P6364Challenges of implementation of new European Guidelines 2018 on hypertension in a real clinical practice

Abstract

Abstract Objective Novel European guidelines 2018 on Hypertension raised the question about the implementation of new target blood pressure (BP) levels into real practice. The aim of the present study was to compare achieved target BP levels in clinical practice according to European guidelines 2013 and 2018. Design and methods Data of 25428 hypertensive patients form the electronic data base of ambulatory of the Research Centre during 2016–2018 years were analyzed. 8484 hypertensive patients were examined in 2016, 8490 patients – in 2017 and 8454 patients – in 2018 year. Only patients with hypertension as the major disease and on current medication were and under the age of 80 years included. Results Applying the Guidelines 2013, 5978 patients (23,5%) were on target and have had BP control under 140/90 mm Hg, while according to new Guidelines 2018 only 1749 patients (6,9%) have achieved recommended BP level under 130/80 mm Hg. BP control according to both Guidelines Year Sex Age group Number of hypertensive patients BP <140/90 mm Hg BP <130/80 mm Hg 2016 Women Under 50 716 208 (29%) 72 (10,1%) Women 50 and older 4894 1197 (24,5%) 344 (7,0%) Men Under 50 997 252 (25,3%) 57 (5,7%) Men 50 and older 1877 402 (21,4%) 104 (5,5%) 2017 Women Under 50 716 201 (28,1%) 66 (9,2%) Women 50 and older 4734 1049 (22,2%) 325 (6,9%) Men Under 50 1156 266 (23%) 59 (5,1%) Men 50 and older 1884 339 (18%) 84 (4,5%) 2018 Women Under 50 744 224 (30,1%) 87 (11,7%) Women 50 and older 4544 1126 (24,8%) 360 (7,9%) Men Under 50 1364 312 (22,8%) 80 (5,9%) Men 50 and older 1802 402 (22,3%) 111 (6,2%) Conclusion According to the previous criteria approximately quarter of all hypertensive patients in real clinical practice in St.Petersburg are on target, while recommended in 2018 Guidelines new target levels are achieved less that in 12%t. Women under 50 have a better BP control. It seems that implementation of new targets for BP will be extremely hard and needs huge investment in education, motivation, compliance and new strategies.