Диспансеризация как важный вектор определения и профилактики сердечно-сосудистого риска в амбулаторных условиях

Abstract

Aim: To assess the importance of dispensary follow-up in the prevention and determination of risk factors for cardiovascular complications in hypertension. Design: A retrospective study. Materials and methods. Dispensary observation cards of 98 patients were analyzed. The average age of patients was 45 ± 5.8 years. Risk factors for the development of cardiovascular diseases were determined (body mass index (BMI), levels of glucose and total cholesterol in the blood, blood pressure (BP) were studied), and the risk was calculated according to the SCORE scale in two formed groups of people: 1st — regularly undergoing medical examinations (n = 47), 2nd — have not passed it for more than 2 years (n = 51). Results. In the 1st group, the maximum increase in average blood pressure was recorded in patients 60–80 years (151/95 ± 5/2.3 mm Hg. Art.), in the 2nd — 60–80 (179/100 ± 3/5.4 mm Hg) and 40–60 years (171/98 ± 5/3.8 mm Hg). Overweight in the 1-st group was more often detected in patients 40–60 years old — in 37.5% cases (n = 18), obesity of 1–2 degrees — in persons 40–60 and 60–80 years old (n = 27, 57.4%). In the group of patients who have not undergone clinical examination for more than 2 years, overweight was determined in persons 40–60 and 60–80 years old (n = 21, 41.2%), grade 1 obesity was detected among patients 40–60 years old (n = 21, 41.2%), obesity of the 2nd degree — in persons 60–80 years old (n = 9, 17.6%). Hyperglycemia in the 1st group was recorded in 2 (4.3%) cases, in the 2nd group it was noted in 24 (47.1%) patients 60–80 years old. Hypercholesterolemia was diagnosed among persons 60–80 years old: in the 1st group — up to 6.4 ± 0.64 mmol/l, in the 2nd — up to 7.8 ± 0.64 mmol/l. In patients 40–60 years old in the 1st group, the average value of total cholesterol was 4.8 ± 0.64 mmol/L, in the 2nd group — 6.2 ± 0.64 mmol/L. In patients who have not undergone clinical examination for more than 2 years, compared with persons regularly participating in it, a statistically significant increase in hyperglycemia by 2 times (p < 0.001), total cholesterol increase by 1.5 times (p < 0.001), the average value of systolic BP increase by 1.5 times (p < 0.001), cases of very high (4 in the 1st group vs 17 in the 2nd (p < 0.001) and extreme (0 vs 14 (p < 0.001) cardiovascular risk in the second group. Positive correlations of mean strength between systolic blood presure, glycemia and total cholesterol were established (r = 0.41, p < 0.001 and r = 0.49, p < 0.001, respectively). Conclusion. Regular medical examination will make it possible to timely identify the risk of developing cardiovascular complications in hypertension and carry out prevention. Keywords: medical examination, arterial hypertension, prevention