title: Epidemiological Trial of Hypertension in North Africa (ETHNA): an international multicentre study in Algeria, Morocco and Tunisia.
abstract: OBJECTIVE
  Inhabitants of developing countries such as those in North Africa have experienced lifestyle changes that have increased the risk of cardiovascular disease. The aim of the Epidemiological Trial of Hypertension in North Africa (ETHNA) was to evaluate the prevalence and clinical profile of hypertension in a large sample of individuals in North Africa.
  
  
  METHODS
  This was an international, multicentre, epidemiological, cross-sectional study conducted in patients consulting primary care physicians in Algeria, Tunisia and Morocco. Data were collected via a medical examination and questionnaire covering patient demographics, medical history and cardiovascular risk factors. Associations between hypertension and patient characteristics were determined using conventional parametric statistical tests.
  
  
  RESULTS
  In total, 28,500 individuals attending primary care physicians participated in this study: 41.8% from Algeria, 37.6% from Morocco and 20.6% from Tunisia. Mean age was 49.2 ± 16.8 years. The total prevalence of hypertension was 45.4% [95% confidence interval (CI) 44.8-46.0]; 29.0% of patients with hypertension were newly detected at the study visit. When adjusted for age and sex, the overall prevalence of hypertension was 26.9% (95% CI 26.4-27.4). Overall, 88.0% of the patients with hypertension were receiving or were newly prescribed antihypertensives (history of hypertension, 91.2%; newly detected, 80.3%). Among patients with a history of hypertension receiving antihypertensives at the study visit, only 35.7% had controlled hypertension.
  
  
  CONCLUSIONS
  This study suggests that the prevalence of hypertension in North Africa is high. Hypertension may also be underdiagnosed and ineffectively treated. Greater awareness and improved management of hypertension and cardiovascular risks are needed in this region.
authors.affiliation: Laboratoire d'Épidémiologie et de Recherche Clinique, Faculté de Médecine et de Pharmacie, Fès, Morocco.
authors.forename: Chakib
authors.initials: C
authors.lastname: Nejjari
authors.forename: Mohammed
authors.initials: M
authors.lastname: Arharbi
authors.forename: Mohand-Tayeb
authors.initials: MT
authors.lastname: Chentir
authors.forename: Rachid
authors.initials: R
authors.lastname: Boujnah
authors.forename: Omar
authors.initials: O
authors.lastname: Kemmou
authors.forename: Hafedh
authors.initials: H
authors.lastname: Megdiche
authors.forename: Fadhila
authors.initials: F
authors.lastname: Boulahrouf
authors.forename: Karima
authors.initials: K
authors.lastname: Messoussi
authors.forename: Laila
authors.initials: L
authors.lastname: Nazek
authors.forename: Vladimir
authors.initials: V
authors.lastname: Bulatov
mesh_terms: D000328:Adult; D000352:Africa, Northern / Q000453:epidemiology; D000368:Aged; D000462:Algeria / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009018:Morocco / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014416:Tunisia / Q000453:epidemiology