Prevalence and therapeutic control of hypertension in French Caribbean regions

OBJECTIVE: To describe characteristics of hypertension in French Caribbean regions. DESIGN: A cross-sectional worksite study. SETTING AND PARTICIPANTS: A random sample of 6136 workers referred for annual check-up from Martinique, French Guyana and Guadeloupe. An average of three consecutive measurements was taken as the blood pressure (BP) level. An additional visit was required in subjects not taking antihypertensive medications with an average BP over 140/90 mmHg. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Hypertension prevalence, awareness, treatment and control. RESULTS: The age-specific prevalence of hypertension, based on two visits, increased from 3.2% in men below 30 years to 46.9% in those older than 50 years. The corresponding values found in women were 1.8 and 42.6%. The overall prevalence was 19.5% in men and 18.9% in women. The rate of awareness remained low while age increased. The use of antihypertensive medications slowly increased with age, but overall the rate remained lower in men compared with women. Up to 71% of hypertensive women received antihypertensive medications. Compared with previous studies, a high proportion of adequately treated patients was found among women (44.9%). Only 30.4% of hypertensive men were treated, and as a result the control rate was lower (13.3%). CONCLUSION: Major sex-related differences are found in the control of high BP, with an unexpected high rate observed among Caribbean women. Better awareness and higher treatment rates play an important role in explaining such results. This may be important, especially in developing countries, where poor control of hypertension is a major cause of cardiovascular diseases.