IDF21-0562 The prevalence and risk factors of arterial hypertension in the Tunisian population

Abstract

Background: The epidemic of diabetes and arterial hypertension (AH) has been overrunning numerous regions, with a devastating impact especially on low- and middle-income countries, including Tunisia. Hypertension is the most common cardiovascular disease, affecting about 22% of the adult population in 2014. Due to its “silent” characteristic, many affected people lack adequate care and follow-up. Aim: Our study aimed to: - diagnose AH in subjects who voluntarily presented to our screening campaign. - Determine the prevalence of AH in the screened population. - Highlight the epidemiological factors associated with AH. Method: This is a regional descriptive cross-sectional survey that studied a representative sample of the Tunisian population by means of questionnaires to assess its health status and medical consumption during the 2014 and 2015 World Diabetes Screening Days. The screening involved 2,012 individuals aged 18 years and over. Blood pressure (BP) was taken by manual blood pressure monitor with an inflatable cuff placed on the arm or by an electronic blood pressure monitor, after a minimum of 10 minutes of rest. A systolic BP ≥ 1 4 0 mmHg and/ or a diastolic BP ≥ 9 0 mmHg confirmed the diagnosis of AH. Results: The median age was 52 years with extremes ranging from 19 to 85 years. The age range 51-60 years was the majority (31.5%). Our study noted a male predominance with a sex ratio of 2.1. Among the subjects screened, 27.5% were smokers and 10.9% were alcoholics. A family history of diabetes and hypertension was found respectively in 47.37% and 48.56% of the subjects screened. During these screening days, the prevalence of AH was 43%. Among the 866 hypertensives, 389 (44.9%) were previously diagnosed with high blood pressure. The majority of these patients (58.6%) had poorly controlled blood pressure. We compared the data of the 1,085 non-hypertensive subjects (G 1) to the 477 newly diagnosed patients with AH (G2). We highlight a significant difference in age since G 2 subjects were older than normal ones (p=0.01). The male gender was identified as a risk factor to have AH, in fact, sex men were significantly more affected by hypertension than women (75.7 % versus 24.3 %, p<0.001). Patients having a personal history of diabetes mellitus are more likely to have associated AH as diabetic patients represented 18.6% in G 2 versus 13.7% in G1, p<0.001). Alcohol consumption was more reported in G2 (G2: 14.7% versus G1:10.3%, p=0.014). Discussion: The large sample size and the impressive number of people presenting voluntarily to the screening campaign represent a pillar of strength for our study. Hence, our results can be extrapolated to the general Tunisian population. Unlike previous studies in Tunisia that were limited to a limited hospital population or other targeted groups, our survey can be considered among the few ones carried out outdoors and focusing on the general public.