Comparison of target blood pressure achievement tactics in ambulatory and hospital settings (ARGUS 2 Study results in Kirov City)

Abstract

Aim. To analyze ambulatory and hospital tactics of target blood pressure (BP) achievement.

Material and methods. In total, 60 ambulatory and 40 hospital case histories of AH patients were analyzed.

Results. Target BP levels were achieved in 6,7% of ambulatory patients. Even though 93,3% needed more aggressive antihypertensive therapy, only in 37%, some treatment optimization efforts were performed (dose increase and/or combined therapy prescription). Mean number of medications prescribed decreased during the control year. The rates of thiazide diuretics (tD) and calcium antagonists (CA) prescription were inadequately low. By the end of control year, target BP levels were achieved in 15% only. Therapy change rates in achievers and non-achievers varied from 0 to 14 (average one-year rate 3,8). Typically, achievers received АСГ inhibitor and tD combination. Main indication for hospitalization was uncontrolled AH (67,5%), due to irregular medication intake (64,9%). During hospitalization, target BP levels were achieved in 97,5% of the patients. Soon after admission, most hospitalized patients were administered three-agent combination therapy, including tD and АСГ inhibitors.

Conclusion. The possibility of achieving target BP in high and very high-risk AH patients was successfully proven. Real-world lapses in ambulatory management of this patient group, leading to inadequate AH control, were identified.