title: [Prevalence of target organ damage in patients treated for primary arterial hypertension: Comparison between men and women. ESSENTIELLE study].
abstract: OBJECTIVE
  To compare the percentages of men and women treated for primary arterial hypertension presenting with at least one target organ damage; to identify factors associated with target organ damage and/or blood pressure control.
  
  
  METHODS
  Observational, transverse study carried out between March 2012 and July 2013 on a representative sample of 2666 outpatients (including 1343 men) consulting general practitioners (n=469) or cardiologists (n=250) in routine follow-up.
  
  
  RESULTS
  Characteristics "men vs. women" were: mean age (62.6 ± 11.6 vs. 57.4 ± 14.7 years; P<0.0001); ≥ 60 years (61.1% vs. 43.9%; P<0.0001); waist circumference (98.9 ± 12.2 vs. 89.4 ± 14.3 cm; P<0.0001); SBP (146.5 ± 16.1 vs. 145.8 ± 17.0 mmHg; NS); DBP (85.1 ± 10.3 vs. 84.2 ± 10.4; P=0,03). Target organ damage was more frequent in men (37.6% vs. 22.9%; P<0.0001), whether it was subclinical (20.4% vs. 13.6%; P<0.0001) or documented (26.3% vs. 13.5%; P<0.0001); some patients presented with both types of damages. Men developed more often microalbuminuria (6.5% vs. 4.3%; P=0.01) and LVH (16.3% vs. 10.5%; P<0.0001); some patients presented with both types of subclinical injuries. Target organ damage was more common in men without regular physical activity than in those exercising regularly (42.1% vs. 32.5%; P=0.0004). Regular exercises had no effect in women (24.1% vs. 21.3%). For both sexes, other factors associated with target organ damage were: age ≥ 60 years, myocardial infarction/sudden death in family history, LDL-cholesterol ≥ 1.60 g/L, HDL-cholesterol ≤ 0.40 g/L. Stroke before 45 years in family history was a predictive factor in women. Hypertension was controlled in one third of patients without difference between sexes. In women, hypertension was less often controlled in case of excessive alcohol consumption compared to normal alcohol intake (17.9% vs. 36.1%; P=0.0007); this factor had no effect in men (28.1% vs. 32.6%). Other factors associated with poor blood pressure control were: BMI (P=0.002), LDL-cholesterol ≥ 1.60 g/L in women. In men, the factors were: tobacco, presence of LVH, absence of physical activity, HDL-cholesterol ≤ 0.40 g/L, absence of diet.
  
  
  CONCLUSIONS
  In a hypertensive population, target organ damage is more common among men despite similar blood pressure control rates for both sexes.
authors.affiliation: Département de médecine générale de Nancy, université de Lorraine, 54505 Vandœuvre-lès-Nancy cedex, France; CIC-P Inserm, Meurthe et Moselle, CHU de Nancy, 54500 Vandœuvre-lès-Nancy, France. Electronic address: jm.boivin@chu-nancy.fr.
authors.forename: J-M
authors.initials: JM
authors.lastname: Boivin
authors.affiliation: Daiichi Sankyo, 92500 Rueil-Malmaison, France.
authors.forename: C
authors.initials: C
authors.lastname: Koch
authors.affiliation: Daiichi Sankyo, 92500 Rueil-Malmaison, France.
authors.forename: L
authors.initials: L
authors.lastname: Vigié
authors.affiliation: Département biométrie, ITEC Services, 33150 Cenon, France.
authors.forename: L
authors.initials: L
authors.lastname: Meppiel
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D058958:Organs at Risk; D015995:Prevalence; D012737:Sex Factors
keywords: Atteinte des organes cibles; Gender; Genre; Hypertension; Target organ damage