PS-C19-11: ASSESSMENT OF ADHERENCE TO ANTIHYPERTENSIVE THERAPY AND BLOOD PRESSURE TARGETS ACHIEVING AMONG HYPERTENSIVE PATIENTS IN THE REPUBLIC OF KAZAKHSTAN

Abstract

Introduction: Arterial hypertension is one of most prevalent cardiovascular diseases and leading factor of mortality and morbidity due to higher cardiovascular risk. To prevent cardiovascular events: myocardial infarction, stroke, heart failure it is crucial to manage hypertensive patients carefully and to achieve blood pressure targets. The one of leading causes of not achieving control of blood pressure levels is low adherence to therapy. Objective: The objective of this investigation is to assess the level of adherence to antihypertensive therapy and blood pressure targets achieving. Methods: A prospective cross-sectional study was conducted from August 2021 to November 2021 in four regions of Kazakhstan, included 1805 adults of both sexes (1073 women (59.40%) and 732 men (40.60%)) of mean age 39 years. Special survey, including assessment of current antihypertensive therapy, blood pressure and heart rate measurement were performed. Statistical test was performed by the StatTech 2.6.1 (Russia, 2020), IBM SPSS statistics version 28.0, Epi Info, version 7. Results: The prevalence of arterial hypertension in the population was 37.06%. Of the 658 participants with hypertension, 333 (40.51%) were aware of their diagnosis and 227 (68.17%) of them were taking antihypertensive medications. 33.5% were on monotherapy; 36.1%, 17.6%, and 3% were taking 2, 3, and 4 classes of antihypertensive drugs, respectively. 113 (49.78%) had a blood pressure lower or equal to 140/90 mm Hg, and only 33 (14.54%) lower or equal to 130/80 mm Hg. Among participants on monotherapy, 42% had blood pressure levels higher or equal to 140/90 mm Hg. Of all patients on therapy, only 152 (45.6%) were taking drugs regularly. A strong relationship was found between adherence to therapy and age (OR 1.049, 95% CI 1.031, 1.066, p < 0.001): adherence to therapy was higher in older patients. It should also be noted that of the total number of participants on antihypertensive therapy, 95 (41.9%) were taking acetylsalicylic acid, of which only 16 (16.8%) had a history of myocardial infarction or stroke. Conclusion: To conclude, the level of adherence to therapy was 45.6%, more than half of the patients were not adherent to current antihypertensive therapy. When using the lower BP target of < 130/80 mm Hg as the definition of control, which more accurately reflects current guidelines the proportion controlled was 14.54%. It could be related to several different causes: low levels of adherence, little knowledge of healthcare specialists about target blood pressure levels and little knowledge of population about importance of control blood pressure. In conclusion, the study confirms the importance and relevance of arterial hypertension as socially significant disease.