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Trends of arterial hypertension in russia: is there a progress in prescription of antihypertensive therapies? (results of studies in 1993–2013)

Shalnova S. A., Deev A. D., Balanova Yu. A., Kapustina A. V., Konstantinov V. V., Muromtseva T. A., Boytsov S. A.
Federal State Budgetary Institution, “National Research Center for Preventive Medicine” of the RF Ministry of Health Care, Petroverigsky Per. 10, Bldg. 3, Moscow 101990

Keywords: hyperpiesis, treatment, RF, epidemiology

DOI: 10.18087/rhj.2015.6.2145

Background. Prevalence of AH in the world varies from zero to more than 50%. At present time, it is well known that decreasing BP can restrict progression of renal insufficiency, development of MI, stroke, cardiovascular mortality, and all-cause mortality resulting from hypertension. Aim. Epidemiological analysis of prevalence of hypertension and drug therapies used in the Russian practice in recent 20 years, from 1993 to 2013. Materials and methods. The study was performed on three samples of Russian population aged 25–64 who were evaluated in 1992–94, 2003–2004, and 2012–14. The total number of evaluated persons was 64 819 including 26 051 men. Protocols of all three studies included general procedures (measurement of BP, heart rate, height, body weight, waist circumference) and questions on awareness, prescription medication, and BP. BP and heart rate, and anthropometrics were measured. In two studies, additional laboratory tests were performed. Results. A small but significant increase in AH incidence was observed in 2013 (44 %) compared with previous data due to an increase in AH among males. In 1993, the prevalence of AH among 25–64 years old men was 43 %; in 2003 – 36.1 %, and in 2013 – 48.2 %. In females, a sustained decrease in AH incidence from 48.6 to 40.8 % has been observed starting from 1993. Coverage of hypertensive men with the treatment was considerably less than of women. However, the effectiveness of treatment increased more than four times, 7 times for men and 3 times for women, in 2013 vs. 1993, although remained insufficient. Three common significant indices were isolated among factors associated with insufficient effectiveness of therapy: low level of education, obesity, and high heart rate. The choice of antihypertensive drugs (AHD) has considerably changed for 20 years. In 1993, central action drugs prevailed, with clonidine accounting for 17.1% of them and rauwolfia – for 47.7%. In 2013, RAAS inhibitors were the most often prescribed drugs, more than 70%. Notably, more than 50% of patients received a monotherapy. Conclusion. Issues of prescription and use of AHD should be continuously monitored in this country, which will allow detecting improper trends in the treatment of hypertension and taking actions for their correction in a timely fashion.
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Shalnova S. A., Deev A. D., Balanova Yu. A., Kapustina A. V., Konstantinov V. V., Muromtseva T. A. et al. Trends of arterial hypertension in russia: is there a progress in prescription of antihypertensive therapies? (results of studies in 1993–2013). Russian Heart Journal. 2015;14 (6):389–396

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