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Changes in prevalence, awareness, treatment and control of hypertension in disadvantaged French Caribbean populations, 2003 to 2014

Journal of Human Hypertension volume 31, pages 596–601 (2017)Cite this article

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Abstract

In 2003, the PHDG (Prevalence of Hypertension among Disadvantaged Guadeloupeans) study highlighted poor management of hypertension in an unemployed French Caribbean population. New processes of health-care coordination and a pay-for-performance system have since been developed. We aimed to assess changes in hypertension characteristics in disadvantaged French Caribbean populations in the last 10 years. Using PHDG 2003 data, in 2014 we undertook a cross-sectional study with identical methods. The source population comprised all Guadeloupeans having undergone periodic heath checks offered by the Social Security insurance at these dates. Only universal health coverage beneficiaries (i.e. in situations of poverty) aged 18–64 were included (2014 in 2014, 1868 in 2003). Hypertension was defined by antihypertensive treatment or a mean of two blood pressure measures ⩾140/90 mm Hg. The 2003 and 2014 data were age adjusted; comparative morbidity factors (CMF) and 95% confidence intervals were calculated to assess changes over time. Hypertension prevalence decreased from 38.3 to 34.5% (CMF 95% CI: 0.83–0.97). The increase in hypertension awareness was greater for women (from 48.3 to 55.3%, CMF 95% CI: 1.00–1.31) than for men (from 28 to 31.1%, NS). Among hypertensive individuals aware of their condition, proportions of those treated increased for women (from 83.1 to 88.3%, NS) but decreased for men (from 80.2 to 75.8%, NS). Controlled hypertension among treated patients increased in women (from 35.2 to 49.2%, CMF 95% CI: 1.07–1.82) and men (from 12.9 to 30.1%, CMF 95% CI: 1.30–4.21). In conclusion, in these poor French Caribbean populations with theoretically adequate access to care, hypertension control remained far below national goals. Neither awareness nor treatment had improved in men.

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Acknowledgements

We would like to thank the personnel of the Guadeloupean Association for the Management and Conduct of Health Examinations and the Promotion of Health (AGREXAM); the Social Security fund of Guadeloupe; Mr Gauthier Chassang, legal counsel; the HTA-Gwad network; the Regional Union of Health Professionals and Private Practitioners of Guadeloupe, General Practice section. This study was funded by the Social Security fund and the Regional Union of Private Practitioners of Guadeloupe.

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Authors and Affiliations

  1. Department of General Medicine, University of the French West Indies and Guiana, Guadeloupe, France

    P Carrère & N Halbert

  2. Laboratory of Epidemiology and Analysis in Public health, UMR1027 INSERM, University of Toulouse III Paul Sabatier, Toulouse, France

    P Carrère, S Lamy, J Inamo & T Lang

  3. Guadeloupean Association for the Management and Conduct of Health Examinations and the Promotion of Health (AGREXAM), Guadeloupe, France

    P Carrère & N Halbert

  4. Department of clinical Pharmacology, Toulouse University Hospital, Toulouse, France

    S Lamy

  5. Department of Cardiology, University of the French West Indies and Guiana, Martinique, France

    J Inamo

  6. Cardiology Unit, Hospital of Basse-Terre, Guadeloupe, France

    A Atallah

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  1. P Carrère
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Correspondence to P Carrère.

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Carrère, P., Halbert, N., Lamy, S. et al. Changes in prevalence, awareness, treatment and control of hypertension in disadvantaged French Caribbean populations, 2003 to 2014. J Hum Hypertens 31, 596–601 (2017). https://doi.org/10.1038/jhh.2017.24

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