High blood pressure prevalence and control in a middle-aged French population and their associated factors: the MONA LISA study

Aims This work aims to assess high blood pressure (BP) prevalence and control and their associated factors in a population-based study conducted in three French areas: the Urban Community of Lille and the districts of Bas-Rhin and Haute-Garonne, between 2005 and 2007. Methods Participants were randomly recruited from electoral rolls after stratification on sex, 10-year age group (35-74 years) and town size. BP was measured by trained medical staff following standardized procedures. High BP was defined as BP at least 140/90mmHg and/or taking antihypertensive drugs or following a specific diet. BP below 140/90mmHg among treated individuals was considered adequately controlled (<130/80mmHg among diabetics). Results Four thousand eight hundred and twenty-five participants were recruited (mean age 55.5 +/- 11.3 years). The prevalence of high BP was greater in men (47%) than in women (35%). Antihypertensive treatment concerned 80% of the hypertensive individuals with most often a combination therapy. Control rates concerned only 38% of women and 22% of men and decreased with age. Metabolic risk factors and aging were independently associated with high BP prevalence as were low educational level and alcohol consumption. Diabetes and high cardiovascular risk were strong independent predictors of uncontrolled BP. The use of multiple drug treatment did not predict a better control. Conclusions Hypertension is frequent in France, particularly in the age group 55-74 years. Control rates remain low, particularly in high-risk, older and diabetic individuals. Intensified efforts are required to improve lifestyle, awareness of the condition, and use of appropriate and well tolerated combination therapy. J Hypertens 29: 43-50 (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.