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Impact of Clinical Factors on the Achievement of Target Blood Pressure in Hypertensive Patients from Ivanovo Region of Russia: Data of 2015

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Abstract

Introduction

In Russia, blood pressure (BP) control is below the optimal. The little is known about regional features and barriers to adequate BP control in Russian primary care.

Aim

To evaluate the impact of clinical factors on achieving the target BP in hypertensive patients in one region of Russia.

Methods

Retrospective medical data of 2015 on 11,129 patients (31.4% male) with hypertension (Htn) from Ivanovo region of Russia were examined. Achievement of target BP was assessed in all patients. We study association between BP control and clinical factors.

Results

45.9% of studied patients with Htn had controlled BP. The frequency of achieving the target BP in subsets of hypertensive patients was 37.8% in patients with diabetes, 39.5% in patients with coronary artery disease, and 29.9% in patients with chronic heart failure. The main clinical factors associated with achieving the target BP in studied hypertensive patients were the advice on alcohol consumption, advice on smoking cessation, and advice on weight reduction. Therapy with main antihypertensive drugs (in particular, beta-blockers and thiazide diuretics) were also factors of optimal BP control in these patients. Comorbidities (chronic heart failure and cardiovascular diseases requiring the prescription of aspirin and statins) and family history of coronary artery disease were associated with inadequate BP control. A negative effect of some antihypertensive drugs (potassium sparing diuretics, ARBs, ACE-Is, and dihydropyridine CCBs) on BP control that was found out in our study requires further investigation. Other studied factors had no influence on BP control in patients with Htn from Ivanovo region.

Conclusion

We identified regional factors of BP control in hypertensive patients from Ivanovo region of Russia. It is shown that individual medical education (in particular, medical advices) is the most important factor of optimal BP control. The intervention with antihypertensive therapy (beta-blockers and thiazide diuretics) facilitates the achievement of target BP. Comorbidity and age reduce the frequency of achieving the target BP.

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Acknowledgements

We thank all participants of the RusR-Htn-CAD-CHF involved in data collection for patients with Htn in Ivanovo region of Russia.

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Correspondence to A. R. Kiselev.

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Conflict of interest

None declared. The RusR-Htn-CAD-CHF is funded by the Russian Ministry of Health as a part of the Health National Project. The Russian Ministry of Health was not involved in the collection, analysis, and interpretation of data; in the writing of this manuscript; or in the decision to submit the paper for publication. The authors have not received any financial support for the preparation of this paper.

Human rights statement

For this type of study formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

This article is part of the topical collection on Epidemiology of Hypertension.

Appendix

Appendix

See Table 7.

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Kiselev, A.R., Posnenkova, O.M., Belova, O.A. et al. Impact of Clinical Factors on the Achievement of Target Blood Pressure in Hypertensive Patients from Ivanovo Region of Russia: Data of 2015. High Blood Press Cardiovasc Prev 24, 425–435 (2017). https://doi.org/10.1007/s40292-017-0227-y

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