[Prevalence of hypertension in a disadvantaged population in Antilles: a major role for obesity?].

Unlabelled: The aim of this study was to evaluate the prevalence of hypertension and its management in a disadvantaged population, essentially composed of those receiving state subsidies and the unemployed.

Methods: The PHAPPG study : Prevalence of Hypertension in a Population Précaire Guadeloupéenne (disadvantaged population in Guadeloupe) included 2420 consecutive people considered to be 'disadvantaged' seen in the two medical examination centres in Guadeloupe between November 2001 and November 2003.

Results: The prevalence of obesity was considerable throughout the female population of Antilles (29%).

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.

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.

[Access to care: not enough to completely abolish the disparity in hypertension management at the socio-economic level].

Higher prevalence and poorer control of hypertension have been observed in populations with low socioeconomic status. The causal link between socioeconomic factors and hypertension is complex. What is the impact of medical services compared with other health status determinants? We aimed to assess blood pressure prevalence and control in an unemployed disadvantaged population receiving state financial support and with easy access to health care.

[Risk assessment of hypertension: from population to individual].

Epidemiological studies have contributed to our understanding of several aspects of hypertension which could not have been remarked upon by clinical medicine alone: 1) the continuous nature of the relationship between the level of hypertension and cardiovascular risk has shown that the clinical definition by criteria based on numbers is arbitrary and should be adjusted according to the context and therapeutic management; 2) the risk of high blood pressure is strongly dependent on the presence or absence of other risk factors (smoking, diabetes, serum lipids, left ventricular hypertrophy), a factor which is not sufficiently taken into account in clinical practice; 3) assessment of the absolute risk of an individual on the basis of the respective roles of the principal risk factors is a useful guide to treatment. Moreover, population studies have shown that mild increases in blood pressure, associated with a long individual risk, are responsible for a large number of cardiovascular events because of the many people affected. Preventive action on the whole population is necessary in addition to individual therapeutic intervention in the clinical setting.