PREVALENCE, TREATMENT AND CONTROL OF HIGH -BLOOD-PRESSURE IN PATIENTSTREATED BY GENERAL-PRACTITIONERS IN FRANCE DURING 1994

The aim of this study was to measure the percentage of patients with h ypertension, treated hypertension and controlled hypertension, using d ata collected over one week by 235 general practitioners well represen tative of the French medical population and selected by SOFRES Medical . Practitioners had to carry out their own survey over a period of one week on all patients above 18 years of age who visited their office. They were initially instructed to use the same type of mercury sphygmo manometer, equiped with the same pneumatic cuffs of different sizes. T hree consecutive blood pressure measurements were effected, the last t wo were recorded. Patients were considered as hypertensive if the mean of the two recorded BP measurements was greater than or equal to 140- 90 mmHg, or <140-90 mmHg under pharmacological treatment. Hypertensive patients were considered as controlled when their blood pressure leve ls were overall <140-90 mmHg under treatment. According to age, two ot her control levels were analysed: blood pressure <160-95 mmHg before 6 5 years and blood pressure <160-90 mmHg at 65 years or more. Among 123 51 patients, 5020 are hypertensive (4%), 2985 under pharmacological tr eatment (59%) and 2035 without treatment (4%). Among untreated patient s, 9% had an hypertension above the borderline values. Before 65 years , 28% had an under treatment blood pressure <140-90 mmHg and 71% <160- 95 mmHg. Among 65 years or more hypertensive patients, 21% had an unde r treatment blood pressure <140-90 mmHg and 60% <160-90 mmHg. Before 6 5 years, 25% among patients with a monotherapy remained with a blood p ressure >160-95 mmHg and 34% with a blood pressure >160-90 mmHg among those of 65 years or more; 230 patients (5%) remained in high risk wit h a blood pressure greater than or equal to 180-105 mmHg, 176 untreate d and 54 despite their treatment. This study carried out in French med ical practice yield two main conclusions regarding the management of h ypertension : as the prevalence of hypertensive patients is 41% : one patient out of two, high blood pressure has to be a main aim for the m edical teaching. Even if a reasonable control of the blood pressure is achieved in most cases, blood pressure got a normal level for 24% onl y of treated hypertensive patients and too many patients were keeping high risk because they have been not or not enough treated. This study , as a real audit, gives some useful informations to general practitio ners in order to improve their scores.