving Adherence to Medications
People who are prescribed blood pressure medication (and their families and care partners) receive information and supports to help them take their medication regularly and as prescribed. At every follow-up visit for hypertension, they have discussions with their clinicians about medication use, possible side effects, and any barriers they experience in taking their medications as prescribed.
Supporting Documents
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Patient guide for this quality standard
Know what to ask for in your care
Placemat for this quality standard
A quick-reference resource for clinicians that summarizes the quality standard and includes links to helpful resources and tools
Quality improvement tools and resources for health care professionals, including an action plan template
Supplementary information to support the data collection and measurement process
The eReport is an online tool for hospitals. It allows you to access indicators that help enable quality improvement. The report is dynamic, and you can view data at the hospital and regional levels. You will need a ONE ID account to access the data.
Additional Resources
If you would like to receive these resources, please send us a message using our contact form:
- Patient guides for this quality standard in Inuktitut, Ojibway, Oji-Cree, Hindi, Punjabi, and Urdu
- Case for improvement (slide deck)
Share why this standard was created and the data behind it, to get the support you need to put it into practice - Technical specifications
See the technical specifications for the indicators within the quality standard - Summary of the public feedback we received
Last Updated: February 24, 2026
