Unhealthy behaviors and risk of uncontrolled hypertension among treated individuals-The CONSTANCES population-based study

Abstract

From an epidemiological standpoint, quantifying the individual and the combined effect of lifestyle factors on uncontrolled blood pressure (BP) deserves further evaluation. We aimed to examine the individual and combined associations between unhealthy behaviors and uncontrolled hypertension among treated hypertensive adults. cross-sectional analysis was conducted using data from CONSTANCES, an ongoing French population-based cohort study. Uncontrolled BP was defined as mean systolic Bp ≥140 mmHg and/or mean diastolic BP ≥90 mmHg. Unhealthy behaviors were considered as heavy alcohol consumption, low or medium adherence to dietary recommendations, sedentary physical activity level, and overweight. A total of 10,710 hypertensive treated volunteer participants were included and 56.1% had uncontrolled hypertension; of them, 2.0%, 24.5%, 54.0% and 19.5% exhibited 0, 1, 2 or ≥3 unhealthy behaviors respectively. In men, there was an increased odds of uncontrolled hypertension with heavy alcohol drinking compared to light-or-never (adjusted odds ratio 1.34, 95% CI 1.10-1.63), with low as well as with medium adherence to dietary recommendations compared to high (p < 0.05 for both), and with overweight or obesity compared to a normal body mass index (p ≤ 0.001 for both). In addition, men reporting a combination of ≥3 unhealthy behaviors compared to none, had an increased odds of hypertension of 1.67 (95% CI 1.09-2.53). Unhealthy behaviors described as, heavy alcohol consumption, non-adherence to dietary recommendations and overweight are associated with uncontrolled hypertension, at the individual and combined level, and particularly in men. Improvement of modifiable lifestyle factors could offer considerable benefits in the management of hypertension. Arterial hypertension is a global public health issue affecting more than 1 billion individuals worldwide and causing an estimated ten million deaths every year 1. Despite the availability of efficient and well-tolerated medications and widespread public health efforts to treat individuals with hypertension, inadequate blood pressure (BP) control is frequently reported among treated hypertensive individuals, and contributes significantly to increased risk of cardiovascular disease (CVD), stroke and chronic kidney disease (CKD) 2. A number of epidemiological studies commonly reported a high prevalence rate of uncontrolled hypertension at the 140/90 mmHg threshold; in the United States, data analysis from the National Health and Nutrition Examination Survey (NHANES) found that among treated individuals around 45% had uncontrolled BP 3. Within

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Pressão arterial não controlada entre pessoas idosas hipertensas assistidas pela Estratégia Saúde da Família

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