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Cardiovascular Health Awareness Program (CHAP)

Hypertension now affects more than six million Canadians (1) and is one of the most significant risk factors driving death and disability (2). High blood pressure is estimated to account for over 10% of total Canadian healthcare spending, with an anticipated cost of $20.5 billion by 2020 (3). The treatment and control of high blood pressure (hypertension) has significantly improved in Canada (4). However, Canada has not been as successful in preventing or delaying the onset of high blood pressure (5).

The Cardiovascular Health Awareness Program (CHAP) is a low cost, patient-centred, community-led cardiovascular disease prevention and management program for adults. CHAP addresses common risk factors, including high blood pressure, tobacco use, physical activity, and dietary habits. The program is currently running in the following Ontario communities: Paris, Oxford County, Huron Perth and Napanee.

In CHAP, free risk assessment and information-providing sessions are held in places where people work, live and gather. These may include pharmacies, community health centers, primary care practices, places of worship, shopping centers, workplaces, community events, service group facilities, or other easily accessible locations.

At these sessions,  trained volunteer health educators assist with  blood pressure measurement, using automated devices recommended by Hypertension Canada.  They can link participants to health promotion programs and resources in the community, based on established health risk profiles. Where applicable, they also provide participants with education materials.

CHAP is interdisciplinary. It partners primary care providers, other healthcare professionals, public health agencies, volunteer health educators, and community organizations.

Since 2000, CHAP has evolved and continues to lead research on an international scale. The CHAP Philippines (CHAP-P) Program of Research is a separately funded study looking at the scale up of CHAP in the Philippines and other Low- and Middle-Income Countries (LMICs). CHAP research contributes to the body of evidence on community led health interventions, cardiometabolic diseases, hypertension detection and management and associated risk factors.


  1. Epidemiology of Hypertension in Canada: An Update. Padwal, R, et al. s.l.: Elsevier, 2016, Canadian Journal of Cardiology, Vol. 32, pp. 687-694.
  2. Health Canada. Institute for Health Metrics and Evaluation. IHME. 2018.
  3. Healthcare Costs Attributable to Hypertension: Canadian Population-Based Cohort Study. Weaver, C, et al. s.l.: American Heart Association, July 13, 2015, Hypertension, Vol. 66, pp. 1-11.
  4. Blood pressure in Canadian adults. Wilkins, K, Campbell, NR, Joffres, MR,. 2010, Health Rep, Vol. 21, pp. 37-46.
  5. Hypertension in Canada: Past, Present, and Future. Schiffrin, E., Campbell, N., Feldman, R., Kacsorowski, J., Lewanczuk, R. et al. 2, s.l. : Elsevier, 2016, Annals of Global Health, Vol. 82, pp. 288-299.

Project Investigators

  • Gina Agarwal, McMaster University
  • Janusz Kaczorowski, Centre de recherche du CHUM and University of Montreal
  • Lisa Dolovich, McMaster University and University of Toronto
  • Tamara Daly, York University
  • Marie-Thérèse Lussier, Centre intégré de santé et services sociaux de Laval and University of Montreal

Notable Publications

Dahrouge S, Kaczorowski J, Dolovich L,Paterson M, Thabane L, Tu K, et al. Economic Appraisal of a Community-wide Long term outcomes of cluster randomized trial to improve cardiovascular health at population level: The Cardiovascular Health Awareness Program (CHAP).   PLoS ONE 13(9): e0201802.

Goree R, Von Keyserling C, Burke N, He J, Kaczorowski J, Chambers L, Dolovich L, Paterson JM, Zagorski B. (2013) Economic Appraisal of a Community-wide Cardiovascular Health Awareness Program (CHAP)Value in Health16(1)39–45. doi: 10.1016/j.jval.2012.09.002

Kaczorowski J, Chambers LW, Dolovich L, Paterson, JM, Karwalajtys T, Gierman T, Farrell B, McDonough B, Thabane L, Tu K, Zagorski B, Goeree R, Levitt CA, Hogg W, Laryea S, Carter MA, Cross D, Sebaldt R J (2011) Improving cardiovascular health at the population level: A 39 community cluster-randomized trial of the Cardiovascular Health Awareness Program (CHAP)BMJ, 7, 342-d442. doi:10.1136/bmj.d442’