1
|
Le Bas F, Massenet M, Humbert X. Necessity of a systematic annual consultation in primary care to better improve detection and control of hypertension? Acta Cardiol 2024:1-3. [PMID: 39377207 DOI: 10.1080/00015385.2024.2413222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Revised: 09/26/2024] [Accepted: 09/30/2024] [Indexed: 10/09/2024]
Abstract
BACKGROUND In 2015, more than 11 million patients treated for arterial hypertension in France. According to several studies in the general population, about 50% of hypertensive subjects are treated and about 20% are treated and controlled. There is very few data in general medicine. Our work has studied how hypertension control may have differed in general medicine. METHODS A cross-sectional observational study was carried out in a rural health centre (Domfront, Normandy, France) on subjects aged 40 to 65 years in 2018. A subject was considered to be hypertensive if his blood pressure (taken in the office in routine care) was greater than 140/90 or if it was treated with antihypertensive drugs. OUTCOMES Of 1,925 subjects, there were 54.3% women, aged 54.6 ± 7.1 years. The mean blood pressure was 127 ± 13/76 ± 8 mmHg, 60.6% (682/1,127) were overweight and 5.0% (96/1,925) were diabetic. 646 (33.6%) were hypertensive and 410 hypertensive (63.5%) were treated. 39.0% (252/646) were treated and controlled. DISCUSSION In general medicine, blood pressure control seems to be better than in the general population, whereas the general practitioner is often the first contact with the healthcare system. Poor blood pressure control in the general population can be explained by the lack of general medicine consultation for untreated hypertensive subjects. A systematic annual consultation in general practice could be proposed for this specific population.
Collapse
Affiliation(s)
- F Le Bas
- Department of General Medicine, Normandie Université, UNICAEN, Caen, France
| | - M Massenet
- Department of General Medicine, Normandie Université, UNICAEN, Caen, France
| | - X Humbert
- Department of General Medicine, Normandie Université, UNICAEN, Caen, France
- INSERM U1086, ANTICIPE, Normandie Université, UNICAEN, Caen, France
| |
Collapse
|
2
|
Lindner SD, Gisinger T, Klimek P, Kautzky-Willer A. Socioeconomic Gender Variables Impact the Association between Hypertension and Chronic Health Issues: Cross-Sectional Study. J Pers Med 2024; 14:890. [PMID: 39202081 PMCID: PMC11355497 DOI: 10.3390/jpm14080890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/25/2024] [Accepted: 08/20/2024] [Indexed: 09/03/2024] Open
Abstract
Our aim is to investigate if sex and gender influence the association of hypertension and their comorbidities. We investigated how gender differences in five socioeconomic factors impact the relation between hypertension and ten comorbidities including diabetes mellitus, renal disease, and chronic pulmonary disease in European countries grouped by their gender inequality index using representative survey data from the European Health Interview Survey. Using logistic regressions, we compute the ratio of odds ratios in females versus males. Therefore, an ORR > 1 is associated with a higher odds ratio for females than for males while an ORR < 1 means the opposite. To account for multiple hypothesis testing, we applied the Bonferroni correction. Hypertension in both sexes was associated with lower educational level, being unemployed, and lower income. In males, being divorced/widowed (OR1.12, p < 0.001) had an association to hypertension, whereas in females, being common-law/married (OR1.30, p < 0.001) and being divorced/widowed (OR1.17, p < 0.001) was associated with a higher risk for hypertension. Moreover, in hypertension, females who worked had an association with myocardial infarction (OR1.39, p < 0.001) and having post-secondary education had an association with arthrosis (OR 1.35, p < 0.001) compared to males. Our findings show that gender variables influence the association of hypertension and comorbidities, especially in females. These results can be used to inform targeted prevention measures taking gender-specific contextual factors into account.
Collapse
Affiliation(s)
- Simon David Lindner
- Institute of the Science of Complex Systems, CeMSIIS, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; (S.D.L.); (P.K.)
- Complexity Science Hub Vienna, Josefstädter Straße 39, 1080 Vienna, Austria
| | - Teresa Gisinger
- Gender Medicine Unit, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna, 1090 Vienna, Austria;
| | - Peter Klimek
- Institute of the Science of Complex Systems, CeMSIIS, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; (S.D.L.); (P.K.)
- Complexity Science Hub Vienna, Josefstädter Straße 39, 1080 Vienna, Austria
- Supply Chain Intelligence Institute Austria, Josefstädter Straße 39, 1080 Vienna, Austria
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institute, 171 77 Stockholm, Sweden
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna, 1090 Vienna, Austria;
| |
Collapse
|
3
|
Humbert X, Dupouy J, Renard V, Pouchain D, Tudrej B, Partouche H, Rousselot N, Vincent YM, Ibanez G, Malmartel A, Jego M, Gilberg S, François M, Ferrat E, Saint-Lary O, Boussageon R. From guidelines to current practices: Suboptimal hypertension management in France. GPs' point of view. JOURNAL DE MEDECINE VASCULAIRE 2024; 49:118-119. [PMID: 38697709 DOI: 10.1016/j.jdmv.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/06/2024] [Indexed: 05/05/2024]
Affiliation(s)
- Xavier Humbert
- Collège national des généralistes enseignants, 75013 Paris, France
| | - Julie Dupouy
- Collège national des généralistes enseignants, 75013 Paris, France
| | - Vincent Renard
- Collège national des généralistes enseignants, 75013 Paris, France
| | - Denis Pouchain
- Collège national des généralistes enseignants, 75013 Paris, France
| | - Benoit Tudrej
- Collège national des généralistes enseignants, 75013 Paris, France.
| | - Henri Partouche
- Collège national des généralistes enseignants, 75013 Paris, France
| | | | | | - Gladys Ibanez
- Collège national des généralistes enseignants, 75013 Paris, France
| | | | - Maëva Jego
- Collège national des généralistes enseignants, 75013 Paris, France
| | - Serge Gilberg
- Collège national des généralistes enseignants, 75013 Paris, France
| | | | - Emilie Ferrat
- Collège national des généralistes enseignants, 75013 Paris, France
| | | | - Rémy Boussageon
- Collège national des généralistes enseignants, 75013 Paris, France
| |
Collapse
|
4
|
Yokobori Y, Fukunaga A, Okawa S, Hachiya M, Nguyen CQ, Pham TPT, Hoang DV, Phan DC, Huynh DV, Le HX, Do HT, Mizoue T, Inoue Y. Sex differences in the association between socioeconomic status and untreated hypertension among residents with hypertension in rural Khánh Hòa, Vietnam: a post-hoc analysis. BMC Cardiovasc Disord 2024; 24:61. [PMID: 38245673 PMCID: PMC10799502 DOI: 10.1186/s12872-024-03706-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Several studies have examined the association between socioeconomic status (SES) and the proportion of untreated hypertension, but have produced conflicting findings. In addition, no study has been conducted to determine sex differences in the association between SES and untreated hypertension. Thus, the aim of this study was to examine whether the associations between SES and the proportion of untreated hypertension differed by sex in Vietnam. METHODS This study was conducted using the data of 1189 individuals (558 males and 631 females) who were judged to have hypertension during the baseline survey of a prospective cohort study of 3000 residents aged 40-60 years in the Khánh Hòa Province. A multilevel Poisson regression model with a robust variance estimator was used to examine whether sex and SES indicators (household income and educational attainment) interacted in relation to untreated hypertension. RESULTS The proportion of untreated hypertension among individuals identified as hypertensive was 69.1%. We found significant interaction between sex and SES indicators in relation to untreated hypertension (education: p < 0.001; household income: p < 0.001). Specifically, the association between SES and untreated hypertension was inverse among males while it was rather positive among females. CONCLUSIONS Our finding suggests that the role of SES in the proportion of untreated hypertension might differ by sex.
Collapse
Affiliation(s)
- Yuta Yokobori
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, Japan.
| | - Ami Fukunaga
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sumiyo Okawa
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, Japan
| | - Masahiko Hachiya
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, Japan
| | - Chau Que Nguyen
- Department of Non-communicable Disease Control and Nutrition, Pasteur Institute in Nha Trang, Nha Trang, Khánh Hòa, Vietnam
| | - Thuy Phuong Thi Pham
- Department of Non-communicable Disease Control and Nutrition, Pasteur Institute in Nha Trang, Nha Trang, Khánh Hòa, Vietnam
| | - Dong Van Hoang
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Danh Cong Phan
- Department of Non-communicable Disease Control and Nutrition, Pasteur Institute in Nha Trang, Nha Trang, Khánh Hòa, Vietnam
| | - Dong Van Huynh
- Khánh Hòa Center for Disease Control, Nha Trang, Khánh Hòa, Vietnam
| | - Huy Xuan Le
- Pasteur Institute in Nha Trang, Nha Trang, Khánh Hòa, Vietnam
| | - Hung Thai Do
- Pasteur Institute in Nha Trang, Nha Trang, Khánh Hòa, Vietnam
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
5
|
Silberzan L, Kelly-Irving M, Bajos N. [Analysing hypertension in France : A call for an intersectional approach of the cascade of care]. Rev Epidemiol Sante Publique 2023; 71:102159. [PMID: 37729691 DOI: 10.1016/j.respe.2023.102159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/28/2023] [Accepted: 08/28/2023] [Indexed: 09/22/2023] Open
Abstract
In metropolitan France, estimates suggest that more than one in three adults has hypertension. Low-cost treatments are available, yet fewer than one in four hypertensive adults has a controlled level of hypertension below 140/90 mmHg. This rate is higher in other high-income countries such as Canada (65%) or Germany (52%). Using a 'cascade of care' model, that decomposes the hypertension care continuum in awareness, treatment, and control, provides a better understanding of the origins of poor control. Furthermore, the theoretical framework of intersectionality, which simultaneously considers social positions of gender, class, and ethno-racial origin, could be used to understand the complexity of the social inequalities observed in hypertension-related outcomes. In this article we conducted a critical review of the international literature to identify new lines of analyses that could be applied to examine complex inequalities in France.
Collapse
Affiliation(s)
- L Silberzan
- Inserm-IRIS (UMR8156 - U997), Inserm, Aubervilliers, France; UMR1295, Toulouse III Université, Inserm, Equipe EQUITY, Equipe constitutive du CERPOP, Toulouse, France.
| | - M Kelly-Irving
- UMR1295, Toulouse III Université, Inserm, Equipe EQUITY, Equipe constitutive du CERPOP, Toulouse, France
| | - N Bajos
- Inserm-IRIS (UMR8156 - U997), Inserm, Aubervilliers, France
| |
Collapse
|
6
|
Social determinants of hypertension in high-income countries: A narrative literature review and future directions. Hypertens Res 2022; 45:1575-1581. [PMID: 35859023 PMCID: PMC9296364 DOI: 10.1038/s41440-022-00972-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/19/2022] [Accepted: 02/02/2022] [Indexed: 11/26/2022]
Abstract
Hypertension is a leading cause of cardiovascular disease and despite established strategies to lower blood pressure, the control of hypertension remains poor. This is true even in high-income countries with well-established welfare and medical systems. Among the social factors associated with hypertension (i.e., social determinants of hypertension, SDHT), individual socioeconomic status (SES), including education, income, and occupation, can be crucial for hypertension management (prevalence, awareness, treatment, and control). This article reviews the findings of recently published studies that examined the association between SES and hypertension management in high-income countries. It also discusses social prescribing, which targets social isolation and loneliness as modifiable SDHT to improve hypertension management. Conceptual framework of social determinants of hypertension![]()
Collapse
|
7
|
Yu S, Zhang Y. Improving patient adherence: the last obstacle to achieving hypertension control. Hypertens Res 2021; 44:725-726. [PMID: 33762739 DOI: 10.1038/s41440-021-00644-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/06/2021] [Accepted: 02/07/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Shikai Yu
- The Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yi Zhang
- The Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
| |
Collapse
|