Prevalence, Treatment, and Control of Hypertension in the French Population *1Data From a Survey on High Blood Pressure in General Practice, 1994

Abstract

A survey was conducted in a cohort of 235 general practitioners (GP) selected by Sofres Medical who were representative of the French medical population, to measure the percentage of patients with hypertension, treated hypertensives and patients with controlled hypertension. Data were collected over 1 week of office consultation. Practitioners were initially instructed to use the same type of mercury sphygmomanometer, equipped with pneumatic cuffs of different sizes. Three consecutive blood pressure (BP) measurements were made and the last two were recorded. Practitioners had to carry out their own survey over a period of 1 week on all patients > 18 years of age who visited their offices. Patients were considered as hypertensive (HP) if the mean of the two recorded BP measurements was > or = 140/90 mm Hg or if they were taking antihypertensive drug treatment. Three cutoff points were used to define controlled hypertension: < 140/90 mm Hg (overall population of HP), < 160/95 mm Hg (HP < 65 years of age), and < 160/90 mm Hg (HP > or = 65 years of age). Among 12,351 patients (mean age, 48.6 years; women, 58%), 5020 were HP, (41%) of whom 2035 were without treatment (41%) and 2985 were receiving antihypertensive drug treatment (59%). Two hundred-thirty patients (4.6%) remained at high risk with moderate or severe hypertension (BP > or = 180 [systolic] or 105 [diastolic] mm Hg), ie, 1 patient/week/GP. The study confirms the high prevalence of hypertension in general practice and shows that 7 of 10 patients have an acceptable control of their BP (< 160/95 or < 160/90 mm Hg according to age) but only 24% of treated HP achieved the target of a BP level < 140/90 mm Hg, representing 28% of the 18 to 64 year old group and 21% of the elderly group. French GP did not choose an optimal control, and the medical community is waiting for answers to crucial questions, ie, does optimal BP control significantly improve the absolute cardiovascular risk? How far should blood pressure be lowered?

Management in general practice of hypertensive patients poorly controlled with a fixed-dose renin–angiotensin system inhibitor and diuretic combination: results from a French national survey

“…A rate of 24% was reported in a survey carried out in general practice. 3 A similar failure rate has been reported in other countries: the rate of control is less than 6% in the United Kingdom, 16 50% in Scotland but with a target of 160/95 mm Hg 17 and 31% in the United States. In the latter, poor results were noted more often in women, Mexican-Americans and patients over 60 years of age.…”

“…Moreover, around 80% of hypertensives are thought to be treated. 2 A high proportion of hypertensives are poorly controlled despite their treatment; Chamontin et al 3 noted a particularly high failure rate (65-75%) in their study. [4][5][6] These poor results could be partly explained by inadequate management of antihypertensive treatments by clinicians.…”

“…3,5,7 Thus, out of the hypertensives receiving treatment in the French subgroup of the MONICA study, 14 which included all types of patients (35-64 years of age), the 140/90 mm Hg goal was only attained in men in 21% of the 35 to 44-year-old range, 11% of the 45-54 age group and 8% of the 55-64 age group. In women, the control rate was 28, 16 and 15% in these three age groups, respectively.…”

The epidemiology of elevated blood pressure as an estimate for hypertension in Aydın, Turkey

“…[35][36][37][38] In conclusion, we have found a high prevalence of HT with a low degree of control. Specific intervention and control programmes, including detection strategies, are needed to increase the extent of control of HT in our region and country-wide.…”

Evaluation of hypertension control in Greek primary care units. The VANK study

“…10 All the above studies were carried out in the general population and the control of hypertension was evaluated in the general population and not in Primary Care. Only in a French study, 11 the hypertension control was evaluated in General Practice. The rate of control in this study was 24.4%.…”