Determinants of hypertension control in a large French population of treated hypertensive subjects.

Only a minority of all hypertensives is well controlled in the population. In order to assess the proportion of well controlled hypertensives and the factors associated with hypertension control in France, we designed an observational cross-sectional epidemiological study in a population of 4702 treated adult hypertensives selected by general practitioners: EPISTRAT. This hypertensive treated population presented the following characteristics (mean+/-standard deviation): age: 60+/-12 years; blood pressure: 151+/-16/87+/-10 mmHg; men: 58%; body mass index: 27+/-5 kg/m2; diabetes mellitus: 12%; subjects in secondary cardiovascular prevention: 14%. Half of the patients presented two or more CV risk factors in addition to hypertension. Forty-eight per cent of the subjects were treated with antihypertensive monotherapy, 31% with bitherapy and 21% with more than two drugs. Patients with controlled hypertension (<140/90 mmHg) represented "only" 18% of the population. Multivariate analysis showed that male gender and advanced age were the two main variables independently associated with poor blood pressure control. Finally, the majority of patients experienced at least one antihypertensive treatment modification, mainly for insufficient therapeutic effect. In conclusion, this study has shown poor blood pressure control in a primary care-recruited population, especially in males and in the elderly.