Incidence de l’hypertension artérielle dans la population française de plus de 60 ans

ObjectiveTo evaluate incidence and determinants of arterial hypertension after 60 years.MethodsFour thousand nine hundred and forty one subjects aged 60 years or above (2505 men: 64.2 ± 4.2 years; 2436 women: 64.8 ± 4.3 years) were explored two times at the IPC center, Paris, between 1992 and 2007, and were normotensive at the first visit (V1): systolic BP (SBP) less than 140 mmHg and diastolic BP (DBP) less than 90 mmHg without treatment. The delay between the two visits was 5.8 ± 2.2 years. At the second visit, population was analysed as normotensives and hypertensives. An age-adjusted Anova compared groups.ResultsIn men, incidence of hypertension is 41.5% and 25.9% for isolated systolic hypertension. In women, incidences were 37.8% and 27.8% respectively. Baseline characteristics for V2-hypertensives showed higher SBP, DBP, BMI, heart rate, glycemia, ECG abnormalities thanV2-normotensives but they had lower physical activity. The determinants of hypertension were: SBP, age, BMI, DBP, glycemia, and lack of physical activity for this age class.ConclusionFrom 60 years old, 6-year incidence of hypertension is about 40% and 26% for isolated systolic hypertension, this latter being higher in women. Regular physical activity is protective.     

Représentations de l’hypertension artérielle : étude exploratoire en France

Aim of the studyNon-adherence to treatment is one of the problems practitioners face with regard to hypertension. This lack of compliance is often attributed to disease representations. Understanding their nature can therefore help to better target therapeutic education messages and thus, increase compliance.MethodIt is in this context that the « groupe infirmiers et acteurs de la SFHTA » initiated a qualitative exploratory study of the representations of arterial hypertension in France. The study covered three sites: Bordeaux, Lyon and Nancy. Interviews with patients were conducted by the members of the group. Questions included the disease definition, its causes and consequences. The interviews were recorded and transcribed verbatim; they were analyzed with Nvivo pro® 11 software.ResultsHTA is discovered accidentally. Patients define the disease according to their experience of symptoms, their perceptions of risks and the disease's consequences. The thresholds of systolic and diastolic blood pressure are unknown; most of the patients ignore their levels of both systolic and diastolic blood pressure. Besides, the fluctuating levels of blood pressure and conflicting messages about “lifestyle” generate confusion. HTA remains associated with stress. Regarding the burden of the disease, having to take a daily medication engendered anxieties, before being integrated into daily routines. The study also showed that patients have the desire to “pay attention” to their diet primarily.ConclusionThis study showed the need to strengthen the training of health professionals and harmonize educational messages, which would allow patients to integrate new recommendations without stress.