Hypertension control during the COVID-19 pandemic: results of the MMM2021 in Russia

Rotar, О. P.; Erina, A.; Boyarinova, M.; Moguchaya, E.; Колесова, Е. П.; Tolkunova, Kristina; Gorshevaya, A. R.; Kovalenko, Kseniya A.; Смирнова, Е. А.; Belenikina, Ya. A.; Bikushova, I. V.; Kercheva, M. A.; Svarovskaya, A. V.; Петрова, М. М.; Kaskaeva, D. S.; Shcherbina, P. A.; Никулина, С. Ю.; Чернова, А. А.; Levshin, A. V.; Shabelsky, А. O.; Железняк, Е. И.; Kartashova, Elena; Sharapova, Yu. A.; Chernykh, T. M.; Derevyanchenko, M. V.; Fedotov, V. V.; Shaposhnikova, N. Yu.; Макеева, Е. Р.; Ulitina, O. V.; Menzorov, M. V.; Dolya, E.; Таничева, А. А.; Конради, А. О.; Shlyakhto, Е. V.

doi:10.15829/1560-4071-2022-5014

Russ J Cardiol

2022

DOI: 10.15829/1560-4071-2022-5014

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Hypertension control during the COVID-19 pandemic: results of the MMM2021 in Russia

О. P. Rotar

A. Erina

M. Boyarinova

et al.

Abstract: Repetitive quarantines and social restrictions during the coronavirus disease 2019 (COVID-19) pandemic have negatively affected the population health in general, and the control of hypertension (HTN) in particular.Aim. To evaluate the control of HTN in the Russian population during the COVID-19 period based on the results of screening for HTN May Measurement Month 2021 (MMM2021).Material and methods. During May-August 2021, 2491 participants from 11 Russian regions took part in the screening. Participation was… Show more

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Cited by 4 publications

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2023 All-Russian screening for hypertension: results

Rotar,

Ilyanova,

Boyarinova

et al. 2024

Russ J Cardiol

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Aim. To assess awareness of blood pressure (BP) level, adherence to therapy and achievement of target BP in residents of Russian regions as part of the 2023 hypertension (HTN) screening campaign.Material and methods. During May 2023, 4613 participants from 23 cities of Russia took part in the screening. Participation was voluntary without restrictions on sex. All patients aged over 18 years. During screening, BP and pulse were measured three times using automatic or mechanical BP monitors, and a questionnaire about behavioral risk factors, concomitant diseases and therapy was filled out. HTN was diagnosed with systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or taking antihypertensive therapy (AHT).Results. The analysis included data from 4585 respondents aged 18 to 95 years with an average age of 45 [28;59] years, of which 1729 were men (37,7%). The proportion of hypertensive patients was 49,6%. Among them, 62,8% took AHT and achieved target BP in 76,6% and 45,7% with the target BP criterion <140/90 mm Hg and <130/80 mm Hg, respectively. Most patients took dual AHT (37,4%), while monotherapy and triple therapy was registered in 27,5% and 23,4%, respectively. Initiation of therapy was performed with combination AHT in 43,7% of patients with HTN and 41,4% are currently using fixed-dose combination therapy. On-demand therapy was the most common reason for skipping medications and was more common in women, while men more often cited the high drug cost and a history of adverse reactions. Among patients with HTN, home BP measurement was associated with a higher prevalence of achieving target BP as follows: 1000 (60%) vs 100 (17%), p<0,001.Conclusion. The data obtained indicate, on the one hand, a continuing insufficient level of awareness about high BP and the use of antihypertensive drugs among the population, but there is a tendency to improve the effectiveness of the treatment of hypertension, including the use of fixed-dose combinations of antihypertensive drugs.

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2023 All-Russian screening for hypertension: results

Rotar,

Ilyanova,

Boyarinova

et al. 2024

Russ J Cardiol

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Patient Adherence and Duration of Continuous Treatment With Various Arbs in Patients With Uncomplicated Arterial Hypertension in the USA Based on The Analysis of the Truven Health Analytics MarketScan Database

Belenkov,

Glezer,

Kozhevnikova

et al. 2024

Kardiologiia

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Aim. To discuss two aspects that can be used to improve the adherence to therapy in patients with arterial hypertension (AH): 1) which of the angiotensin II receptor blockers (ARBs) provides the highest adherence rates; 2) how various factors influence adherence rates.Material and methods. An analysis of one of the world's largest clinical practice databases, Truven Health Analytics MarketScan (currently Merative MarketScan), was performed. The analysis included data on patients of both sexes aged 30 to 65 years who had been diagnosed with uncomplicated AH (at least once between March 1, 2012 and January 1, 2018) and prescribed monotherapy with one of ARBs. The exclusion criteria were heart failure and the treatment with two or more ARBs (simultaneously or sequentially) during the treatment period. Ultimately, the study included 717,099 patients with uncomplicated AH, who were divided into four groups based on the prescribed drug: azilsartan (n=4276), candesartan (n=6023), losartan (n=586,857), and valsartan (n=119,943). Adherence to treatment was evaluated by two parameters: duration of continuous therapy and medication possession ratio (MPR). The individual effect of each factor (specific ARB used for therapy, patient gender, age, initial ARB dose, patient co-payment per day of treatment) on the adherence to treatment was assessed using a regression analysis.Results. The adherence to the ARB therapy was generally high. The MPR was the lowest in the azilsartan group and the highest in the candesartan group. However, the parameters that potentially influenced both the MPR and the duration of continuous therapy (patient’s gender and age, initial ARB dose, co-payment size) differed significantly between the groups receiving different ARBs. The regression analysis showed that both adherence parameters and the duration of continuous therapy were higher in patients receiving candesartan than in patients receiving azilsartan, losartan or valsartan, when the effect on the adherence of other factors available for study (age, gender, initial dose of the drug, and the absolute size of co-payment for a day of therapy) was excluded. The lowest adherence to therapy was observed in the azilsartan treatment group (p<0.01).Conclusion. The study provided data for comparing the adherence of patients with uncomplicated AH to the therapy with different ARBs. Further study of adherence to treatment will provide additional data that will allow an optimal selection of drugs for the treatment of AH in patients with potentially poor adherence.

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Factors, associated with effective control of arterial hypertension in the general working-age population

2022

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Objective. To analyze determinants and their contribution to efficiency of arterial hypertension (AH) control in the hypertensive population.Design and methods. In the cross-sectional study a total of 334 men and 436 women derived from a representative sample of the general population aged 25–64 years, meeting criteria for AH, were examined. All subjects signed voluntary informed consent to participate in the study. A standard questionnaire based on adapted international methods was used. The associative analysis included sets of socioeconomic, behavioral, psychosocial, medical and biological variables. We used univariable (χ2, Fisher exact test, Student’s t-test, Mann–Whitney test) and multivariable statistics (logistic regression). Effective AH control was considered in case of blood pressure (BP) < 140/90 mm Hg. Probabilities of error < 5% were considered statistically significant.Results. Irrespective of gender, use of hypotensive drugs was the most influential factor in ensuring effective control of AH in the population. A major barrier to reaching target BP levels in women was the number of current metabolic risk factors (RF). Age (more significant in men), general obesity (both sexes), history of kidney disease (men), elevated glucose and triglycerides (women) were also associated with ineffective AH control. Angiotensine receptor blockers, angiotensin converting enzyme inhibitors (ACEI), sympatholytics/ spasmolythics in men and ACEI, beta-blockers and diuretics (at moderate or higher affluence only) in women were associated with a higher probability of reaching BP targets. Knowledge of cholesterol level (both sexes), cardiovascular disease, use of statins, reduced quality of life (difficulty with daily activities), sedentary working activity and affluence in men were also associated with effective control of BP.Conclusions. The data obtained demonstrate that with an increase in the coverage of the hypertensive population with antihypertensive treatment, an increase in the proportion of people reaching the target BP levels may be significant, but still the most important issue is the treatment efficiency. The need to correct behavioral factors that lead to the development of metabolic disorders, especially obesity, but also other RF, remains the most challenging issue in this regard. The findings convince us that it is advisable to take measures to increase awareness of the main cardiovascular disease RF, to involve patients more in controlling their RF, to prescribe statins more frequently, to create conditions for taking antihypertensive drugs in the so-called “mobile” types of working activity, to keep developing infrastructure for mass participation of population in sport activities, and to improve economic conditions.

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Hypertension control during the COVID-19 pandemic: results of the MMM2021 in Russia

Cited by 4 publications

References 18 publications

2023 All-Russian screening for hypertension: results

2023 All-Russian screening for hypertension: results

Patient Adherence and Duration of Continuous Treatment With Various Arbs in Patients With Uncomplicated Arterial Hypertension in the USA Based on The Analysis of the Truven Health Analytics MarketScan Database

Factors, associated with effective control of arterial hypertension in the general working-age population

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