Abstract
Aim. To reveal peculiarities of arterial hypertension (AH) diagnosis and therapy and their matching with international and national guidelines on AH. Material and Methods. An interview among Moscow physicians dealing with hypertensive patients was conducted in April-June 2005. Interview was taken with specially worked out forms containing 15 questions about hypertensive patient management. 102 physicians took part in interviewing, among them 65 internists and 37 cardiologists. Among interviewed physicians 56 ones were from outpatient clinics, 19 - from diagnostic centers, 14 - from hospitals, 5 - from commercial medical centers, 4 - from research center and 3 physicians had private practice. Results. 80,4% of interviewed physicians correctly determined the main goals of AH therapy. 16% of doctors did not indicate blood pressure level below 140/90 mm Hg as target level of secondary prevention. Mainly antihypertensive therapy was presented by four classes of medicines, their shares were as follow: ACE inhibitors - 35%, beta-blockers – 28%, diuretics – 26% and calcium antagonists – 10%. Other classes of antihypertensive medicines (antagonists of angiotensin-II receptors, central acting medicines) made about 1% of share. When choosing original medicine among several suggested trade marks, only 22% of doctors defined the medicine correctly. Original medicines made only 29,4% prescriptions in real medical practice. Conclusion. Real practice of AH diagnosis and therapy considerably differs from international and national guidelines on AH. It is possibly related with lack of appropriate knowledge among physicians as well as problems in public health service.
Highlights
Особенности диагностики и вторичной профилактики артериальной гипертонии по результатам опроса врачей Н.С
Реальная практика диагностики и лечения артериальной гипертонии (АГ) существенно отличается от международных и национальных рекомендаций по АГ, что возможно связано как с недостаточными теоретическими знаниями врачей так и с определенными трудностями, существующими в практическом здравоохранении
Real practice of arterial hypertension (AH) diagnosis and therapy considerably differs from international and national guidelines on AH. It is possibly related with lack of appropriate knowledge among physicians as well as problems in public health service
Summary
Государственный научно-исследовательский центр профилактической медицины Росздрава, Москва, Агенство медицинской информации "СМ", Москва. Real practice of AH diagnosis and therapy considerably differs from international and national guidelines on AH. It is possibly related with lack of appropriate knowledge among physicians as well as problems in public health service. Что эти показатели в России остаются на уровне 90-х годов прошлого века, тогда как во Франции эффективность лечения составляет 24% [6], а в США эта цифра достигает 34% [7]. Однако в ряде исследований было показано, что практические врачи в стратегии и тактике лечения АГ недостаточно четко представляют себе конечные цели терапии АГ (максимальное снижение сердечнососудистых заболеваний и смертности), мало знакомы с критериями разделения по категориям риска развития сердечно-сосудистых осложнений и далеко не всегда последовательно добиваются целевых цифр АД. Одним из методов изучения состояния диагностики и лечения АГ является анкетирование врачей
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