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

Abstract

-Terre, GuadeloupeHigh 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 crosssectional 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.

Assessing Medication Default, Alcohol Intake and Smoking Habits among Hypertensive Patients in a Rural Village of Limpopo Province, South Africa

“…Undoubtedly, such a high divorce rate of 78.7% and 44.9% unemployment rate among the participants in this study can trigger unhealthy social habits like smoking, drinking and drug abuse. Subscribing to this notion, Pharr et al (2012) posit that unemployment is associated with unhealthy behaviours; and study conducted by Atallah et al (2007) in the Caribbean, indicate that the high prevalence and poor control of hypertension have been observed in populations with low-socioeconomic status including poor therapeutic control in lower social classes.…”

Role of Area-Level Access to Primary Care on the Geographic Variation of Cardiometabolic Risk Factor Distribution: A Multilevel Analysis of the Adult Residents in the Illawarra—Shoalhaven Region of NSW, Australia

“…Previous studies have reported that access to primary care can play a role in the control and management of certain CMRFs [21,[25][26][27][28]. The dimensions of access to primary care can be fundamentally conceptualized into (1) physical access (2) affordability and (3) acceptability [29].…”

“…There is also evidence that medical consultations were reported less likely to happen when physical access to health care services is lower [21]. In addition, access to adequate treatment facilities were reported to have an inverse association with certain CMRFs, such as hypertension [25,26], end stage renal disease [27] and diabetes mellitus [32]. However, these reports are based on individual CMRFs but consistent evidence across a range of CMRFs may provide a stronger evidence base for healthcare service commissioning across areas.…”

HTA et précarité perçue en population précaire guadeloupéenne : l’enquête PHAPPG

“…On sait la responsabilité de l'HyperTension Artérielle (HTA) dans la survenue d'un AVC. La prévalence de l'HTA aux Antilles françaises n'est pourtant pas très différente de celle observée en France métropolitaine, tout du moins chez les hommes et parmi les actifs ; mais cette prévalence de l'HTA est plus élevée chez les Guadeloupéens privés d'emploi [3].…”