SPECIFICS OF ANTIHYPERTENSION THERAPY IN HYPERTENSIVES OF VARIOUS CARDIOVASCULAR RISK (BY THE REGISTRY OF CHRONIC NON-COMMUNICABLE DISEASES IN TYUMENSKAYA OBLAST)
https://doi.org/10.15829/1728-8800-2018-3-4-10
Abstract
Aim. To assess the specifics of antihypertension therapy (AHT) in hypertensives of various cardiovascular risk, in the registry of chronic non-communicable diseases in Tyumenskaya oblast.
Material and methods. A random sample studied, of 1704 patients with hypertension, inhabitants of Tyumenskaya oblast (region), ascribed to dispensary follow-up. Mean age 62±7,5 y.o. Of those 31,5% (n=537) males. The prevalence and efficacy of AHT assessed according to cardiovascular risk level. The significance was evaluated with the criteria χ2.
Results. AHT was characterized by the growth of the frequency of treatment approaches with cardiovascular risk consideration. Regular treatment took 33,9% patients of low and moderate risk vs 41,3% of high and very high (p<0,01). In the male group such tendency also took place. Gender specifics of AHT was characterized by that in the groups of high and very high risk females took medications significantly more commonly than males — 46,6% vs 29,1% in high risk group (p<0,01) and 47,5% vs 30% in very high risk group (p<0,01). With the increase of the risk level, there was decline of treatment efficacy — from 95% in low risk group to 32,5% in very high risk group; 53,1% of the participants were taking monotherapy, 32,9% — two drugs, 14,0% — ≥3 drugs. With the increase of risk grade there is tendency to increase of combinational AHT, however with no significant increase of efficacy. Treatment efficacy in high and very high risk patients comparing to patients with low and moderate risk was significantly lower — 33,1% vs 69,7% (p<0,01), respectively. Statins intake among the high and very high risk patients was 10,6-11,0% males and 7,8% females (p<0,05).
Conclusion. AHT in hypertensives in Tymenskaya oblast, under dispensary follow-up, is characterized by insufficient usage of combinational drugs. With the raise of cardiovascular risk there is tendency to higher rate of combinational AHT. However there is no significant increase in efficacy of treatment with the increase of medications number. A very low rate of statins intake is noted. The obtained specifics witness for the necessity to optimize AHT among the high and very high risk patients — inhabitants of Tyumenskya oblast.
About the Authors
A. Yu. EfanovRussian Federation
Tyumen
Yu. A. Vyalkina
Russian Federation
Tyumen
Yu. A. Petrova
Russian Federation
Tyumen
Z. M. Safiullina
Russian Federation
Tyumen
O. V. Abaturova
Russian Federation
Tyumen
S. V Shalaev
Russian Federation
Tyumen
References
1. Olives C, Myerson R, Mokdad AH, et al. Prevalence, Awareness, Treatment, and Control of Hypertension in United states Counties, 2001-2009. PLosONe 2013; 8 (4): e60308. DOI: 10.1371/journal.pone.0060308.
2. Gu Q, Burt VL, Dillon Cf, et al. Trends in antihypertensive medication use and blood pressure control among united states adults with hypertension: The national health and nutrition examination survey, 2001 to 2010. Circulation 2012; 126: 2105-14. DOI: 10.1161/CIRCULATIONAHA.112.096156.
3. Wang J, Zhang L, Wang f, et al. Prevalence, awareness, treatment, and control of hypertension in China: results from a national survey. Am J Hypertens 2014; 27 (11): 1355-61. DOI: 10.1093/ajh/hpu053.
4. Boytsov SA, Balanova YuA, Shalnova SA, et al. Arterial hypertension among individuals of 25-64 years old: prevalence, awareness, treatment and control. By the data from ECCD. Cardiovascular Therapy and Prevention 2014; 14 (4): 4-14. (In Russ.) DOI: 10.15829/1728-8800-2014-4-4-14.
5. Falaschetti E, Chaudhury M, Mindell J, et al. Continued Improvement in Hypertension Management in England: Results From the Health Survey for England 2006. Hypertension 2009; 53: 480-6. DOI: 10.1161/HYPERTENS.IONAHA.108.125617.
6. The Working Group for the treatment of hypertension European Society of Hypertension, ESH, European Society of Cardiology, ESC. Practicle guideline track on arterial hypertension. ESH/ESC 2013. Russian Journal of Cardiology 2014; (1): 7-94. (In Russ.) DOI: 10.15829/1560-4071-2014-1-7-94.
7. Abaci A, Kozan O, Oguz A, еt al. Prescribing pattern of antihypertensive drugs in primary care units in Turkey: resuts from TURKSAHA study. Eur J Clin Pharmacol 2007; 63 (4): 391-402.
8. Shalnova SA, Deev AD, Balanova YuA, et al. Treatment of hypertension in high-risk patients. Monotherapy or combination? The Practitioner 2016; 7: 17-23. (In Russ.)
9. Oganov RG, Timofeeva TN, Koltunov IE, et al. Epidemiology of arterial hypertension in Russia. Epidemiological Monitoring Results 2003-2010. Cardiovascular Therapy and Prevention 2011; 10 (1): 9-13. (In Russ.)
10. Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42: 1206-52.
11. Shalnova SA, Deev AD, Metelskaya VA, et al. Awareness and statin therapy in patients with various cardiovascular risk. By the data from ECCD. Cardiovascular Therapy and Prevention 2016; 15 (4): 29-37. (In Russ.)
Review
For citations:
Efanov A.Yu., Vyalkina Yu.A., Petrova Yu.A., Safiullina Z.M., Abaturova O.V., Shalaev S.V. SPECIFICS OF ANTIHYPERTENSION THERAPY IN HYPERTENSIVES OF VARIOUS CARDIOVASCULAR RISK (BY THE REGISTRY OF CHRONIC NON-COMMUNICABLE DISEASES IN TYUMENSKAYA OBLAST). Cardiovascular Therapy and Prevention. 2018;17(3):4-10. (In Russ.) https://doi.org/10.15829/1728-8800-2018-3-4-10