title: [Severe hypertension: definition and patients profiles].
abstract: Severe arterial hypertension gathers relatively different clinical situations explained by the heterogeneity of the definitions of this clinical setting. From a medical point of view, severe hypertension is a short course situation defined by very high values of blood pressure corresponding to grade 3 hypertension. In France, until 2011, the social security also included in the definition of severe HTA chronic situations characterized by moderate blood pressure values requiring at least triple anthihypertensive therapies associated with a clinical or infraclinical target organ damages. These clinical profiles, much more frequent than grade 3 hypertension, allowed the full reimbursement of care costs for these patients. In France, it is estimated that 10% of hypertensive patients present a severe form with an annual incidence of 50,000 patients. The patients with severe hypertension have an increased cardiovascular morbidity justifying a closer clinical monitoring. From an economic point of view, these severe forms of hypertension have a higher cost of care, explained primarily by a more frequent need of specialized referrals, radiological exams and hospitalizations. This excess cost justified the existence of a full coverage of induced costs by the social security, since the incidence of severe hypertension is more frequent in the low social categories, and in patients with economic fragility.
authors.affiliation: Service de médecine interne et unité HTA, CHU Avicenne, AP-HP, 93000 Bobigny, France. jean-jacques.mourad@avc.aphp.fr
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Mourad
mesh_terms: D003935:Diagnostic Techniques, Cardiovascular; D017048:Health Care Costs; D006801:Humans; D006974:Hypertension, Malignant / Q000145:classification / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology*; D009017:Morbidity; D012720:Severity of Illness Index; D012959:Socioeconomic Factors