[Management of essential arterial hypertension and cardiovascular risk levels. Observation in general medicine: national PHENOMEN study. Evaluation and stratification of cardiovascular risk based on the 2000 ANAES recommendations in a population of hypertensive patients].
OBJECTIVE
To define the prevalence of cardiovascular risk (CVR) levels in a population of hypertensive patients (whether treated or not) monitored by General Practitioners, using the stratification system proposed by the ANAES in 2000.


METHODS
Between January and July 2001, a nation-wide survey was carried out based on a representative sample of 8,177 General Practitioners spread evenly throughout all of the 22 administrative regions in France. The evaluation of CVR levels took into account blood pressure readings as well as CVR factors and indicators.


RESULTS
This survey covered 16,358 patients (53.2% men, 46% women; mean age = 62.5 +/- 11.9 years; BMI = 27.3 +/- 4.5 kg/m2) with a mean history of hypertension of 7 +/- 7 years. The most common CVR factors were dyslipidemia (59.5%), smoking (19%) and diabetes (16%). Concomitant target organ damage was recorded in 17% and heart disease in 21.8%. One patient in four had more than three CVR factors; respectively 56.5%, 30.9% and 12.5% of the patients had mild, moderate or severe hypertension. More than 50% of the patients were classified as being at "high" or "very high" CV risk. The distribution of risk levels was similar throughout the country with a North-South gradient of the high/very high levels. Only 17% of the patients being treated had completely normal blood pressure (< 140/190 mmHg), although 19% more count as normal if the limit values are included.


CONCLUSIONS
The main objective of this large-scale, nation-wide epidemiological survey was to evaluate how well CVR is being managed in a representative sample of patients with high blood pressure. In general, none of the risk factors is adequately controlled, especially in populations considered as being at high CVR. Moreover, the notion of CVR has only been partially assimilated by General Practitioners.
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000209:etiology*; D016021:Epidemiologic Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family; D012307:Risk Factors
D000959:Antihypertensive Agents
Prise en charge de l'HTA essentielle et du niveau de risque cardiovasculaire. Observatoire en médecine générale: enquête nationale PHENOMEN. Evaluation et stratification du risque cardiovasculaire selon les recommandations de l'ANAES 2000 dans une population d'hypertendus.