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Abid L, Hammami R, Chamtouri I, Drissa M, Boudiche S, Bahloul M, BenSlima H, Sayahi K, Charfeddine S, Allouche E, Rais L, Kaab B, IbnHadjamor H, BenFatma L, Garbaa R, Boukhris S, Halima MB, Amdouni N, Ghorbel C, Soudani S, Khaled I, Triki S, Bouazizi F, Jemai I, Abdeljalil O, Ammar Y, Farah A, Neji A, Oumayma Z, Seghaier S, Mokrani S, Thawaba H, Sarray H, Ouaghlani K, Thabet H, Mnif Z, Boujelban F, Sghaier M, Khalifa R, Fourati S, Kammoun Y, Abid S, Hamza C, Jeddou SB, Sabbah L, Lakhdhar R, Dammak N, Sellami T, Herbegue B, Koubaa A, Triki F, Ellouz T, Hmoudi A, BenAmeur I, Boukhchina M, Abid N, Wachtati W, Nasrallah N, Houidi Y, Meghaieth F, Ghodhbane E, Chayeb M, Chenik S, Kaabachi S, Saadaoui N, BenAmeur I, Affes M, Ouali S, Chaker M, Naanaa H, Dghim M, Jarrar M, Mnif J, Turki A, Zairi I, Langar J, Dardouri S, Hchaichi I, Chettaoui R, Essmat W, Chakroun A, Mzoughi K, Mechmeche R, BenHalima A, BenKhala S, Chtourou S, Maalej A, Ayari M, Hadrich M, Tlili R, Azaiez F, Bouhlel I, Sahnoun S, Jerbi H, BenMrad I, Riahi L, Sahnoun M, BenJemaa A, BenSalem A, Rekik B, BenDoudou M, Boujneh R, Joulak A, Mejdoub Y, Gtif I, Jribi G, Naffeti E, Gamra H, BenYousef S, Sdiri W, BenHalima N, BenAmeur Y, Kachboura S, Kraiem S, Fehri W, Bazdeh L, Mourali M, Milouchi S, Drissa H, Maatouk F, Zakhama L, Addad F, Kammoun S, Abdesselem S. Epidemiologic features and management of hypertension in Tunisia, the results from the Hypertension National Registry (NaTuRe HTN). BMC Cardiovasc Disord 2022; 22:131. [PMID: 35351007 PMCID: PMC8966189 DOI: 10.1186/s12872-022-02584-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 03/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypertension is the leading cause of morbi-mortality in our country. Thus, we conducted this national survey on hypertension to analyze the profile of the Tunisian hypertensive patient and to assess the level of blood pressure control. METHODS Nature HTN is an observational multicentric survey, including hypertensive individuals and consulting their doctors during the period of the study. Blood pressure measurements were conducted during consultation, using a standardized auscultatory or oscillometric sphygmomanometer after at least 15 min of rest. The diagnosis of new hypertension is based on the 2018 ESC/ESH criteria. The primary endpoint of our study was uncontrolled hypertension defined by a systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. RESULTS Three hundred twenty-one investigators participated in the study. We enrolled 25,890 patients with a female predominance (Sex ratio, 1.21) and an average age of 64.4 ± 12.2 years. Most individuals were treated in the public sector (74%), 39.4% of patients were diabetic, 25.8% were obese, 44.6% were overweight and 14% were smokers. Hypertension was controlled in 51.7% of cases if we consider 140/90 as a BP target, and only in 18.6% if we consider 130/80 as a target. The independent predictors of uncontrolled blood pressure were male sex (OR = 1.09, 95%CI [1.02-1.16]), age > 65 year-old (OR = 1.07, 95% CI[1.01-1.13], diabetes (OR = 1.18, 95% CI [1.11-1.25], Smoking (OR = 1.15, 95% CI [1.05-1.25]), Obesity (OR = 1.14, 95% CI[1.07-1.21]), management in public sector (OR = 1.25, 95% CI [1.16-1.34]), and Heart rate > 80 bpm (OR = 1.59, 95% CI [1.48-1.71]). Contrarily, high educational level (OR = 0.9, 95% CI [0.84-0.97], absence of history of coronary disease (OR = 0.86, 95% CI [0.8-0.93]), salt restriction (OR = 0.48, 95% CI [0.45-0.51]), drug compliance (OR = 0.57, 95% CI[0.52-0.61]), and regular physical activity (OR = 0.77, 95% CI[0.71-0.84]) are strong predictors of blood pressure control. CONCLUSION NaTuRe HTN showed that blood pressure control was reached in more than half of the Tunisian people. The control remains low in patients with high cardiovascular profiles and in those treated in the public sector. A national health program based on therapeutic education, regular control and continuous support to the public institutions is needed to decrease the burden of hypertension incidence rate.
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Affiliation(s)
- Leila Abid
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia.
| | - Rania Hammami
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Ikram Chamtouri
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Meriam Drissa
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Tunis, Tunisia
| | - Selim Boudiche
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Tunis, Tunisia
| | | | - Hedi BenSlima
- Cardiology Department, Hospital of Menzel Bourguiba, Bizerte, Tunisia
| | - Khaled Sayahi
- Cardiology Department, ElKef Hospital, Elkef, Tunisia
| | - Selma Charfeddine
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Emna Allouche
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | - Lamia Rais
- Nephrology Department, La Rabta University Hospital, Tunis, Tunisia
| | - Badr Kaab
- Nephrology Department, La Rabta University Hospital, Tunis, Tunisia
| | | | - Lilia BenFatma
- Nephrology Department, La Rabta University Hospital, Tunis, Tunisia
| | | | - Sabrine Boukhris
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Tunis, Tunisia
| | - Manel Ben Halima
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Tunis, Tunisia
| | - Nesrine Amdouni
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Chaima Ghorbel
- Cardiology Department, Habib Bourguiba Hospital, Medenine, Tunisia
| | - Sabrine Soudani
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Tunis, Tunisia
| | | | - Syrine Triki
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | | | - Imen Jemai
- Habib Bourguiba Hospital, Medenine, Tunisia
| | - Ouday Abdeljalil
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | | | - Amani Farah
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | | | - Zeineb Oumayma
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | | | | | | | - Hela Sarray
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Khalil Ouaghlani
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | - Houssem Thabet
- Cardiology Department, Farhat Hached Hospital, Sousse, Tunisia
| | | | | | | | - Roueida Khalifa
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | | | - Yasmin Kammoun
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | | | | | - Syrine Ben Jeddou
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Tunis, Tunisia
| | | | | | - Najla Dammak
- Nephrology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | | | | | | | - Faten Triki
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Tarek Ellouz
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | | | | | | | | | - Wejdene Wachtati
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | | | | | - Fathia Meghaieth
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Tunis, Tunisia
| | | | | | - Sarra Chenik
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Tunis, Tunisia
| | | | | | | | | | - Sana Ouali
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Tunis, Tunisia
| | - Mouna Chaker
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | | | - Meriem Dghim
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Tunis, Tunisia
| | | | | | - Ahmed Turki
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Ihsen Zairi
- Cardiology Department, Habib Thameur Hospital, Tunis, Tunisia
| | | | - Safa Dardouri
- Cardiology Department, Farhat Hached Hospital, Sousse, Tunisia
| | | | | | | | | | - Khadija Mzoughi
- Cardiology Department, Habib Thameur Hospital, Tunis, Tunisia
| | | | - Afef BenHalima
- Cardiology Department, Abderrahmen Mami-Ariana Hospital, Ariana, Tunisia
| | | | | | | | | | | | - Rami Tlili
- Cardiology Department, Mongi Slim Hospital, Tunis, Tunisia
| | - Fares Azaiez
- Cardiology Department, Mongi Slim Hospital, Tunis, Tunisia
| | - Imen Bouhlel
- Cardiology Department, Farhat Hached Hospital, Sousse, Tunisia
| | | | | | | | - Leila Riahi
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Tunis, Tunisia
| | | | | | - Amel BenSalem
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | - Bassem Rekik
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | | | | | | | - Yosra Mejdoub
- Community Medicine Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Imen Gtif
- Laboratory of Screening Cellular and Molecular Process, Centre of Biotechnology of Sfax, Sfax, Tunisia
| | - Gouider Jribi
- Cardiology Department, Farhat Hached Hospital, Sousse, Tunisia
| | - Elyes Naffeti
- Cardiology Department, University Hospital Sahloul, Sousse, Tunisia
| | - Habib Gamra
- Cardiology Department A, Fatouma Bourguiba Hospital, Monastir, Tunisia
| | - Soraya BenYousef
- Cardiology Department, Internal Security Forces Hospital, Tunis, Tunisia
| | - Wissem Sdiri
- Cardiology Department, Bougatfa Hospital, Bizerte, Tunisia
| | - Najeh BenHalima
- Cardiology Department, Ibn El Jazzar Hospital, Kairouan, Tunisia
| | | | - Salem Kachboura
- Cardiology Department, Abderrahmen Mami-Ariana Hospital, Ariana, Tunisia
| | - Sondes Kraiem
- Cardiology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Wafa Fehri
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Tunis, Tunisia
| | - Leila Bazdeh
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | - MohamedSami Mourali
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Tunis, Tunisia
| | - Sami Milouchi
- Cardiology Department, Habib Bourguiba Hospital, Medenine, Tunisia
| | - Habiba Drissa
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Tunis, Tunisia
| | - Faouzi Maatouk
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Lilia Zakhama
- Cardiology Department, Internal Security Forces Hospital, Tunis, Tunisia
| | - Faouzi Addad
- Cardiology Department, Abderrahmen Mami-Ariana Hospital, Ariana, Tunisia
| | - Samir Kammoun
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
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