Sex differences in awareness and control of hypertension in France

Objective To assess the prevalence, awareness, treatment and control of hypertension for men and women living in three French regions. Design A cross-sectional population survey. Setting Subjects in the World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease population surveys of Bas-Rhin, the urban community of Lille and Haute-Garonne, France. Subjects We studied 1924 men and 1874 women aged 35-64 years. Main outcome measures Hypertension was defined as a systolic blood pressure greater than or equal to 160 mmHg, a diastolic blood pressure greater than or equal to 95 mmHg, being administered antihypertensive drug treatment or any combination of the foregoing. Treated hypertensive subjects were considered controlled if their systolic blood pressure was <160 mmHg and their diastolic blood pressure was <95 mmHg. Results The prevalence of hypertension was 40.2, 43.8 and 27.7% among men in Lille, Bas-Rhin and Haute-Garonne, respectively. For women, the corresponding values were 31.5, 33.8 and 18.9%. Among hypertensive men, 51.8% were aware of their condition, 30.0% were being administered drug treatment and 9.2% were controlled; the respective values for hypertensive women were 69.8, 51.2 and 25.3% (P < 0.001). Awareness of hypertension was associated with antihypertensive treatment more commonly in Haute-Garonne (81.0% for men and 84.7% for women). The percentages of treated subjects in whom adequate control of the blood pressure had been achieved were only 30.7% for men and 49.4% for women. Conclusion Women have a better awareness of hypertension than do men and their hypertension is controlled better but the low rate of control for both sexes calls for further improvements.