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. 2022 Mar 29;22(1):131.
doi: 10.1186/s12872-022-02584-y.

Epidemiologic features and management of hypertension in Tunisia, the results from the Hypertension National Registry (NaTuRe HTN)

Leila Abid  1 , Rania Hammami  2 , Ikram Chamtouri  3 , Meriam Drissa  4 , Selim Boudiche  5 , MohamedAmine Bahloul  2 , Hedi BenSlima  6 , Khaled Sayahi  7 , Selma Charfeddine  2 , Emna Allouche  8 , Lamia Rais  9 , Badr Kaab  9 , Hassen IbnHadjamor  10 , Lilia BenFatma  9 , Riadh Garbaa  11 , Sabrine Boukhris  4 , Manel Ben Halima  5 , Nesrine Amdouni  3 , Chaima Ghorbel  12 , Sabrine Soudani  4 , Imen Khaled  13 , Syrine Triki  2 , Feten Bouazizi  13 , Imen Jemai  14 , Ouday Abdeljalil  3 , Yemna Ammar  13 , Amani Farah  3 , Adnen Neji  15 , Zeineb Oumayma  8 , Sana Seghaier  16 , Samir Mokrani  17 , Hamza Thawaba  18 , Hela Sarray  2 , Khalil Ouaghlani  8 , Houssem Thabet  19 , Zeineb Mnif  20 , Fatma Boujelban  21 , Mohamed Sghaier  22 , Roueida Khalifa  3 , Sami Fourati  21 , Yasmin Kammoun  2 , Syrine Abid  16 , Chihab Hamza  16 , Syrine Ben Jeddou  4 , Lassaad Sabbah  21 , Rim Lakhdhar  23 , Najla Dammak  24 , Tarek Sellami  25 , Basma Herbegue  23 , Alia Koubaa  26 , Faten Triki  2 , Tarek Ellouz  2 , Aicha Hmoudi  27 , Ikhlas BenAmeur  21 , MohamedMongi Boukhchina  28 , Neila Abid  21 , Wejdene Wachtati  8 , Nizar Nasrallah  23 , Yousra Houidi  29 , Fathia Meghaieth  5 , Elhem Ghodhbane  27 , Mounira Chayeb  29 , Sarra Chenik  30 , Samira Kaabachi  31 , Nizar Saadaoui  21 , Ines BenAmeur  21 , Moufida Affes  21 , Sana Ouali  5 , Mouna Chaker  2 , Hela Naanaa  32 , Meriem Dghim  30 , Mourad Jarrar  33 , Jihene Mnif  21 , Ahmed Turki  2 , Ihsen Zairi  34 , Jamel Langar  32 , Safa Dardouri  19 , Imen Hchaichi  35 , Rafik Chettaoui  23 , Wajih Essmat  36 , Amel Chakroun  37 , Khadija Mzoughi  34 , Rachid Mechmeche  16 , Afef BenHalima  38 , Sahar BenKhala  39 , Slim Chtourou  21 , Abdelkader Maalej  21 , Mohsen Ayari  32 , Moufid Hadrich  23 , Rami Tlili  40 , Fares Azaiez  40 , Imen Bouhlel  19 , Samira Sahnoun  21 , Habib Jerbi  33 , Imtinene BenMrad  34 , Leila Riahi  30 , Mohamed Sahnoun  21 , Abdelhamid BenJemaa  2 , Amel BenSalem  8 , Bassem Rekik  8 , Maroua BenDoudou  34 , Rachid Boujneh  16 , Anissa Joulak  16 , Yosra Mejdoub  41 , Imen Gtif  42 , Gouider Jribi  19 , Elyes Naffeti  43 , Habib Gamra  44 , Soraya BenYousef  45 , Wissem Sdiri  46 , Najeh BenHalima  47 , Youssef BenAmeur  40 , Salem Kachboura  38 , Sondes Kraiem  34 , Wafa Fehri  30 , Leila Bazdeh  8 , MohamedSami Mourali  5 , Sami Milouchi  12 , Habiba Drissa  4 , Faouzi Maatouk  3 , Lilia Zakhama  45 , Faouzi Addad  38 , Samir Kammoun  2 , Salem Abdesselem  16
Affiliations

Epidemiologic features and management of hypertension in Tunisia, the results from the Hypertension National Registry (NaTuRe HTN)

Leila Abid et al. BMC Cardiovasc Disord. .

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.

Keywords: Blood pressure control; Epidemiology; Hypertension; Predictors; Registry.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Forest Plot Graph: Predictors of blood pressure control according to the multivariate regression analysis. BP: Blood Pressure, bpm: beat per minute, CI: confidence Interval, HR: Heart rate, OR: odds ratio, Yo: year old
See this image and copyright information in PMC

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