Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Reducing the burden of arterial hypertension: what can be expected from an improved access to health care? Results from a study in 2420 unemployed subjects in the Caribbean

Journal of Human Hypertension volume 21, pages 316–322 (2007)Cite this article

Abstract

High prevalence and poor control of hypertension have been observed in populations with low-socioeconomic status. Comparing an unemployed population with another employed population sharing the same culture, and another employed population living in another environment might enlighten the effects of factors accessible to primary prevention on the one hand and access to health care on the other hand. The objectives are, first, to describe blood pressure (BP) prevalence and control in an unemployed Caribbean population benefiting from State financial support and good access to health care and second, compare the results in this population with those observed, with the same methodology in two employed populations, one in the Caribbean and one in metropolitan France. A cross-sectional study of 2420 consecutive unemployed subjects referred for check-up in the two health centres of Guadeloupe, a French Caribbean island. Hypertension prevalence was 25.2% in men and 22.1% in women. BP was controlled in 17.3% of men and 37.2% of women receiving antihypertensive medication. Among women, 58% were overweight and 29% obese. Prevalence of hypertension was higher among the unemployed and employed Caribbean population, than among an employed metropolitan French population. A high prevalence of obesity was observed in the two Caribbean populations suggesting the interest of primary prevention in the Caribbean. Burden of hypertension in a population relates to the development of hypertension (primary prevention) and control of hypertension (secondary prevention). Identifying hypertensive patients and controlling blood pressure are both important to reduce the disease burden.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Andrulis DP . Access to care is the centerpiece in the elimination of socioeconomic disparities in health. Ann Intern Med 1998; 129: 412–416.

    Article  CAS  Google Scholar 

  2. Pincus T, Esther R, DeWalt DA, Callahan LF . Social conditions and self-management are more powerful determinants of health than access to care. Ann Intern Med 1998; 129: 406–411.

    Article  CAS  Google Scholar 

  3. Kaplan GA, Keil JE . Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation 1993; 88: 1973–1998.

    Article  CAS  Google Scholar 

  4. Lang T, Ducimetière P, Arveiler D, Amouyel P, Cambou JP, Ruidavets JB . Incidence, case fatality, risk factors of acute coronary heart disease and occupational categories in men aged 30–59 in France. Int J Epidemiol 1997; 26: 47–57.

    Article  CAS  Google Scholar 

  5. Lang T, Degoulet P, Menard J . Socio-economic influences on treatment. In: Buhler F, Laragh J (eds). Handbook of hypertension. Elsevier Science Publishers BV: Amsterdam, 1997; 13, pp 411–424.

    Google Scholar 

  6. Shea S, Misra D, Ehrlich MH, Field L, Francis CK . Predisposing factors for severe, uncontrolled hypertension in an inner-city minority population. N Engl J Med 1992; 327: 776–781.

    Article  CAS  Google Scholar 

  7. De Gaudemaris R, Lang T, Chatellier G, Larabi L, Lauwers-Cancès V, Maître A et al. Socioeconomic inequalities in hypertension prevalence and care: the IHPAF Study. Hypertension 2002; 39: 1119–1125.

    Article  CAS  Google Scholar 

  8. Lang T, De Gaudemaris R, Chatellier G, Hamici L, Dione E . Prevalence and therapeutic control of hypertension in 30 000 subjects in the workplace. Hypertension 2001; 38: 449–454.

    Article  CAS  Google Scholar 

  9. Failde I, Balkau B, Costagliola D, Moutet JP, Gabriel JM, Donnet JP et al. Arterial hypertension in the adult population of Guadeloupe and associated factors in subjects of African origin. Rev Epidemiol Sante Publique 1996; 44: 417–426.

    CAS  PubMed  Google Scholar 

  10. Inamo J, Lang T, Atallah A, Inamo A, Larabi L, Chatellier G et al. Prevalence and control of hypertension in French Caribbean regions. J Hypertens 2005; 223: 1341–1346.

    Article  Google Scholar 

  11. Burt VL, Whelton P, Roccella EJ, Brown C, Cutler JA, Higgins M et al. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988–1991. Hypertension 1995; 25: 305–313.

    Article  CAS  Google Scholar 

  12. Emmons KM . Health behaviors in a social context. In: Berkman L, Kawachi I, (eds). Social Epidemiology. Oxford University Press: New York, NY, 2000, pp 242–266.

    Google Scholar 

  13. Allen JP, Litten RZ . The role of laboratory tests in alcoholism treatment. J Subst Abuse Treat 2001; 20: 81–85.

    Article  CAS  Google Scholar 

  14. Bots ML, Salonen JT, Elwood PC, Nikitin Y, Freire de Concalves A, Inzitari D et al. Gamma-glutamyltransferase and risk of stroke: the EUROSTROKE project. J Epidemiol Community Health 2002; 56 (Suppl 1): i25–i29.

    Article  Google Scholar 

  15. Colhoun HM, Hemingway H, Poulter NR . Socio-economic status and blood pressure: an overview analysis. J Hum Hypertens 1998; 12: 91–110.

    Article  CAS  Google Scholar 

  16. Dressler WW, Grell GA, Gallagher PN, Viteri FE . Blood pressure and social class in a Jamaican community. Am J Public Health 1998; 78: 714–716.

    Article  Google Scholar 

  17. Hutchinson J . Association between stress and blood pressure variation in a Caribbean population. Am J Phys Anthropol 1986; 71: 69–79.

    Article  CAS  Google Scholar 

  18. Gulliford MC, Mahabir D, Rocke B . Socioeconomic inequality in blood pressure and its determinants: cross-sectional data from Trinidad and Tobago. J Hum Hypertens 2004; 18: 61–70.

    Article  CAS  Google Scholar 

  19. Lurie N . Studying access to care in managed care environments. Health Serv Res 1997; 32: 691–701.

    CAS  PubMed  PubMed Central  Google Scholar 

  20. Ambrosioni E, Leonetti G, Pessina AC, Rappelli A, Trimarco B, Zanchetti A . Patterns of hypertension management in Italy: results of a pharmacoepidemiological survey on antihypertensive therapy. Scientific committee of the italian pharmacoepidemiological survey on antihypertensive therapy. J Hypertens 2000; 18: 1691–1699.

    Article  CAS  Google Scholar 

  21. Gulbrandsen P, Hjortdahl P, Fugelli P . General practitioners' knowledge of their patients' psychosocial problems: multipractice questionnaire survey. BMJ 1997; 314: 1014–1018.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This study was supported by grants from the Agence Départementale d'Insertion and from Sanofi-Aventis. Special thanks to the Centre de Santé Sainte-Geneviève. This study was supported by grants from the Regional Agency for Integration (French Health Ministry), the Epidemiology Group of the French Society of Hypertension and Sanofi-Aventis.

Author information

Authors and Affiliations

  1. Service de Cardiologie, CH de la Basse-Terre, Basse-Terre, Guadeloupe

    A Atallah & C Machuron

  2. Département d'Epidémiologie et de Santé Publique, Unité INSERM U558, Institut Fédératif de Recherche, Toulouse, France

    J Inamo & T Lang

  3. Département de Cardiologie, CHU de Fort-de-France, Martinique, France

    J Inamo & R de Gaudemaris

  4. Service de Médecine et Santé au Travail, CHU de Grenoble, France

    L Larabi

  5. Département de Santé Publique et d'Informatique, Hôpital Européen Georges Pompidou, Paris, France

    G Chatellier

  6. Centre de Santé Sainte-Geneviève, Basse-Terre, Guadeloupe

    J-E Rozet

Authors
  1. A Atallah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J Inamo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L Larabi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G Chatellier
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J-E Rozet
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C Machuron
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. R de Gaudemaris
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. T Lang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A Atallah.

Additional information

Conflict of Interest

These authors have no conflict of interest.

Appendix

Appendix

Physicians were Drs MP Adam, W Chelala, S Faure, G Germain, H Maillard, JE Rozet and D Siarras.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Atallah, A., Inamo, J., Larabi, L. et al. Reducing the burden of arterial hypertension: what can be expected from an improved access to health care? Results from a study in 2420 unemployed subjects in the Caribbean. J Hum Hypertens 21, 316–322 (2007). https://doi.org/10.1038/sj.jhh.1002150

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jhh.1002150

Keywords

This article is cited by

Search

Advanced search

Quick links