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. 2025 Feb;82(2):357-369.
doi: 10.1161/HYPERTENSIONAHA.124.23760. Epub 2024 Dec 9.

Burden of Cardio-Cerebrovascular and Renal Diseases Attributable to Systolic Hypertension in France in 2021

Clémence Grave  1 , Christophe Bonaldi  2 , Laure Carcaillon-Bentata  3 , Amélie Gabet  1 , Jean-Michel Halimi  4   5 , Christophe Tzourio  6 , Yannick Béjot  7 , Marion J Torres  1 , Philippe Gabriel Steg  8 , Isabelle Durand Zaleski  9 , Jacques Blacher  10   11 , Valérie Olié  1
Affiliations

Burden of Cardio-Cerebrovascular and Renal Diseases Attributable to Systolic Hypertension in France in 2021

Clémence Grave et al. Hypertension. 2025 Feb.

Abstract

Background: Hypertension is the most common chronic disease and a major modifiable risk factor for cardio-cerebrovascular and renal diseases. This study estimated the national burden of hypertension, defined as systolic blood pressure ≥140 mm Hg, on morbidity and mortality in 2021 in France.

Methods: For all diseases causally associated with hypertension (cardiovascular diseases, chronic kidney diseases, and dementia), the number and proportion of cases attributable to hypertension in adults aged ≥35 years were estimated using population attributable fractions. Age- and sex-specific population attributable fractions were computed using the distribution of hypertension in the French population. These population attributable fractions were applied to nationwide statistics for mortality, hospitalizations, disease prevalence, years of life lost, years of life lived with disability, and disability-adjusted years of life.

Results: The largest population attributable fractions were for ischemic heart disease and hemorrhagic stroke, with over 40% of cases attributable to hypertension. Overall, more than 385 000 patients were hospitalized due to hypertension, with 3.7 million hospitalizations and 6.2 million hospital days (all hospitalizations, including 3.4 million for chronic kidney disease) and including 390 000 overnight hospitalization. In 2021, more than 1.15 million individuals lived with ischemic heart disease attributable to hypertension, 1.26 million with chronic kidney diseases, and 358 033 with heart failure. Among 184 059 annual deaths from cardiovascular diseases, dementia, and chronic kidney diseases, 30% (55 280 deaths) were attributable to hypertension. Hypertension accounted for 8.5% of all deaths and 498 052 years of life lost.

Conclusions: In France, despite near-universal health coverage and free health care access, the burden attributable to hypertension remains high.

Keywords: cardiovascular diseases; chronic disease; dementia; hypertension; renal insufficiency, chronic.

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Conflict of interest statement

J. Blacher reports, outside the submitted work, personal fees from Abbott, Bayer, Bottu, Egis, Ferring, Steripharma, Kantar, Sanofi, Servier, and Teriak, as well as personal fees and nonfinancial support from Pfizer and Quantum Genomics. P.G. Steg reports, outside the submitted work, receiving research grants from Amarin and Sanofi, working on clinical trials (steering committee, Clinical Events Committee, Data and Safety Monitoring Board) for Amarin, AstraZeneca, Bayer, Bristol-Myers Squibb (BMS), Idorsia, Novartis, Pfizer, Sanofi, and Servier, and consulting or speaking for Amarin, Amgen, BMS/Myokardia, Novo Nordisk, and SFJ. He is a Senior Associate Editor at Circulation. Y. Béjot reports, outside the submitted work, personal fees from BMS, Pfizer, Medtronic, Amgen, Servier, Novo Nordisk, and Novartis. J.M. Halimi reports, outside the submitted work, honoraria from AstraZeneca, Alexion, Bayer, Novo Nordisk, Servier, and Vifor Fresenius. I.D. Zaleski reports, outside the submitted work, fees for consulting and educational programs from Amgen, BMS, Boston Scientific, Medtronic, Merck Sharp & Dohme, and Roche. The other authors report no conflicts.

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