[Severe hypertension: definition and patients profiles]

Area of Science:

• Cardiology
• Public Health
• Health Economics

Context:

• Severe arterial hypertension presents heterogeneous clinical definitions and patient profiles.
• Historically in France, severe hypertension included chronic conditions with organ damage requiring triple therapy, distinct from acute Grade 3 hypertension.
• An estimated 10% of hypertensive patients, approximately 50,000 annually, experience severe forms.

Purpose:

• To clarify the varied definitions and implications of severe arterial hypertension.
• To highlight the increased cardiovascular morbidity and healthcare utilization associated with severe hypertension.
• To explain the socioeconomic factors influencing the incidence and management of severe hypertension.

Summary:

• Severe hypertension encompasses both acute, very high blood pressure (Grade 3) and chronic conditions with target organ damage under specific therapeutic regimens.
• Patients with severe hypertension exhibit elevated cardiovascular risks, necessitating closer medical supervision and leading to higher care costs.
• The higher incidence in lower socioeconomic groups and economically fragile individuals historically justified social security coverage for associated costs in France.

Impact:

• Understanding the heterogeneity of severe hypertension is crucial for accurate diagnosis and management.
• The increased cardiovascular morbidity underscores the need for proactive monitoring and intervention strategies.
• The socioeconomic gradient in severe hypertension incidence highlights the importance of health equity and targeted public health initiatives.