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Feb 05, 2026
This blog post was written by second-year Dalhousie Medical students Gracious Kasheke and Gabrielle Clark, with editing by Dr. Jeremy Wood, Dr. Samuel Jessula, Dr. Claire Nowlan, Dr. David. Haase, Kate McKesey, Jenelle Gowie (Co-president of the Black Medical Students’ Association) and Eva-Brenda Bandyayera (Co-president of the Black Medical Students’ Association).
Heart and blood vessel conditions, such as heart attack and stroke, cause more than one in five deaths in Canada, with hypertension (or high blood pressure) being the most common treatable contributor.
Doctors have many effective medications to treat high blood pressure, but it is not always clear which option is best for each patient. To guide care, researchers update Canadian hypertension guidelines every few years.
For decades, doctors have treated hypertension differently in Black patients. With race thought to be an important factor, Black Canadian patients with uncomplicated high blood pressure were prescribed different first-line medications than other Canadians. But in 2025, that changed.
In the updated Canadian guidelines, Black patients are now prescribed the same first-line medications as other racial groups.
Why race-based recommendations changed
Researchers have long studied how disease risk and treatment responses can vary across populations. Some large American studies suggested that common first-line blood pressure medications were less effective in Black American patients than certain alternatives. These findings influenced earlier guidelines.
However, race has never been a precise indicator of biological differences. It’s a social category, not a biological one, and individuals within racial groups vary widely. There is also uncertainty about whether findings from Black American populations apply to Black Canadians, given differences in genetics, healthcare access and social context. Rather than focus on race, the updated guidelines take an individualized approach to care based on cardiovascular risk and relevant biological factors.
How doctors apply the guidelines
Dr. Jeremy Wood, Division Head of Cardiac Surgery at Nova Scotia Health and Dalhousie University, emphasizes individualized, patient-centred care. He explains that blood pressure management should focus on cardiovascular risk, measurable biological factors, comorbidities and the social determinants of health, such as housing, finances and food security, rather than race.
Dr. Samuel Jessula, a vascular surgeon and associate professor at Dalhousie University, echoes this approach, noting that he treats patients on a case-by-case basis, focusing on their specific needs. Both doctors stress the importance of healthy eating, regular exercise, reduced smoking and lower alcohol intake to reduce the risk of heart attack and stroke and to help enhance the benefits of medication. Dr. Claire Nowlan, a family physician, notes that regular physical activity strengthens the heart and blood vessels over time and may also reduce the risk of Alzheimer’s disease.
4 tips to keep your blood pressure healthy:
Measure, measure, measure
Dr. Wood recommends patients monitor their blood pressure at home. For at-risk patients, check blood pressure several times a day over a few weeks and record the date and time for each reading. If you’re not experiencing heart issues, blood pressure checks a few times a year at the pharmacy is adequate. Readings taken outside of a medical office are key because measurements taken in a medical setting are often higher than usual, known as white coat hypertension. Measurements taken at home or the pharmacy can provide a better picture of true blood pressure. How to measure your blood pressure.
Share readings with your healthcare provider
If your blood pressure is consistently above the healthy range (generally over 130/80 mmHg), report this to a nurse practitioner, family doctor, or walk-in clinic. The Nova Scotia Brotherhood and Sisterhood clinics are also available and provide healthcare services for Black Nova Scotians. Even without a regular family doctor, engaging with the healthcare system can help identify your risk early. You can also ask your provider about the updated prescribing guidelines.
Focus on protective lifestyle factors
Large lifestyle changes can be difficult, but small steps matter. Smoking and diabetes greatly increase cardiovascular risk. While you can’t change some factors, such as age and family history, you can take steps to improve your health. Managing diabetes, cholesterol and blood pressure, stopping smoking, eating well, and staying active all reduce risk. Aerobic activity, such as walking for 30 minutes four times per week, can also help.
Choose a plan that works for you
Blood pressure treatment should fit your life. Whether the plan involves lifestyle changes, medication or both, consistency matters. High blood pressure affects every blood vessel in the body, and controlling it will reduce your risk of serious health outcomes.
Helpful resources
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