{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T12:40:43Z","timestamp":1786884043906,"version":"build-2736575974"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Caisse nationale d\u2019assurance maladie"},{"name":"Ministry of Research"},{"DOI":"10.13039\/100007054","name":"MSD","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013327","name":"Lundbeck","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013327","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We aimed to assess factors associated with uncontrolled blood pressure (BP) among individuals with hypertension on treatment, by sex.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>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\u201369\u2009years at study inception. We included 11\u200a760 participants previously diagnosed with hypertension and taking antihypertensive medications. Uncontrolled BP was defined as mean systolic BP \u2265140\u2009mmHg and\/or mean diastolic BP \u226590\u2009mmHg. Sex-specific age-adjusted multivariable analyses were performed using logistic regression models stratified by stages of uncontrolled hypertension.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The mean age of participants was 59.4\u2009years. 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\u20131.94]. 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\u20131.32; and aOR, 1.45; 95% CI, 1.23\u20131.70, respectively), lack of physical activity (aOR, 1.20; 95% CI, 1.04\u20131.40), low adherence to a Dietary Approach to Stop Hypertension diet (aOR, 1.21; 95% CI, 1.05\u20131.40) and heavy alcohol consumption (aOR, 1.33; 95% CI, 1.08\u20131.63), with the last two factors persisting across different stages of uncontrolled BP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ije\/dyae027","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T22:40:51Z","timestamp":1709073651000},"source":"Crossref","is-referenced-by-count":11,"title":["Risk factors for uncontrolled blood pressure among individuals with hypertension on treatment: the CONSTANCES population-based study"],"prefix":"10.1093","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6438-0159","authenticated-orcid":false,"given":"Michelle","family":"Cherfane","sequence":"first","affiliation":[{"name":"Population Health Division, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University , Byblos,","place":["Lebanon"]},{"name":"Nutritional Epidemiology Research Unit (EREN), Inserm U1153, Paris 13 University Sorbonne Paris Cit\u00e9 , Bobigny,","place":["France"]},{"name":"INSPECT-LB, Institut National de Sant\u00e9 Publique d'\u00c9pid\u00e9miologie Clinique et de Toxicologie-Liban (INSPECT-LB) , Beirut,","place":["Lebanon"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Vall\u00e9e","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universit\u00e9 Paris Cit\u00e9 , Paris,","place":["France"]},{"name":"Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, H\u00f4tel-Dieu Hospital, AP-HP , Paris,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6041-9602","authenticated-orcid":false,"given":"Sofiane","family":"Kab","sequence":"additional","affiliation":[{"name":"Population-Based Epidemiological Cohorts Unit, Inserm, UMS011 , Villejuif,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascale","family":"Salameh","sequence":"additional","affiliation":[{"name":"Population Health Division, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University , Byblos,","place":["Lebanon"]},{"name":"INSPECT-LB, Institut National de Sant\u00e9 Publique d'\u00c9pid\u00e9miologie Clinique et de Toxicologie-Liban (INSPECT-LB) , Beirut,","place":["Lebanon"]},{"name":"Department of Primary Care and Population Health, University of Nicosia Medical School , Nicosia, Cyprus"},{"name":"Faculty of Pharmacy, Lebanese University , Hadat,","place":["Lebanon"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6161-5880","authenticated-orcid":false,"given":"Marcel","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universit\u00e9 Paris Cit\u00e9 , Paris,","place":["France"]},{"name":"Population-Based Epidemiological Cohorts Unit, Inserm, UMS011 , Villejuif,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4540-4282","authenticated-orcid":false,"given":"Marie","family":"Zins","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universit\u00e9 Paris Cit\u00e9 , Paris,","place":["France"]},{"name":"Population-Based Epidemiological Cohorts Unit, Inserm, UMS011 , Villejuif,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4860-4279","authenticated-orcid":false,"given":"Jacques","family":"Blacher","sequence":"additional","affiliation":[{"name":"Nutritional Epidemiology Research Unit (EREN), Inserm U1153, Paris 13 University Sorbonne Paris Cit\u00e9 , Bobigny,","place":["France"]},{"name":"Faculty of Medicine, Universit\u00e9 Paris Cit\u00e9 , Paris,","place":["France"]},{"name":"Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, H\u00f4tel-Dieu Hospital, AP-HP , Paris,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,2,27]]},"reference":[{"key":"2024101618405187000_dyae027-B1","volume-title":"A Global Brief on Hypertension","author":"World Health Organization","year":"2013"},{"key":"2024101618405187000_dyae027-B2","first-page":"e2","article-title":"Heart disease and stroke statistics\u20142012 update: a report from the American Heart Association","volume":"125","author":"Roger","year":"2012","journal-title":"Circulation"},{"key":"2024101618405187000_dyae027-B3","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1016\/S0140-6736(01)06411-X","article-title":"Cardiovascular protection and blood pressure reduction: a meta-analysis","volume":"358","author":"Staessen","year":"2001","journal-title":"Lancet"},{"key":"2024101618405187000_dyae027-B4","first-page":"703","article-title":"Vital signs: awareness and treatment of uncontrolled hypertension among adults\u2013 United States, 2003\u20132010","volume":"61","author":"Centers for Disease Control and Prevention (CDC)","year":"2012","journal-title":". MMWR Morb Mortal Wkly Rep"},{"key":"2024101618405187000_dyae027-B5","doi-asserted-by":"crossref","first-page":"1912","DOI":"10.1016\/S0140-6736(14)60688-7","article-title":"Hypertension management in England: a serial cross-sectional study from 1994 to 2011","volume":"383","author":"Falaschetti","year":"2014","journal-title":"Lancet"},{"key":"2024101618405187000_dyae027-B6","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1097\/HJH.0000000000000162","article-title":"Prevalence, awareness, treatment and control of hypertension and salt intake in Portugal: Changes over a decade. The PHYSA study","volume":"32","author":"Polonia","year":"2014","journal-title":"J Hypertens"},{"key":"2024101618405187000_dyae027-B7","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1038\/jhh.2014.82","article-title":"Hypertension prevalence, awareness, treatment and control in Germany 1998 and 2008-11","volume":"29","author":"Neuhauser","year":"2015","journal-title":"J Hum Hypertens"},{"key":"2024101618405187000_dyae027-B8","first-page":"170","article-title":"L\u2019hypertension art\u00e9rielle en France: pr\u00e9valence, traitement et contr\u00f4le en 2015 et \u00e9volution depuis 2006","volume":"10","author":"Perrine","year":"2018","journal-title":"Bull Epidemiol Hebd"},{"key":"2024101618405187000_dyae027-B9","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1161\/01.HYP.0000127424.59774.84","article-title":"Blood pressure control and physician management of hypertension in hospital hypertension units in Spain","volume":"43","author":"Banegas","year":"2004","journal-title":"Hypertension"},{"key":"2024101618405187000_dyae027-B10","doi-asserted-by":"crossref","first-page":"2563","DOI":"10.1001\/jama.296.21.joc60162","article-title":"Effect of a pharmacy care program on medication adherence and persistence, blood pressure and low-density lipoprotein cholesterol: a randomized controlled trial","volume":"296","author":"Lee","year":"2006","journal-title":"JAMA"},{"key":"2024101618405187000_dyae027-B11","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1097\/HJH.0b013e3282f4edd7","article-title":"Discontinuation of and changes in drug therapy for hypertension among newly- treated patients: a population-based study in Italy","volume":"26","author":"Corrao","year":"2008","journal-title":"J Hypertens"},{"key":"2024101618405187000_dyae027-B12","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1177\/1010539509347941","article-title":"Lifestyle factors associated with blood pressure control among those taking antihypertensive medication","volume":"23","author":"Ham","year":"2011","journal-title":"Asia Pac J Public Health"},{"key":"2024101618405187000_dyae027-B13","volume-title":"Patient Adherence to the Dietary Approaches to Stop Hypertension (DASH) Diet for Non-Primary English Speakers","author":"Stern","year":"2009"},{"key":"2024101618405187000_dyae027-B14","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1007\/s00038-008-7016-2","article-title":"The French National Nutrition and Health Program: 2001\u20132006\u20132010","volume":"53","author":"Hercberg","year":"2008","journal-title":"Int J Public Health"},{"key":"2024101618405187000_dyae027-B15","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.jmv.2012.09.002","article-title":"Objective for 2015: 70% of treated and controlled hypertensive patients. Seven key points to reach this goal in practice. A joint call for action of the French League Against Hypertension and the French Society of Hypertension","volume":"37","author":"Mourad","year":"2012","journal-title":"J Mal Vasc"},{"key":"2024101618405187000_dyae027-B16","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1186\/1471-2458-10-479","article-title":"The CONSTANCES cohort: an open epidemiological laboratory","volume":"10","author":"Zins","year":"2010","journal-title":"BMC Public Health"},{"key":"2024101618405187000_dyae027-B17","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1007\/s10654-015-0096-4","article-title":"The French CONSTANCES population-based cohort: design, inclusion and follow-up","volume":"30","author":"Zins","year":"2015","journal-title":"Eur J Epidemiol"},{"key":"2024101618405187000_dyae027-B18","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1186\/s12889-016-3439-5","article-title":"High quality standards for a large-scale prospective population-based observational cohort: constances","volume":"16","author":"Ruiz","year":"2016","journal-title":"BMC Public Health"},{"key":"2024101618405187000_dyae027-B19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/fcp.12044","article-title":"Management of hypertension in adults: the 2013 French Society of Hypertension guidelines","volume":"28","author":"Blacher","year":"2014","journal-title":"Fundam Clin Pharmacol"},{"key":"2024101618405187000_dyae027-B20","doi-asserted-by":"crossref","first-page":"1925","DOI":"10.1038\/s41598-020-58685-1","article-title":"Unhealthy behaviors and risk of uncontrolled hypertension among treated individuals-the CONSTANCES population-based study","volume":"10","author":"Cherfan","year":"2020","journal-title":"Sci Rep"},{"key":"2024101618405187000_dyae027-B21","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1108\/S0195-6310(2013)0000030017","volume-title":"Class and Stratification Analysis (Comparative Social Research","author":"Schneider","year":"2013"},{"key":"2024101618405187000_dyae027-B22","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1177\/1741826710394303","article-title":"Patterns of hypertension management in France (ENNS 2006\u20132007)","volume":"19","author":"Godet-Mardirossian","year":"2012","journal-title":"Eur J Prev Cardiol"},{"key":"2024101618405187000_dyae027-B23","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1093\/eurheartj\/ehy339","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension","volume":"39","author":"Williams","year":"2018","journal-title":"Eur Heart J"},{"key":"2024101618405187000_dyae027-B24","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1179\/174329211X13002357050897","article-title":"Age-related changes in an antioxidant defense system in elderly patients with essential hypertension compared with healthy controls","volume":"16","author":"Rybka","year":"2011","journal-title":"Redox Rep"},{"key":"2024101618405187000_dyae027-B25","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1111\/jch.12775","article-title":"Predictors of uncontrolled blood pressure in treated hypertensive individuals: first population-based study in Lebanon","volume":"18","author":"Farah","year":"2016","journal-title":"J Clin Hypertens (Greenwich)"},{"key":"2024101618405187000_dyae027-B26","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1186\/s13104-017-2971-4","article-title":"Predictors of poor blood pressure control among Iranian hypertensive patients","volume":"10","author":"Jahangiry","year":"2017","journal-title":"BMC Res Notes"},{"key":"2024101618405187000_dyae027-B27","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1161\/01.CIR.96.1.308","article-title":"Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study","volume":"96","author":"Franklin","year":"1997","journal-title":"Circulation"},{"key":"2024101618405187000_dyae027-B28","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1001\/jamacardio.2017.1658","article-title":"Income disparities in absolute cardiovascular risk and cardiovascular risk factors in the United States, 1999\u20132014","volume":"2","author":"Odutayo","year":"2017","journal-title":"JAMA Cardiol"},{"key":"2024101618405187000_dyae027-B29","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1001\/jamacardio.2017.1654","article-title":"Trends in cardiovascular health of US adults by income, 2005\u20132014","volume":"2","author":"Beckman","year":"2017","journal-title":"JAMA Cardiol"},{"key":"2024101618405187000_dyae027-B30","doi-asserted-by":"crossref","first-page":"197","DOI":"10.20344\/amp.8321","article-title":"[Characteristics associated with uncontrolled blood pressure among portuguese primary care patients with type 2 diabetes]","volume":"30","author":"Rosendo","year":"2017","journal-title":"Acta Med Port"},{"key":"2024101618405187000_dyae027-B31","doi-asserted-by":"crossref","first-page":"269","DOI":"10.2105\/AJPH.94.2.269","article-title":"Working class matters: socioeconomic disadvantage, race\/ethnicity, gender, and smoking in NHIS 2000","volume":"94","author":"Barbeau","year":"2004","journal-title":"Am J Public Health"},{"key":"2024101618405187000_dyae027-B32","doi-asserted-by":"crossref","first-page":"e012277","DOI":"10.1161\/JAHA.119.012277","article-title":"Disparities in socioeconomic context and association with blood pressure control and cardiovascular outcomes in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)","volume":"8","author":"Shahu","year":"2019","journal-title":"J Am Heart Assoc"},{"key":"2024101618405187000_dyae027-B33","doi-asserted-by":"crossref","first-page":"e0196535","DOI":"10.1371\/journal.pone.0196535","article-title":"Determinants of blood pressure control amongst hypertensive patients in Northwest Ethiopia","volume":"13","author":"Teshome","year":"2018","journal-title":"PLoS One"},{"key":"2024101618405187000_dyae027-B34","doi-asserted-by":"crossref","first-page":"e0166432","DOI":"10.1371\/journal.pone.0166432","article-title":"Assessment of blood pressure control among hypertensive patients in southwest Ethiopia","volume":"11","author":"Asgedom","year":"2016","journal-title":"PLoS One"},{"key":"2024101618405187000_dyae027-B35","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1001\/archinte.1995.00430070027003","article-title":"Population awareness and control of hypertension and hypercholesterolemia","volume":"155","author":"Nieto","year":"1995","journal-title":"Arch Intern Med"},{"key":"2024101618405187000_dyae027-B36","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1111\/jch.12597","article-title":"Effects of the DASH diet and walking on blood pressure in patients with type 2 diabetes and uncontrolled hypertension: a randomized controlled trial","volume":"17","author":"Paula","year":"2015","journal-title":"J Clin Hypertens (Greenwich)"},{"key":"2024101618405187000_dyae027-B37","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1001\/archinte.162.9.1051","article-title":"Factors associated with hypertension control in the general population of the United States","volume":"162","author":"He","year":"2002","journal-title":"Arch Intern Med"}],"container-title":["International Journal of Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ije\/article-pdf\/53\/2\/dyae027\/59812823\/dyae027.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ije\/article-pdf\/53\/2\/dyae027\/59812823\/dyae027.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T18:41:14Z","timestamp":1729104074000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ije\/article\/doi\/10.1093\/ije\/dyae027\/7615097"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,14]]},"references-count":37,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2,14]]}},"URL":"https:\/\/doi.org\/10.1093\/ije\/dyae027","relation":{},"ISSN":["0300-5771","1464-3685"],"issn-type":[{"value":"0300-5771","type":"print"},{"value":"1464-3685","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,4,1]]},"published":{"date-parts":[[2024,2,14]]},"article-number":"dyae027"}}