QUALITY OF TREATMENT OF ARTERIAL HYPERTENSION IN COMBATANTS TAKING INTO ACCOUNT THE PRESENT COMORBID PATHOLOGY

Abstract

Objective: Assessment of compliance of treatment of arterial hypertension (AH) in participants of modern armed conflicts with the requirements of evidence-based medicine, taking into account their comorbid pathology. Design and method: The design of the study was passive retrospective one-time (cross-sectional). The medical charts of inpatient patients of 213 male combatants, aged 27-59 years, average age 45.0 ± 6.8 years, who underwent treatment during 2018-2021, were analyzed by the method of random sampling. Results: It was established that all combatants with hypertension were prescribed antihypertensive drugs: angiotensin-converting enzyme inhibitors (54% of patients), calcium channel blockers (26%), angiotensin receptor blockers (25%) (that is, not all patients used angiotensin-converting enzyme inhibitors or angiotensin receptor blockers), beta blockers (24%) and diuretics (16%). In combatants suffering from hypertension with comorbid coronary heart disease (CHD), beta blockers were prescribed in 26%, calcium channel blockers in 28%, statins in only 45% of patients, without monitoring the achievement of target levels of low-density lipoprotein cholesterol density; antiplatelet therapy was prescribed for 70% of patients, which does not meet the requirements of modern medical and technological documents and needs correction. An insufficient prescription of antihypertensive drugs from the groups of beta blockers (26% of patients) and calcium channel blockers (28%) was established in military personnel with hypertension - participants in modern armed conflicts with comorbid coronary artery disease. Inadequate prescribing of statins (only in 45% of patients) and antiplatelet therapy (70%) to patients with hypertension with comorbid coronary heart disease and lack of strict control of low-density lipoprotein cholesterol levels were revealed. Conclusions: It is necessary to increase the awareness of military doctors about the need for cardiovascular risk stratification in all patients with hypertension and patients with hypertension with comorbid coronary heart disease of combatants, regarding modern requirements for the treatment of patients with hypertension with concomitant pathology, on issues of safety and feasibility of prescribing statins and antiplatelet therapy to combatants with hypertension and concomitant coronary heart disease to reduce the risk of developing cardiovascular complications and improve the prognosis with this comorbidity.