Abstract
Objective: Cardiovascular and renal diseases and dementia constitute major hypertension-related conditions and have a high burden for public health. The aim of our study was to estimate the burden of these diseases attributable to hypertension in France by providing the number of hospital stays and deaths attributable to hypertension in 2017. Design and method: Age- and sex-specific attributable fractions were calculated by combining relative risks extracted from the literature with the prevalence of hypertension (defined as a systolic blood pressure higher than 140mmHg) estimated in the Esteban Study, a national representative survey. These fractions were applied to the nationwide statistics of death and hospitalization stays with a primary diagnosis for cardiovascular or renal diseases, or dementia whose risk is known to increase with hypertension. Data were extracted from the French National Health Insurance Information System (SNDS) which contains nationwide and exhaustive hospital stays and deaths occurring in France. Results: In France in 2017, 1 043 207 hospital stays and 185 459 deaths related to cardiovascular, renal or dementia condition occurred. Of these, 164 093 hospital stays (119 640 in men and 44 453 in women) and 35 017 deaths (17 436 in men and 16 142 in women) were estimated to be attributable to hypertension, representing 16% of all cardiovascular, renal and dementia-related hospital stays and 19% of all cardiovascular renal and dementia deaths. Regarding the attributable fraction, the largest impact was observed on hemorrhagic stroke (26.8% of cases attributable to hypertension in men and 15.8% in women) and on ischemic heart disease (25.0% in men and 15.4% in women). For all cardiovascular diseases the highest attributable fraction were reach in adults aged 55-74 years old. Conclusions: In France, the burden attributable to hypertension is high and is expected to increase in the coming years given the aging of the population. The reduction of the burden attributable to hypertension requires ambitious public health policies aimed at promoting healthy lifestyles but also an improvement in the awareness and management of hypertension, which has not improved over the last 20 years, unlike in several other European countries.
Published Version
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