Treatment of patients with arterial hypertension in clinical practice in 2010–2020 (according to the national register of hypertension)

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Aim. To analyze therapy in patients with arterial hypertension (AH) in 2010–2020.

Materials and methods. Data of hypertensive patients observed in primary health care, entered into the base of hypertension registry for 2010–2020 years in the whole group (n=44 653) and in a separate subgroup of hypertensive patients in the absence of: ischemic heart disease, a history of myocardial infarction, chronic heart failure (n=20 569).

Results. About 80% of hypertensive patients are patients of high and very high risks (from 2010 to 2020, the proportion of very high cardiovascular risk (CVR) increased from 18.1 to 57.3%). The number of hypertensive patients with a history of myocardial infarction increased in 5 times, in 3 times with ischemic heart disease and with chronic heart failure. The number of prescribed drugs increased: mineralocorticoid receptor antagonist (in 5.8 times), loop diuretics (in 7.2) angiotensin receptor blockers (in 3 times), b-adrenoblockers, calcium channel blockers of the dihydropyridine series, thiazide-like diuretics in 2 times. Patients at high and very high risk are more likely reached target blood pressure values. Angiotensin-converting enzyme inhibitors were prescribed in more than 70% of patients with hypertension and the absence of coronary heart disease, chronic heart failure, history of myocardial infarction; the prescription of b-adrenoblockers, angiotension receptor blockers, thiazide-like and loop diuretics increased.

Conclusion. The proportion of more severe and comorbid patients has increased in observed in primary health care patients with AH over a 10-year period (2010–2020). This was probably the main factor of increasing antihypertensive therapy and prescribing drugs with additional indications and improving the achievement of target blood pressure in patients with high and very high cardiovascular risk.

作者简介

Anna Aksenova

National Medical Research Center of Cardiology

编辑信件的主要联系方式.
Email: aksenovaannav@gmail.com
ORCID iD: 0000-0001-8048-4882

канд. мед. наук, науч. сотр. отд. гипертонии, рук. отд. гипертонии

俄罗斯联邦, Moscow

Elena Oschepkova

National Medical Research Center of Cardiology

Email: aksenovaannav@gmail.com
ORCID iD: 0000-0003-4534-9890

д-р мед. наук, проф., гл. науч. сотр. отд. гипертонии, рук. отд. гипертонии

俄罗斯联邦, Moscow

Irina Chazova

National Medical Research Center of Cardiology

Email: aksenovaannav@gmail.com
ORCID iD: 0000-0002-9822-4357

акад. РАН, д-р мед. наук, проф., зам. ген. дир. по научно-экспертной работе, рук. отд. гипертонии

俄罗斯联邦, Moscow

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2. Fig. 1. The frequency of prescribing antihypertensive drugs to patients with arterial hypertension (AH) in 2010–2020 (n=44 653): a – β-blockers, angiotensin-converting enzyme inhibitor, mineralocorticoid receptor antagonist, angiotensin receptor blockers; b – dihydropyridine calcium channel blocker, loop diuretic, thiazide-like diuretic, thiazide diuretic, calcium channel blocker.

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3. Fig. 2. Dynamics of the number of prescribed antihypertensive drugs for patients with AH in 2010–2020: a – all patients with AH in the whole group(n=44 653); b – patients with AH without other cardiovascular diseases (ischemic heart disease and myocardial infarction in history, chronic heart failure; n=20 569).

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4. Fig. 3. Dynamics of the structure of cardiovascular risk groups in patients with AH in 2010–2020: a – all patients with AH in the whole group (n=44 653); b – patients with AH without cardiovascular diseases (ischemic heart disease and myocardial infarction in history, chronic heart failure; n=20 569).

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5. Fig. 4. Dynamics of the structure of diagnoses of cardiovascular diseases in patients with AH in 2010–2020 (n=44 653).

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6. Fig. 5. Analysis of the frequency of coronary bypass surgery and percutaneous coronary interventions in men (n=7083, p=0.0001), in women (n=7900, p=0.0001) in 2015–2017 and 2018–2020.

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7. Fig. 6. Dynamics of achieving target blood pressure in 2010–2020 in men and women with AH: a – in general for the entire group (n=44 653); b – in patients with AH without cardiovascular diseases (ischemic heart disease, myocardial infarction in anamnesis, chronic heart failure; n=20 569).

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8. Fig. 7. Dynamics of achievement of target blood pressure in men (n=5016) and women (n=4003) with AH depending on cardiovascular risk in 2015–2017 and 2018–2020.

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9. Fig. 8. The frequency of prescribing antihypertensive drugs to patients with AH without coronary heart disease, myocardial infarction, chronic heart failure in 2010–2020 (n=20 569): a – β-blockers, angiotensin-converting enzyme inhibitor, mineralocorticoid receptor antagonist, angiotensin receptor blockers; b – dihydropyridine calcium channel blocker, loop diuretic, thiazide-like diuretic, thiazide diuretic, calcium channel blocker.

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