title: Determinants of blood pressure treatment and control in obese people:  evidence from the general population.
abstract: OBJECTIVE
  We assessed hypertension prevalence, blood pressure (BP)-lowering treatment and control in obese adults compared with lean/normal-weight individuals in France.
  
  
  METHODS
  Multistage stratified random sample of 2075 adults from the French Nutrition and Health Survey (ENNS), a cross-sectional national survey carried out in 2006-2007. BP was measured three times on the left arm using an automatic device. Weight and height were assessed using standardized methods to compute body mass index (BMI, kg/m(2)). BP-lowering drugs were self-reported. BP control was defined as SBP/DBP less than 140/90 among hypertensive individuals.
  
  
  RESULTS
  As anticipated, mean SBP and DBP increased significantly across BMI categories (P for trend <0.0001). The age-adjusted and sex-adjusted prevalence of hypertension also increased across the same categories (15.7, 24.7 and 56.9%, respectively, P < 0.001). Among hypertensive individuals, obese participants were more likely to receive BP-lowering drugs compared with their lean/normal weight counterparts (P = 0.02). However, independently of age, smoking status and alcohol intake, obesity was associated with a 62% lower risk of BP control (OR: 0.38, 95% CI: 0.19-0.75) compared with the lean/normal-weight status.
  
  
  CONCLUSIONS
  Although hypertension was much more prevalent in the obese compared with overweight and lean/normal-weight individuals, uncontrolled hypertension was also more frequent despite a higher rate of treatment. To some extent, this observation may probably be the consequence of obesity and its complex pathophysiology, more than to an inadequate therapeutic decision by clinicians.
authors.affiliation: Department of Nutrition, Assistance Publique-Hôpitaux de Paris, Hôpital A Paré, Université Versailles St-Quentin, Boulogne, France. sebastien.czernichow@apr.aphp.fr
authors.forename: Sébastien
authors.initials: S
authors.lastname: Czernichow
authors.forename: Katia
authors.initials: K
authors.lastname: Castetbon
authors.forename: Benoit
authors.initials: B
authors.lastname: Salanave
authors.forename: Michel
authors.initials: M
authors.lastname: Vernay
authors.forename: Yaya
authors.initials: Y
authors.lastname: Barry
authors.forename: George D
authors.initials: GD
authors.lastname: Batty
authors.forename: Serge
authors.initials: S
authors.lastname: Hercberg
authors.forename: Jacques
authors.initials: J
authors.lastname: Blacher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D015992:Body Mass Index; D001835:Body Weight; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D015995:Prevalence; D012189:Retrospective Studies; D057566:Self Report; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents