In France, 17 million adults are hypertensive, i.e. 30.6% of the population. Hypertension is responsible for 56,000 deaths and the hospitalisation of 350,000 patients a year. Despite this high burden, there has been no improvement in the screening, treatment and control of hypertension in France over the past 10 years, with an awareness rate of 55.5% of hypertensives, a treatment rate of 72.6% of aware hypertensives and a control rate of 49.6% among treated patients. This exposes a large proportion of hypertensive patients to complications. Several countries in Europe and North America have made hypertension a public health priority, which has enabled them to improve their situation.

To study the impact of reducing the prevalence of hypertension and improving awareness, treatment and control of blood pressure on morbi-mortality of hypertension complications.

The burden attributable to hypertension in France was estimated using systolic blood pressure data from the Esteban survey; morbidity and mortality data from the Système National des Données de Santé; and the risks of hypertension-related complications from the literature. The potential impact fraction were calculated for cardiovascular diseases, dementia and chronic kidney disease and was used to calculate the number of deaths and hospitalisations that could be avoided by different scenarios. These scenarios were defined based on the rates achieved in European and North American countries:

– S1: 30% relative decrease in the hypertension prevalence (Canadian prevalence 22.6%),

– S2: 48% relative increase in the awareness of hypertensives (Germany 82.3%),

– S3: 21% relative increase in the treatment of aware hypertensives (Germany 87.7%),

– S4: 44% relative increase in the control of treated hypertensives (Germany 71.5%).

A reduction in the prevalence of hypertension in France to the Canadian level (S1) would prevent 18,145 deaths and the hospitalisation of 122,450 patients. This scenario would prevent 14.0% of cases of IHD, 13.5% of haemorrhagic strokes, 12.7% of CKD and 4.6% of dementia. Improved screening (S2), treatment (S3) or control (S4) would prevent 4,945, 9,486 and 7,915 deaths and the hospitalisation of 30,095, 51,456 and 47,021 patients respectively.

Reducing the hypertension prevalence and improving screening, treatment and blood pressure control should be a public health priority, given the number of avoidable cases.