ESTABLISHED COMORBIDITY IN ARTERIAL HYPERTENSION PATIENTS IN RURAL AREAS

Aim. To analyze the specifics of comorbidity forming and age­related correlations of the risk factors (RF) distribution in arterial hypertension (AH) patients living in rural areas.

Material and methods. In 2015­2017 a retrospective analysis of 2500 patients database was done at two general practitioners offices in Konakovsky District of Tverskaya Oblast. Of those, 350 were selected (14%) at the age 44­53 (164 males, 186 females) among the charts containing most complete data on the dispanserization. Additionally, surveying of the group was done for more detailed retrospective analysis of comorbidity and RF existence during lifetime of 25­35 years.

Results. In the structure of comorbidity AH predominates, which has been diagnosed in 50,86% of patients; mostly it is diagnosed at the age 44­53 (81,06%). After AH, 2nd place is held by dorsopathies (24%), 3rd — gastrointestinal disorders (12%). For chronic pulmonary obstructive disease and cerebrovascular disease — it is less than 3%. 96,1% of men with AH are smokers at the age 18 to 53 y. o. By the age 53, in 40,26% of men and 36,63% of women there is bodyweight increase; and raised cholesterol — in 48,05% and 22,77%, respectively.

Conclusion. In rural areas inhabitants, the formation of comorbidity is ongoing mostly at age 44­53 y. o. Of the specifics of comorbidity in these patients, there is often combination of AH with dorsopathies, and quite rare — with chronic obstructive lung disease or cerebrovascular diseases. The observed at the age 34­43 “diagnostic gap” points on the necessity for attention to this exact age strata with the aim of ontime diagnostics and early stages of diseases reveal. The structure of RF during the lifetime is not homogenic and is the highest at the age of comorbidity forming (except smoking and professional harms). All the considered RF are more prominent in men than in women.

1. Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Russian Journal of Cardiology 2014; 1 (105): 7­94. (In Russ.) DOI: 10.1097/01.hjh.0000431740.32696.

2. Pedersen HS, Vestergaard M, Prior A, et al. The impact of socioeconomic status and multimorbidity on mortality: a population­based cohort study. Jensen Clinical Epidemiology 2017; 9: 279­89. DOI: 10.2147/CLEP.S129415.

3. Hillas G, Perlikos F, Tsiligianni I, Tzanakis N. Managing comorbidities in COPD. Int J Chron Obstruct Pulmon Dis 2015; 10: 95­109. DOI: 10.2147/COPD.S54473.

4. Health care in Russia. 2015. Article collection Rosstat. Moscow, 2015.174 p. (In Russ.) Здравоохранение в России. 2015. Стат. сб. Росстат. М., 2015. 174 с. URL: http://www.gks.ru/free_doc/doc_2015/zdrav15.pdf. ISBN 978­589476­399­6.

5. Boytsov SA, Balanova YA, Shalnova SA, et al. Arterial hypertension among individuals of 25­64 years old: prevalence, awareness, treatment and control (data from the ESSE study). Cardiovascular Therapy and Prevention 2014; 13 (4): 4­14. (In Russ.) DOI: 10.15829/1728­8800­2014­4­4­14.

6. Lyamina NP, Nalivaeva AV, Senchikhin VN, Lipchanskaya TP. Intensity of cardiovascular and behavioral risk factors inmasked and stable arterial hypertension in young subjects. Arterial Hypertension 2016; 22 (3): 244­52. (In Russ.). DOI: 10.18705/1607­419X2016­22­3­244­252.

7. Shalnova SA, Deev AD, Karpov YA. The arterial hypertension and ischemic heart disease in actual practice cardiologist. Cardiovascular Therapy and Prevention 2006; 5 (2): 73­80. (In Russ.)

8. Kannel WB. Risk stratification in hypertension: new insights from the Framingham Study. Am J Hypertens 2000; 13(1), Pt. 2.: 3­10. https://www.ncbi.nlm.nih.gov/pubmed/10678282 PMID: 10678282 [Indexed for MEDLINE].

9. Sumerkina VA, Chulkov VS, Golovneva ES, Chulkov VS. Age features of lipid, carbohydrate metabolism and hemostasis in young patients with different components of the metabolic syndrome. Arterial Hypertension 2016; 22 (6): 594­609. (In Russ.) DOI: 10.18705/1607­419X2016­22­6­594­609.

10. Pastukhov AV, Cherkashin DV, Solncev VN, et al. Peculiarities of arterial hypertension in men of different age ranges. Arterial Hypertension 2014; 20 (4): 296­306. (In Russ.) DOI: 10.18705/1607­419X­2014­20­4­296306.