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Health-related determinants of undiagnosed arterial hypertension: a population-based study

Abstract : Abstract BACKGROUND: Undiagnosed arterial hypertension is frequent. Whether it is associated with gender and the absence of cardiovascular-disease warning signs is unknown. Knowledge of the features of undiagnosed-hypertension subjects may help their identification in primary care. OBJECTIVE: To examine whether gender, alcohol consumption, smoking status, health status, cardiovascular diseases/diabetes, familial hypertension history, anti-cholesterol treatment, GP-consultation frequency, body mass index (BMI), waist circumference and metabolic measurements were associated with having undiagnosed hypertension among hypertensive subjects. METHODS: This population-based study included 281 hypertensive adults (aged 50-76 years): 222 subjects with diagnosed and treated-hypertension and 59 undiagnosed-hypertension subjects (no hypertension history, office and 24-h ambulatory blood pressures ≥140/90 and ≥130/80 mmHg, respectively). Subjects' characteristics, clinical and biological measurements, health problems and blood pressures were collected. Data were analyzed using adjusted odds ratios (OR) computed with multivariable logistic regression models. RESULTS: Undiagnosed-hypertension represented 21% of hypertensive subjects. Multivariable logistic regression modeling showed that five risk factors were associated with undiagnosed-hypertension among hypertensive subjects: male gender (OR = 4.61, P < 0.001), no cardiovascular diseases/diabetes (OR=8.51, P < 0.001), no familial hypertension history (OR = 3.15, P = 0.002), number of GP consultations per year (3+, 1-2, and 0; OR = 3.18 per 1-category increase, P < 0.001), and lower waist circumference (OR = 1.05 per 1-cm decrease, P = 0.002). Living alone, alcohol consumption, health status, anti-cholesterol treatment, BMI, and blood glucose were also significant factors (P < 0.05) in bivariate analysis. CONCLUSION: Undiagnosed-hypertension subjects exhibit specific features associated with their hypertension awareness. These findings help understand undiagnosed-hypertension risk patterns and enable better identification of affected subjects for lifestyle management and care. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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https://hal.univ-lorraine.fr/hal-02509511
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Submitted on : Monday, March 16, 2020 - 7:08:21 PM
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Kénora Chau, Nicolas Girerd, Faiez Zannad, Patrick Rossignol, Jean-Marc Boivin. Health-related determinants of undiagnosed arterial hypertension: a population-based study. Family Practice, Oxford University Press (OUP): Policy B - Oxford Open Option D, 2019, 36 (3), pp.276-283. ⟨10.1093/fampra/cmy075⟩. ⟨hal-02509511⟩

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