BMC Cardiovascular Disorders (Mar 2022)

Epidemiologic features and management of hypertension in Tunisia, the results from the Hypertension National Registry (NaTuRe HTN)

  • Leila Abid,
  • Rania Hammami,
  • Ikram Chamtouri,
  • Meriam Drissa,
  • Selim Boudiche,
  • MohamedAmine Bahloul,
  • Hedi BenSlima,
  • Khaled Sayahi,
  • Selma Charfeddine,
  • Emna Allouche,
  • Lamia Rais,
  • Badr Kaab,
  • Hassen IbnHadjamor,
  • Lilia BenFatma,
  • Riadh Garbaa,
  • Sabrine Boukhris,
  • Manel Ben Halima,
  • Nesrine Amdouni,
  • Chaima Ghorbel,
  • Sabrine Soudani,
  • Imen Khaled,
  • Syrine Triki,
  • Feten Bouazizi,
  • Imen Jemai,
  • Ouday Abdeljalil,
  • Yemna Ammar,
  • Amani Farah,
  • Adnen Neji,
  • Zeineb Oumayma,
  • Sana Seghaier,
  • Samir Mokrani,
  • Hamza Thawaba,
  • Hela Sarray,
  • Khalil Ouaghlani,
  • Houssem Thabet,
  • Zeineb Mnif,
  • Fatma Boujelban,
  • Mohamed Sghaier,
  • Roueida Khalifa,
  • Sami Fourati,
  • Yasmin Kammoun,
  • Syrine Abid,
  • Chihab Hamza,
  • Syrine Ben Jeddou,
  • Lassaad Sabbah,
  • Rim Lakhdhar,
  • Najla Dammak,
  • Tarek Sellami,
  • Basma Herbegue,
  • Alia Koubaa,
  • Faten Triki,
  • Tarek Ellouz,
  • Aicha Hmoudi,
  • Ikhlas BenAmeur,
  • MohamedMongi Boukhchina,
  • Neila Abid,
  • Wejdene Wachtati,
  • Nizar Nasrallah,
  • Yousra Houidi,
  • Fathia Meghaieth,
  • Elhem Ghodhbane,
  • Mounira Chayeb,
  • Sarra Chenik,
  • Samira Kaabachi,
  • Nizar Saadaoui,
  • Ines BenAmeur,
  • Moufida Affes,
  • Sana Ouali,
  • Mouna Chaker,
  • Hela Naanaa,
  • Meriem Dghim,
  • Mourad Jarrar,
  • Jihene Mnif,
  • Ahmed Turki,
  • Ihsen Zairi,
  • Jamel Langar,
  • Safa Dardouri,
  • Imen Hchaichi,
  • Rafik Chettaoui,
  • Wajih Essmat,
  • Amel Chakroun,
  • Khadija Mzoughi,
  • Rachid Mechmeche,
  • Afef BenHalima,
  • Sahar BenKhala,
  • Slim Chtourou,
  • Abdelkader Maalej,
  • Mohsen Ayari,
  • Moufid Hadrich,
  • Rami Tlili,
  • Fares Azaiez,
  • Imen Bouhlel,
  • Samira Sahnoun,
  • Habib Jerbi,
  • Imtinene BenMrad,
  • Leila Riahi,
  • Mohamed Sahnoun,
  • Abdelhamid BenJemaa,
  • Amel BenSalem,
  • Bassem Rekik,
  • Maroua BenDoudou,
  • Rachid Boujneh,
  • Anissa Joulak,
  • Yosra Mejdoub,
  • Imen Gtif,
  • Gouider Jribi,
  • Elyes Naffeti,
  • Habib Gamra,
  • Soraya BenYousef,
  • Wissem Sdiri,
  • Najeh BenHalima,
  • Youssef BenAmeur,
  • Salem Kachboura,
  • Sondes Kraiem,
  • Wafa Fehri,
  • Leila Bazdeh,
  • MohamedSami Mourali,
  • Sami Milouchi,
  • Habiba Drissa,
  • Faouzi Maatouk,
  • Lilia Zakhama,
  • Faouzi Addad,
  • Samir Kammoun,
  • Salem Abdesselem

DOI
https://doi.org/10.1186/s12872-022-02584-y
Journal volume & issue
Vol. 22, no. 1
pp. 1 – 12

Abstract

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Abstract Background Hypertension is the leading cause of morbi-mortality in our country. Thus, we conducted this national survey on hypertension to analyze the profile of the Tunisian hypertensive patient and to assess the level of blood pressure control. Methods Nature HTN is an observational multicentric survey, including hypertensive individuals and consulting their doctors during the period of the study. Blood pressure measurements were conducted during consultation, using a standardized auscultatory or oscillometric sphygmomanometer after at least 15 min of rest. The diagnosis of new hypertension is based on the 2018 ESC/ESH criteria. The primary endpoint of our study was uncontrolled hypertension defined by a systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Results Three hundred twenty-one investigators participated in the study. We enrolled 25,890 patients with a female predominance (Sex ratio, 1.21) and an average age of 64.4 ± 12.2 years. Most individuals were treated in the public sector (74%), 39.4% of patients were diabetic, 25.8% were obese, 44.6% were overweight and 14% were smokers. Hypertension was controlled in 51.7% of cases if we consider 140/90 as a BP target, and only in 18.6% if we consider 130/80 as a target. The independent predictors of uncontrolled blood pressure were male sex (OR = 1.09, 95%CI [1.02–1.16]), age > 65 year-old (OR = 1.07, 95% CI[1.01–1.13], diabetes (OR = 1.18, 95% CI [1.11–1.25], Smoking (OR = 1.15, 95% CI [1.05–1.25]), Obesity (OR = 1.14, 95% CI[1.07–1.21]), management in public sector (OR = 1.25, 95% CI [1.16–1.34]), and Heart rate > 80 bpm (OR = 1.59, 95% CI [1.48–1.71]). Contrarily, high educational level (OR = 0.9, 95% CI [0.84–0.97], absence of history of coronary disease (OR = 0.86, 95% CI [0.8–0.93]), salt restriction (OR = 0.48, 95% CI [0.45–0.51]), drug compliance (OR = 0.57, 95% CI[0.52–0.61]), and regular physical activity (OR = 0.77, 95% CI[0.71–0.84]) are strong predictors of blood pressure control. Conclusion NaTuRe HTN showed that blood pressure control was reached in more than half of the Tunisian people. The control remains low in patients with high cardiovascular profiles and in those treated in the public sector. A national health program based on therapeutic education, regular control and continuous support to the public institutions is needed to decrease the burden of hypertension incidence rate.

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