RISK PROFILE AND ANTIHYPERTENSIVE TREATMENT EFFICACY IN PATIENTS REFERRED TO THE CARDIOLOGICAL CENTRE: POST-HOC ANALYSIS

Abstract

Background : Arterial hypertension (HTN) remains a key risk factor for cardiovascular disease burden and mortality. Efficacy of treatment differs across regions, depending on various medical facilities. Assessment of specific features of antihypertensive treatment (AHT) provided in cardiology outpatient care setting is of special interest. Objective : To investigate comorbidity and cardiovascular risk factors and to determine the features of treatment in patients with HTN referred to federal cardiology center. Design and methods : Retrospective analysis was conducted using 100 randomly selected electronic health records of patients who had attended to the Almazov National Medical Research Centre (former Federal Almazov North-West Medical Research Centre) seeking for doctor’s advice on cardiovascular diseases in the period from 2010-2013. Men (n=44) and women (n=56) aged 23 to 88 years (59 ± 13 years) represented a sample size. HTN was diagnosed as systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg, or if patient had been receiving antihypertensive therapy. The efficacy of treatment was taken as target BP achievement by patients on AHT. Controlled hypertension shall mean the number of patients reached target BP levels among all hypertensives. AHT was analyzed with defining its type and groups of prescribed medications. Results : In vast majority of cases HTN was associated with overt cardiovascular diseases. An incidence of tobacco smoking was minimal while obesity and diabetes mellitus were diagnosed typically in patients with HTN. Mean SBP and DBP levels were 143±23 mmHg and 87±11 mmHg, respectively. Antihypertensive treatment was prescribed for all hypertensive patients (n=82), 62% of them were taking medications (n = 51), while women were more adherent to doctors’ advices (p = 0.026). Effective treatment was observed in (n=40) 78% of cases, and in 65% (n = 53) of them HTN was controlled. Most patients were prescribed combination therapy (n = 65) 79%, more often – a threedrug combination (n=32, 48.5%). Antihypertensive drugs were mainly beta-adrenoblockers, ACE inhibitors and diuretics. Conclusion : There is a strict association of HTN with overt cardiovascular diseases. More than half of the patients achieved adequate blood pressure control. Young female patients who take combination therapy regularly and those with concomitant chronic heart failure are likely to have HTN to be under control.