Background We aimed to assess factors associated with uncontrolled blood pressure (BP) among individuals with hypertension on treatment, by sex. Methods We conducted a nested cross-sectional analysis using data from the population-based cohort study CONSTANCES, designed as a randomly selected sample of French adults aged 18–69 years at study inception. We included 11 760 participants previously diagnosed with hypertension and taking antihypertensive medications. Uncontrolled BP was defined as mean systolic BP ≥140 mmHg and/or mean diastolic BP ≥90 mmHg. Sex-specific age-adjusted multivariable analyses were performed using logistic regression models stratified by stages of uncontrolled hypertension. Results The mean age of participants was 59.4 years. The prevalence of uncontrolled BP was 51.4%, and it was higher in men than in women [adjusted odds ratio (aOR), 1.80; 95% CI, 1.67–1.94]. In both sexes, the lower the age, the lower the prevalence of uncontrolled hypertension. Low level of education and history of cardiovascular events had, respectively, higher and lower odds of uncontrolled BP. In men, additional risk factors included overweight and obesity (aOR, 1.15; 95% CI, 1.00–1.32; and aOR, 1.45; 95% CI, 1.23–1.70, respectively), lack of physical activity (aOR, 1.20; 95% CI, 1.04–1.40), low adherence to a Dietary Approach to Stop Hypertension diet (aOR, 1.21; 95% CI, 1.05–1.40) and heavy alcohol consumption (aOR, 1.33; 95% CI, 1.08–1.63), with the last two factors persisting across different stages of uncontrolled BP. Conclusions From a population-based perspective, socio-economic and behavioural characteristics were risk factors for uncontrolled hypertension, but they differed by sex and by stage of uncontrolled hypertension. Modifiable risk factors, such as weight, diet, physical activity and alcohol consumption, have an important role in the control of hypertension.

中文翻译：

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接受治疗的高血压患者血压不受控制的危险因素：CONSTANCES 基于人群的研究

背景我们的目的是按性别评估接受治疗的高血压患者血压失控的相关因素。方法 我们使用基于人群的队列研究 CONSTANCES 的数据进行了巢式横断面分析，该研究设计为研究开始时随机选择的 18-69 岁法国成年人样本。我们纳入了 11 760 名之前被诊断患有高血压并服用抗高血压药物的参与者。未控制的血压定义为平均收缩压≥140 mmHg和/或平均舒张压≥90 mmHg。使用按未受控制的高血压阶段分层的逻辑回归模型进行性别特异性年龄调整多变量分析。结果 参与者的平均年龄为 59.4 岁。血压未受控制的患病率为 51.4%，男性高于女性 [调整优势比 (aOR)，1.80；95% CI，1.67–1.94]。无论性别，年龄越低，未控制的高血压患病率越低。教育水平低和心血管事件史低的人血压不受控制的几率分别较高和较低。在男性中，其他危险因素包括超重和肥胖（aOR，1.15；95% CI，1.00-1.32；aOR，1.45；95% CI，1.23-1.70）、缺乏体力活动（aOR，1.20；95% CI，1.04–1.40）、对控制高血压饮食方法的依从性低（aOR，1.21；95% CI，1.05–1.40）和大量饮酒（aOR，1.33；95% CI，1.08–1.63），最后两个因素在血压不受控制的不同阶段持续存在。结论 从人群角度来看，社会经济和行为特征是未受控制的高血压的危险因素，但它们因性别和未受控制的高血压的阶段而异。可改变的危险因素，如体重、饮食、体力活动和饮酒，在控制高血压方面具有重要作用。