Tunis Med. 2022;100(2):167-179.
Tunisia is experiencing a double burden of morbidity, characterized by the explosion of cardiovascular diseases and their risk factors including arterial Hypertension. The objective of this study, based on the HSHS cohort (Hammam Sousse Sahloul Heart Study), was to determine the prevalence of hypertension in the general population and to identify its predisposing factors.
HSHS is a cardiovascular health promotion initiative in the city of Hammam Sousse (Tunisia). The study was conducted via a random sample of households, using the WHO PEV technique, made up of 33 clusters, of 33 households each. All people aged 20 and over, included, benefited from a questionnaire, a physical examination and a biological assessment. The Systolic Blood Pressure (SBP) and the Diastolic Blood Pressure (DBP) were measured from the average of the last two measurements, by an OMRON type tensiometer, of suitable width. These prevalences were adjusted according to sex and age group, by their weighting coefficients in the general population, and they were accompanied by their 95% CIs. Binary logistic regression was conducted to identify independent factors associated with hypertension.
The study population was composed of 481 men (33.4%) and 960 women (66.6%), with an average age of 49.6±16.35 years in males (M) and 46.6±16.18 in females (F). In addition to the family history of hypertension, the sufficient weekly consumption of vegetables and fruits was low (M: 32.4%, F: 24.9%). The adjusted rate of hypertension in the adult study population was 32.5%, 95%CI[31.9-33.1] (M: 36.4%, 95%CI[35, 5-37.3]; F: 28.4%; 95% CI[27.6-29.2]), reaching in the age group of 60 years and above: M: 74.6% (95%CI[66.9-82.3], F: 82.7% (95%CI[73.8-83.6]) Multivariate analysis identified five independent factors significantly associated with hypertension: male sex (ORa=1.55 [1.18-2.03]), age over 40 years (ORa=6.54[4.70-9.11]), low level of schooling (ORa=1.80 [1.36-2.38]), low physical activity (ORa=1.42[1.07-1.88]) and high socio-economic level (ORa=1 .84 [1.30-2.63]).
The HSHS study confirmed the high prevalence of hypertension, and the extent of its low detection and control. Hence the need for a universal approach to health promotion, oriented towards the general population, piloted by its local organizations, based on the adoption of a healthy lifestyle, and centered on physical activity.
突尼斯正面临着发病率的双重负担，其特点是心血管疾病及其风险因素（包括动脉高血压）的爆发。本研究基于 HSHS 队列（哈马姆苏塞萨勒赫心脏研究），旨在确定普通人群中高血压的患病率，并确定其致病因素。
HSHS 是哈马姆苏塞市（突尼斯）的一项心血管健康促进计划。该研究通过家庭的随机抽样进行，采用世界卫生组织的 PEV 技术，由 33 个集群组成，每个集群有 33 个家庭。所有 20 岁及以上的人都受益于一份问卷、体检和生物评估。收缩压（SBP）和舒张压（DBP）通过欧姆龙型血压计从最后两次测量的平均值中测量，血压计的宽度要合适。这些患病率根据性别和年龄组进行了调整，根据总人口的加权系数，并伴有 95%CI。采用二元逻辑回归分析确定与高血压相关的独立因素。
研究人群由 481 名男性（33.4%）和 960 名女性（66.6%）组成，平均年龄男性为 49.6±16.35 岁，女性为 46.6±16.18 岁。除高血压家族史外，每周蔬菜和水果的充足摄入量也较低（男性：32.4%，女性：24.9%）。成年研究人群中高血压的调整患病率为 32.5%，95%CI[31.9-33.1]（男性：36.4%，95%CI[35%，5-37.3]；女性：28.4%，95%CI[27.6-29.2]），在 60 岁及以上的年龄组中达到：男性：74.6%（95%CI[66.9-82.3]，女性：82.7%（95%CI[73.8-83.6]）。多变量分析确定了五个与高血压显著相关的独立因素：男性（ORa=1.55[1.18-2.03]）、年龄超过 40 岁（ORa=6.54[4.70-9.11]）、低教育程度（ORa=1.80[1.36-2.38]）、低体力活动（ORa=1.42[1.07-1.88]）和高社会经济水平（ORa=1.84[1.30-2.63]）。
HSHS 研究证实了高血压的高患病率，以及检测和控制不足的程度。因此，需要一种普遍的方法来促进健康，面向普通人群，由其地方组织推动，基于采取健康的生活方式，并以身体活动为中心。
