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The impact of a cardiovascular health awareness program (CHAP) on reducing blood pressure: a prospective cohort study

Chenglin Ye12, Gary Foster12, Janusz Kaczorowski34, Larry W Chambers1567, Ricardo Angeles3, Francine Marzanek-Lefebvre3, Stephanie Laryea8, Lehana Thabane12 and Lisa Dolovich13*

Author Affiliations

1 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada

2 Biostatistics Unit, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada

3 Department of Family Medicine, McMaster University, McMaster Innovation Park, 175 Longwood Road South, Hamilton, ON L8P 0A1, Canada

4 CRCHUM and Département de médecine de famille et de médecine d’urgence, Université de Montréal, Montreal, Canada

5 Institut de recherche Élisabeth-Bruyère Research Institute, Bruyère Continuing Care and University of Ottawa, Ottawa, ON, Canada

6 Institute for Clinical Evaluative Sciences, Toronto, ON, Canada

7 Faculty of Health, York University, Toronto, ON, Canada

8 Pan-American Health Organization / World Health Organization, Paramaribo, Suriname

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BMC Public Health 2013, 13:1230  doi:10.1186/1471-2458-13-1230

Published: 25 December 2013



Hypertension is an important and modifiable cardiovascular risk factor that remains under-detected and under-treated, especially in the older individuals. Community-led interventions that integrate primary health care and local resources are promising approaches to improve awareness and management of hypertension and other cardiovascular risk factors. We aimed to evaluate the effect of a community-based Cardiovascular Health Awareness Program (CHAP) on participants’ blood pressure.


This study followed a cohort of community residents that participated in CHAP across 22 mid-sized Ontario communities over an 18-month period. The participants’ baseline risk factors, including blood pressure, and subsequent measures of blood pressure were recorded. We employed a bivariate linear mixed-effect model to estimate the change of systolic and diastolic blood pressure over time among the participants who attended more than two CHAP sessions.


Of 13,596 participants, 2498 attended more than two CHAP sessions. For those repeated participants (attending more than two sessions) initially identified with high blood pressure, the average reduction of systolic blood pressure was from 142 to 123 mmHg over an 18-month period, a monthly rate ratio of 0.992 (95% CI: 0.991,0.994; p < 0.01). Similarly, the average reduction of diastolic blood pressure was from 78 to 69 mmHg, a monthly rate ratio of 0.993 (95% CI: 0.991,0.994; p < 0.01). The average blood pressure of the participants with normal baseline blood pressure remained controlled and unchanged. We also found that older adult participants who lived alone, were diagnosed with hypertension, reported healthier eating habits, and presented with a higher baseline systolic blood pressure had significantly greater odds of attending more than one session.


CHAP was associated with a reduction in systolic and diastolic blood pressure for those participants who attended more than one session. The magnitude of blood pressure reductions was significant clinically and statistically.