[Causes of uncontrolled hypertension. DUO-HTA survey].
OBJECTIVE
To identify the socio-demographic, clinical, psycho-behavioural and therapeutic factors explaining uncontrolled blood pressure in a population of hypertensives in ambulatory practice.


METHODS
The DUO-HTA survey is a national, cross-sectional, mirrored, observational study, from a representative sample of 347 general practitioners (MG) and 210 cardiologists, and a population of 2022 hypertensive patients followed by these doctors. The data were collected by means of questionnaires completed by the hypertensives and their doctors.


RESULTS
The factors significantly discriminating patients for whom BP was controlled (C) from those patients whose BP was not controlled (NC) were an age less than 65 years, smoking, obesity, alcohol consumption, sedentary lifestyle and multiple anti-hypertensive treatment. On the psycho-behavioural front, the NC patients were more often anxious and irritable, claiming to lead a stressful life and for whom hypertension was often perceived as a "foreign entity" and a source of frustration and multiple deprivations. The factors discriminating the NC doctors from the C doctors were essentially psycho-behavioural, with the NC doctors considering the management of hypertension as being less gratifying, and hypertension as a condition with fluctuating progression, poorly understood and dramatized by patients.


CONCLUSIONS
The DUO-HTA survey underlines the weight of reciprocal representation systems in hypertension for patients and their doctors, as well as the quality of the doctor-patient relationship in blood pressure control. It prompts the development of sensitisation actions for practitioners centered on improving the doctor-patient relationship.
Service de pharmacologie, Inserm EMI 0107, Hôpital Européen Georges-Pompidou. stephane.laurent@egp.ap-hopparis.fr
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Laurent
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Consoli
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Girerd
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Thomas
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Amouyel
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Levy
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Pouchain
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004351:Drug Resistance; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012307:Risk Factors; D013315:Stress, Psychological
D000959:Antihypertensive Agents