In France, hypertensive disorders of pregnancy complicate approximately 7.4% of pregnancies. They are associated with a significant risk of hypertension, diabetes, and cardiovascular disease throughout a woman’s lifetime. However, few women are aware of this risk or how to prevent it.

Tension'Elles (pdf-352KB) is a health literacy project aimed at co-developing, testing, and evaluating an intervention for women who have had a hypertensive disorder of pregnancy. Its objectives are to improve information, follow-up, and the adoption of a healthier lifestyle among these women in order to reduce their cardiovascular risk. It will be co-developed with all stakeholders, including the women themselves and healthcare professionals, and then tested and evaluated in maternity wards across the Île-de-France region.

The National Health Data System (SNDS)* has revolutionized the epidemiological surveillance of diabetes in France since 2010 by enabling the routine production of indicators of the prevalence and incidence of pharmacologically treated diabetes, broken down by geographic and socioeconomic factors.

However, it has certain limitations, such as the inability to identify individuals at high risk for diabetes, the lack of clinical and laboratory data needed to monitor risk factors for complications, and the inability to produce analyses stratified by type of diabetes.

As part of three pilot projects, Santé publique France proposes to strengthen the SNDS by making reference data available as open data in order to improve the diabetes surveillance system in France: 

• Unknown Diab (PDF—390 KB): Develop an algorithm to identify individuals at high risk for undiagnosed diabetes and map the results for local stakeholders. The goal is to directly target these individuals and their healthcare providers, launch personalized prevention campaigns as part of a proactive approach to “reach out to” these populations and then “bring them back into” the healthcare system.

• Diab-Lab (PDF—345 KB): Create a passive cohort (a group of individuals monitored without active outreach, such as through questionnaires) by collecting biological data from clinical laboratories, combined with data from the SNDS, in two French regions (Réunion and French Guiana). This cohort will be enriched by data collected in 2019–2020 as part of the Entred 3 study. The objective is to test the feasibility and relevance of a surveillance system for risk factors of diabetes-related complications, based on linking biological data repositories with the SNDS. 

• Diab-Type 1 (PDF—386 KB): to develop a classification algorithm within the SNDS capable of distinguishing between type 1 and type 2 diabetes cases. The objective is to create a surveillance system specific to each type of diabetes in order to improve decision support for diabetes management and open up new avenues for diabetes research in France. 

*The SNDS is a pseudonymized medical-administrative database that includes, among other things, medical consultations, medication dispensing, treatments fully covered by health insurance, and hospitalizations for individuals residing in France and covered by a health insurance plan.

Drawing on the National Health Data System (SNDS), the DECADIS pilot project (PDF—349 KB) produces up-to-date and accurate national data on gender-based disparities in cardiovascular disease and diabetes. 

It modernizes epidemiological surveillance by placing gender-based health inequalities at the center of the analysis. By incorporating the socioeconomic deprivation index (FDep), the study analyzes prevalence and mortality across the entire French population. The goal is to identify critical gaps in the care pathway, particularly for women, and to support targeted public health policies aimed at reducing social and regional health inequalities.

Many countries are launching campaigns to raise awareness of high blood pressure (HBP) among the general public. Many combine public awareness campaigns with blood pressure screenings in public places, such as the “Know Your Numbers” campaign (Blood Pressure UK—United Kingdom) and “May Measurement Month” (International Society of Hypertension, World Health Organization).

In France, despite the proven benefits of prevention, screening, and management of high blood pressure, several indicators—such as prevalence, screening rates, and control rates—have not improved since 2006.

Santé publique France proposes adapting this type of campaign to the French context by drawing on the principles of health literacy and social marketing, and is launching the TAC Tension! (pdf-259 KB) in four regions particularly affected by hypertension, in the Hauts-de-France and Grand Est regions.

Among the keys to their success is comprehensive, integrated care within a care pathway leading to a primary care physician and, if necessary, to other specialists (cardiologist, nutritionist, addiction specialist, psychologist, etc.).

ALISA DIAB – Paimpol Hospital

Background: Led by the Paimpol Hospital (22) in partnership with Santé publique France, the ALISA DIAB project (PDF—268 KB) is part of WP6. It is being implemented in two distinct regions: Paimpol-Guingamp (22) and Saint-Denis (93).

Objectives: To improve health literacy among people living with type 2 diabetes and reduce inequalities in access to health information and services.

Methodology and innovation: The project is based on a co-creation approach involving patients, healthcare professionals, and institutional stakeholders. Based on a multidimensional and qualitative approach to health literacy, it develops, tests, and evaluates tailored interventions aimed at strengthening patients’ ability to self-manage their condition.

Contributions to JACARDI: ALISA DIAB combines national expertise in public health with a strong local presence in healthcare, contributing to the development of transferable models for health literacy interventions.

ITINERANCE – Nantes University Hospital

Background: The ITINERANCE project (PDF—355 KB) addresses the challenge of underdiagnosis and undertreatment of diabetic patients with chronic kidney disease (CKD).

Objectives: To evaluate the impact of targeted public health messages on the occurrence of major cardiovascular and renal events (MARCE), as well as on mortality and serious complications at two years.

Methodology and Innovation: The core innovation involves mobilizing clinical laboratories as strategic contact points: personalized messages are delivered to patients and healthcare professionals when lab results are provided.

As part of JACARDI, the initial phase focuses on developing the messages and implementing evaluation tools based on data from the National Health Data System (SNDS).

Contributions to JACARDI: The project will analyze changes in care pathways, referrals to specialists (nephrologists, cardiologists, and diabetologists), and the medical and economic impact on the national health insurance system.

PANOPLY – Hospices Civils de Lyon

Background: Following an acute coronary syndrome (ACS), the long-term prognosis depends heavily on treatment adherence and lifestyle changes. Despite recommendations from the European Society of Cardiology, the use of cardiac rehabilitation remains insufficient in France.

Objectives: To improve the quality of secondary prevention and to structure data collection for optimized follow-up of post-ACS patients.

Methodology and Innovation: PANOPLY (PDF—235 KB) is testing a digitally designed care pathway aimed at streamlining follow-up, strengthening patient engagement, and ensuring the completeness of health data at both the individual and population levels.

Contributions to JACARDI: The project provides robust indicators to guide cardiovascular prevention policies and improve long-term clinical outcomes.

MAGIC Study – Hospices Civils de Lyon

Background: The rise in obesity and its association with type 2 diabetes and hypertension contribute to the emergence of metabolic heart failure. Diagnosis and prognostic assessment in obese individuals remain complex

Objectives: To develop and validate standardized measurement methods to improve the diagnosis of heart failure in obese patients.

Methodology and Innovation: The study focuses on optimizing echocardiographic measurements and developing decision algorithms tailored to this specific population to improve diagnostic accuracy and guide treatment.

Contributions to JACARDI: The MAGIC Study (PDF—244 KB) contributes to better allocation of healthcare resources by more precisely identifying patients eligible for innovative treatments and improving long-term clinical outcomes.

Ischemic Heart Disease Registry – Toulouse University Hospital

Background: The Haute-Garonne Ischemic Heart Disease Registry, launched in 1985 as part of the international MONICA project led by Profhttps://www.santepubliquefrance.fr/sites/default/files/2026 international MONICA project coordinated by the WHO, aims to analyze trends in the incidence, mortality, and management of coronary heart disease.

Objectives: As part of JACARDI’s Work Package 7 (PDF—342 KB), to enrich and improve the registry data in order to refine our understanding of acute coronary syndrome and optimize prevention and management.

Methodology and Innovation

The pilot project includes:

• The addition of new variables (history of atherosclerosis, comorbidities, clinical and biological parameters).

• Improving the completeness of data collection on out-of-hospital deaths.

Contributions to JACARDI: Strengthening the registry will enable a more detailed analysis of clinical and organizational determinants, supporting the development of cardiovascular prevention strategies based on robust data.