What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=1925). Primary outcome: Hypertension prevalence, treatment, and control rates.

What does this research mean for the field?

Blood pressure control among hypertensive patients managed in general practice is substantially better than rates observed in the general population, suggesting that systematic annual primary care consultations could improve overall hypertension detection and control. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

September 13, 2024

Necessity of a systematic annual consultation in primary care to better improve detection and control of hypertension?

Key Result

In a primary care setting, 33.6% of subjects aged 40-65 were hypertensive, of whom 63.5% were treated and 39.0% were treated and controlled.

Study Design

Type

Cross-Sectional (n=1,925)

Multicenter

Structured PICO

Population

1,925 subjects aged 40 to 65 years in a rural health centre (Domfront, Normandy, France)

Outcome

Hypertension prevalence, treatment, and control ratessurrogate

In a rural primary care setting, hypertension control rates (39.0%) appear better than general population estimates, suggesting the potential benefit of systematic annual consultations for untreated individuals.

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.

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