Epidemiological Trial of Hypertension in North Africa (ETHNA)

Abstract

Inhabitants of developing countries such as those in North Africa have experienced lifestyle changes that have increased the risk of cardiovascular disease. The aim of the Epidemiological Trial of Hypertension in North Africa (ETHNA) was to evaluate the prevalence and clinical profile of hypertension in a large sample of individuals in North Africa. This was an international, multicentre, epidemiological, cross-sectional study conducted in patients consulting primary care physicians in Algeria, Tunisia and Morocco. Data were collected via a medical examination and questionnaire covering patient demographics, medical history and cardiovascular risk factors. Associations between hypertension and patient characteristics were determined using conventional parametric statistical tests. In total, 28,500 individuals attending primary care physicians participated in this study: 41.8% from Algeria, 37.6% from Morocco and 20.6% from Tunisia. Mean age was 49.2 ± 16.8 years. The total prevalence of hypertension was 45.4% [95% confidence interval (CI) 44.8-46.0]; 29.0% of patients with hypertension were newly detected at the study visit. When adjusted for age and sex, the overall prevalence of hypertension was 26.9% (95% CI 26.4-27.4). Overall, 88.0% of the patients with hypertension were receiving or were newly prescribed antihypertensives (history of hypertension, 91.2%; newly detected, 80.3%). Among patients with a history of hypertension receiving antihypertensives at the study visit, only 35.7% had controlled hypertension. This study suggests that the prevalence of hypertension in North Africa is high. Hypertension may also be underdiagnosed and ineffectively treated. Greater awareness and improved management of hypertension and cardiovascular risks are needed in this region.