PREVALENCE OF THE CLINICAL FEATURES OF HYPERTENSION FOLLOWS THE EUROPEAN CARDIOVASCULAR DISEASE GRADIENT: 7C.05:

Objective: To estimate the regional prevalence of 3 clinical features (familial, metabolic, vascular) of essential hypertension, either alone or in combination, in French hypertensive patients followed-up by cardiologists. Methods: A cross-sectional survey included subjects with essential hypertension and office BP ≥140/90 mmHg (or ≥130/80 mmHg if diabetes or renal insufficiency). They were stratified according to the presence/absence of ≥1 antihypertensive drug. At analysis, each hypertension was classified in clinical features: familial (antihypertensive treatment initiated <50 years); metabolic (abdominal obesity and/or diabetes); vascular (pulse pressure ≥65 mmHg). Results: 356 cardiologists recruited 1706 hypertensive patients (834 untreated and 872 treated but uncontrolled). Prevalence of each clinical feature, alone or in combination, did not depend on treatment. ≥63% of the patients had vascular hypertension at least; 53 to 61%, metabolic one at least; 23%, familial one at least. 11% of the patients had no classifying characteristic. Vascular hypertension was independent of geography. Familial hypertension was predominant in the North of the country (OR = 1.7, p < 10–4) and metabolic hypertension, in the East (OR = 1.5, p < 10–3). Unclassified patients were more frequent in the South (OR = 1.6, p < 10–2). Conclusion: Essential hypertension is divided in clinical features, which follows differently the European CV gradients. Prevalence of familial hypertension in the North suggests a genetic pattern in the CV diseases and prevalence of metabolic hypertension in the East, a behaviour pattern.