학술논문
Epidemiologic features and management of hypertension in Tunisia, the results from the Hypertension National Registry (NaTuRe HTN)
Document Type
Report
Author
Abid, Leila; Hammami, Rania; Chamtouri, Ikram; Drissa, Meriam; Boudiche, Selim; Bahloul, MohamedAmine; BenSlima, Hedi; Sayahi, Khaled; Charfeddine, Selma; Allouche, Emna; Rais, Lamia; Kaab, Badr; IbnHadjamor, Hassen; BenFatma, Lilia; Garbaa, Riadh; Boukhris, Sabrine; Halima, Manel Ben; Amdouni, Nesrine; Ghorbel, Chaima; Soudani, Sabrine; Khaled, Imen; Triki, Syrine; Bouazizi, Feten; Jemai, Imen; Abdeljalil, Ouday; Ammar, Yemna; Farah, Amani; Neji, Adnen; Oumayma, Zeineb; Seghaier, Sana; Mokrani, Samir; Thawaba, Hamza; Sarray, Hela; Ouaghlani, Khalil; Thabet, Houssem; Mnif, Zeineb; Boujelban, Fatma; Sghaier, Mohamed; Khalifa, Roueida; Fourati, Sami; Kammoun, Yasmin; Abid, Syrine; Hamza, Chihab; Jeddou, Syrine Ben; Sabbah, Lassaad; Lakhdhar, Rim; Dammak, Najla; Sellami, Tarek; Herbegue, Basma; Koubaa, Alia; Triki, Faten; Ellouz, Tarek; Hmoudi, Aicha; BenAmeur, Ikhlas; Boukhchina, MohamedMongi; Abid, Neila; Wachtati, Wejdene; Nasrallah, Nizar; Houidi, Yousra; Meghaieth, Fathia; Ghodhbane, Elhem; Chayeb, Mounira; Chenik, Sarra; Kaabachi, Samira; Saadaoui, Nizar; BenAmeur, Ines; Affes, Moufida; Ouali, Sana; Chaker, Mouna; Naanaa, Hela; Dghim, Meriem; Jarrar, Mourad; Mnif, Jihene; Turki, Ahmed; Zairi, Ihsen; Langar, Jamel; Dardouri, Safa; Hchaichi, Imen; Chettaoui, Rafik; Essmat, Wajih; Chakroun, Amel; Mzoughi, Khadija; Mechmeche, Rachid; BenHalima, Afef; BenKhala, Sahar; Chtourou, Slim; Maalej, Abdelkader; Ayari, Mohsen; Hadrich, Moufid; Tlili, Rami; Azaiez, Fares; Bouhlel, Imen; Sahnoun, Samira; Jerbi, Habib; BenMrad, Imtinene; Riahi, Leila; Sahnoun, Mohamed; BenJemaa, Abdelhamid; BenSalem, Amel; Rekik, Bassem; BenDoudou, Maroua; Boujneh, Rachid; Joulak, Anissa; Mejdoub, Yosra; Gtif, Imen; Jribi, Gouider; Naffeti, Elyes; Gamra, Habib; BenYousef, Soraya; Sdiri, Wissem; BenHalima, Najeh; BenAmeur, Youssef; Kachboura, Salem; Kraiem, Sondes; Fehri, Wafa; Bazdeh, Leila; Mourali, MohamedSami; Milouchi, Sami; Drissa, Habiba; Maatouk, Faouzi; Zakhama, Lilia; Addad, Faouzi; Kammoun, Samir; Abdesselem, Salem
Source
BMC Cardiovascular Disorders. March 29, 2022, Vol. 22 Issue 1
Subject
Language
English
ISSN
1471-2261
Abstract
Author(s): Leila Abid[sup.1] , Rania Hammami[sup.2] , Ikram Chamtouri[sup.3] , Meriam Drissa[sup.4] , Selim Boudiche[sup.5] , MohamedAmine Bahloul[sup.2] , Hedi BenSlima[sup.6] , Khaled Sayahi[sup.7] , Selma Charfeddine[sup.2] , Emna Allouche[sup.8] [...]
Background Hypertension is the leading cause of morbi-mortality in our country. Thus, we conducted this national survey on hypertension to analyze the profile of the Tunisian hypertensive patient and to assess the level of blood pressure control. Methods Nature HTN is an observational multicentric survey, including hypertensive individuals and consulting their doctors during the period of the study. Blood pressure measurements were conducted during consultation, using a standardized auscultatory or oscillometric sphygmomanometer after at least 15 min of rest. The diagnosis of new hypertension is based on the 2018 ESC/ESH criteria. The primary endpoint of our study was uncontrolled hypertension defined by a systolic blood pressure [greater than or equai to] 140 mmHg and/or diastolic blood pressure [greater than or equai to] 90 mmHg. Results Three hundred twenty-one investigators participated in the study. We enrolled 25,890 patients with a female predominance (Sex ratio, 1.21) and an average age of 64.4 [+ or -] 12.2 years. Most individuals were treated in the public sector (74%), 39.4% of patients were diabetic, 25.8% were obese, 44.6% were overweight and 14% were smokers. Hypertension was controlled in 51.7% of cases if we consider 140/90 as a BP target, and only in 18.6% if we consider 130/80 as a target. The independent predictors of uncontrolled blood pressure were male sex (OR = 1.09, 95%CI [1.02-1.16]), age > 65 year-old (OR = 1.07, 95% CI[1.01-1.13], diabetes (OR = 1.18, 95% CI [1.11-1.25], Smoking (OR = 1.15, 95% CI [1.05-1.25]), Obesity (OR = 1.14, 95% CI[1.07-1.21]), management in public sector (OR = 1.25, 95% CI [1.16-1.34]), and Heart rate > 80 bpm (OR = 1.59, 95% CI [1.48-1.71]). Contrarily, high educational level (OR = 0.9, 95% CI [0.84-0.97], absence of history of coronary disease (OR = 0.86, 95% CI [0.8-0.93]), salt restriction (OR = 0.48, 95% CI [0.45-0.51]), drug compliance (OR = 0.57, 95% CI[0.52-0.61]), and regular physical activity (OR = 0.77, 95% CI[0.71-0.84]) are strong predictors of blood pressure control. Conclusion NaTuRe HTN showed that blood pressure control was reached in more than half of the Tunisian people. The control remains low in patients with high cardiovascular profiles and in those treated in the public sector. A national health program based on therapeutic education, regular control and continuous support to the public institutions is needed to decrease the burden of hypertension incidence rate. Keywords: Hypertension, Blood pressure control, Epidemiology, Predictors, Registry
Background Hypertension is the leading cause of morbi-mortality in our country. Thus, we conducted this national survey on hypertension to analyze the profile of the Tunisian hypertensive patient and to assess the level of blood pressure control. Methods Nature HTN is an observational multicentric survey, including hypertensive individuals and consulting their doctors during the period of the study. Blood pressure measurements were conducted during consultation, using a standardized auscultatory or oscillometric sphygmomanometer after at least 15 min of rest. The diagnosis of new hypertension is based on the 2018 ESC/ESH criteria. The primary endpoint of our study was uncontrolled hypertension defined by a systolic blood pressure [greater than or equai to] 140 mmHg and/or diastolic blood pressure [greater than or equai to] 90 mmHg. Results Three hundred twenty-one investigators participated in the study. We enrolled 25,890 patients with a female predominance (Sex ratio, 1.21) and an average age of 64.4 [+ or -] 12.2 years. Most individuals were treated in the public sector (74%), 39.4% of patients were diabetic, 25.8% were obese, 44.6% were overweight and 14% were smokers. Hypertension was controlled in 51.7% of cases if we consider 140/90 as a BP target, and only in 18.6% if we consider 130/80 as a target. The independent predictors of uncontrolled blood pressure were male sex (OR = 1.09, 95%CI [1.02-1.16]), age > 65 year-old (OR = 1.07, 95% CI[1.01-1.13], diabetes (OR = 1.18, 95% CI [1.11-1.25], Smoking (OR = 1.15, 95% CI [1.05-1.25]), Obesity (OR = 1.14, 95% CI[1.07-1.21]), management in public sector (OR = 1.25, 95% CI [1.16-1.34]), and Heart rate > 80 bpm (OR = 1.59, 95% CI [1.48-1.71]). Contrarily, high educational level (OR = 0.9, 95% CI [0.84-0.97], absence of history of coronary disease (OR = 0.86, 95% CI [0.8-0.93]), salt restriction (OR = 0.48, 95% CI [0.45-0.51]), drug compliance (OR = 0.57, 95% CI[0.52-0.61]), and regular physical activity (OR = 0.77, 95% CI[0.71-0.84]) are strong predictors of blood pressure control. Conclusion NaTuRe HTN showed that blood pressure control was reached in more than half of the Tunisian people. The control remains low in patients with high cardiovascular profiles and in those treated in the public sector. A national health program based on therapeutic education, regular control and continuous support to the public institutions is needed to decrease the burden of hypertension incidence rate. Keywords: Hypertension, Blood pressure control, Epidemiology, Predictors, Registry