INFLUENCE OF GLOBAL CARDIOVASCULAR RISK ASSESSMENT ON THE MANAGEMENT OF HYPERTENSION IN SOUTHWESTERN FRANCE

1 160 subjects aged 35-64 years were recruited by the Haute-Garonne MO NICA center, and selected by stratified randomization on age and size of home area. The hypertensive group included: 176 subjects newly diag nosed as hypertensives (blood pressure greater than or equal to 140/90 mmHg), 86 known but untreated hypertensives and 178 hypertensives und er treatment. For each subject a score of coronary heart disease risk based on the Framingham point score probability algorithm was calculat ed. The prevalence of hypertension was 37,9 %. Among the 440 subjects considered as hypertensives, 60 % were aware of having hypertension. O nly 30 % of the 178 patients treated achieved blood pressure control. The population as a whole was at low coronary heart disease risk (< 5 % at 10 years); the groups at higher risk were newly diagnosed hyperte nsives and treated hypertensives. Among known hypertensives, the risk level was higher in treated compared with untreated. In this survey 1) the prevalence of hypertension was high; 2) only 30 % of treated hype rtensives were below 140/90 mmHg; 3) usual care failed to recognize 40 % of hypertensives at same risk level as treated ones; 4) treated hyp ertensives had higher coronary heart disease risk than untreated known hypertensives. The hypertension therapeutic strategy could be based o n the reduction of blood pressure below the threshold 140/90 mmHg rath er than on the absolute cardiovascular risk.