Consumption Of Antihypertensive Drugs Research Articles

Depression Onset After a Spouse’s Cardiovascular Event

Although cardiovascular disease (CVD) is a known risk factor for depression, evidence is lacking regarding whether and to what extent a spouse's CVD is associated with the subsequent mental health of individuals. To examine the association between CVD onset in spouses and subsequent depression. This cohort study examined 277 142 matched married couples enrolled in the Japan Health Insurance Association health insurance program between April 2015 and March 2022, covering approximately 40% of the working-age population in Japan. Index individuals (primary insured) whose spouses (dependent) experienced incident CVD between April 2016 and March 2022 were 1:1 matched to controls whose spouses did not experience CVD. Matching was based on age, sex, income, or the onset date of the spouses' CVD. Data analysis was conducted from April 2016 to March 2022. Spousal onset of CVD between fiscal years 2016 and 2021. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes were used to identify the composite CVD outcomes (stroke, heart failure, and myocardial infarction). Multivariate Cox proportional hazards models were used to investigate the association between spouses' new-onset CVD and individuals' depression, adjusting for sociodemographic characteristics and comorbidities of index individuals (diabetes, hypertension, and CVD) and spouses (diabetes, hypertension, and depression). Subgroup analyses were conducted according to sex, age, income levels, and history of CVD. Among 277 142 matched pairs of married couples, 263 610 (95.1%) had a male index individual; the mean (SD) age of index individuals was 58.2 (10.2) years. A new onset of depression was observed in 4876 individuals (1.8%). In multivariable Cox models, there was an association between the spouse's CVD and the individuals' depression (hazard ratio, 1.13 [95% CI, 1.07-1.20]). The subgroup analysis found no evidence of heterogeneity in sex, age, income level, or CVD history. The results were consistent when additionally adjusted for health behaviors (smoking, alcohol consumption, physical activity, and use of antihypertensive drugs) and objectively measured physical health conditions (body mass index, blood pressure, cholesterol levels, glucose levels, and estimated glomerular filtration rate) (hazard ratio, 1.16 [95% CI, 1.06-1.28]). In this nationwide cohort study of matched couples, a spouse's onset of CVD was associated with an increased risk of an individual's depression. These findings highlight the importance of preventive care for mental health disorders in individuals whose spouses experience incident CVD.

Research of trends in population consumption of antihypertensive drugs in the constituent entities of the Russian Federation

Aim is to study of the characteristics of population consumption of antihypertensive drugs in individual regions of the Russian Federation (using the example of Moscow and St. Petersburg).
 Materials and methods. When conducting the study, the following methods were used: content analysis, structural, comparative, logical, systemic, predictive, retrospective, graphic, marketing. The results were processed using normalization methods and mathematical statistics. The object of the study was statistical indicators of the sale of a range of antihypertensive drugs in the retail sector of the pharmaceutical market in Moscow and St. Petersburg.
 Results. In Moscow and St. Petersburg there is a wide range of drugs sold for the treatment of arterial hypertension. Monopreparations predominate in the sales structure of both constituent entities of the Russian Federation (90.08% and 85.64%). In Moscow, the leaders in consumption among single drugs are ACE inhibitors (26.62%), in St. Petersburg - -blockers (25.67%). In the subgroup of fixed combinations in both regions of the Russian Federation, ACE inhibitors in combination with diuretics are most in demand, accounting for 3.54% and 5.15% in the structure of sales of antihypertensive drugs in Moscow and St. Petersburg, respectively. Ratings of the most popular single drugs and fixed combinations of antihypertensive drugs have been compiled. A mathematical and statistical analysis was carried out.
 Conclusions. This article describes the characteristics of the population consumption of drugs prescribed for arterial hypertension in Moscow and St. Petersburg. The most consumed classes of antihypertensive drugs and INNs were identified. It has been established that there is a relationship between the sales volumes of drugs in physical terms (in packages) prescribed for arterial hypertension, the population size and the incidence of CSD in the constituent entities of the Russian Federation.

Age and duration of hypertension are associated with carotid artery tortuosity.

Tortuosity of the carotid artery is a common angiographic finding that may impact blood flow and neuronal function. However, information on its prevalence and risk factors remains limited. In this study, we determined to explore the factors affecting carotid artery tortuosity. The head and neck computed tomography angiography (CTA) imaging and cerebral angiography data performed at the Second Affiliated Hospital of Wenzhou Medical University between January 2019 and September 2021 were collected, and a total of 356 cases were enrolled in the study after screening. Carotid artery tortuosity refers to the angle between the two adjacent segments of the carotid artery, from the opening of the aortic arch on either side to the external orifice of the carotid canal, being less than 150°. A retrospective analysis was performed to compare the general information, laboratory indicators, personal history, and medical history between the two groups. The χ2 test, t-test, and Mann-Whitney U-test were performed to compare the parameters between the two groups. If there were significant differences between the groups, multivariate logistic regression was performed to analyze the factors affecting carotid artery tortuosity. A total of 222 of the 356 cases were determined to have carotid artery tortuosity, accounting for 63.6%. There were statistically significant differences in age, body mass index (BMI), duration of diabetes and hypertension, levels of low-density lipoprotein cholesterol (LDL-C), diastolic blood pressure, history of ischemic and hemorrhagic stroke, and the usage of antihypertensive drugs between the two groups. Multivariate logistic regression analysis of the above factors showed that age (OR = 5.063, 95% CI 2.963-10.26, p < 0.001) and duration of hypertension (OR = 2.356, 95% CI 1.353-8.625, p = 0.021) were associated with a higher incidence of carotid artery tortuosity. Compared to patients who did not consume antihypertensive drugs, the incidence of carotid artery tortuosity was significantly less (OR = 0.094, 95% CI 0.002-0.713, p = 0.019) in those consuming antihypertensive drugs. Carotid artery tortuosity is a relatively common carotid artery disease. The incidence of carotid artery tortuosity may increase with age and the duration of hypertension. The consumption of antihypertensive drugs may reduce the incidence of carotid artery tortuosity.

Exploring the primary health facility availability, health control, drug consumption, and healthy living behavior among patients with hypertension

Hypertension has been identified as a causative factor for cardiovascular disease, a leading global cause of death. The accessibility of health services plays a pivotal role in shaping community awareness and engagement in hypertension management. This research aimed to explore the availability of primary health facilities, health control practices, drug consumption, and healthy living behaviors among individuals with hypertension. Utilizing a correlation study with a cross-sectional design, the sample comprised 130 hypertensive individuals selected through purposive sampling. Statistical analysis used the Spearman rho correlation test. The findings revealed that significant correlations between primary health facility availability and health control behavior (α=0.000, r=0.310), antihypertensive drug consumption behavior (α=0.000, r=0.461), and healthy lifestyle behavior (α=0.000, r=0.478) among hypertensive patients. These results underscore the relationship between the availability of primary health facilities and the behavior of hypertensive patients in terms of health control, drug consumption, and healthy lifestyle choices within the community. While the full implementation of these behaviors among hypertensive patients may not be optimal, the observed good availability of primary health facilities serves as an initial step to promote improved behaviors in the management and prevention of hypertension complications within the community.

Relationship Between of Adherence Rate to Taking Drugs Antihypertensives against Blood Pressure of Elderly Patients in Sekarjaya Health Center Ogan Komering Ulu Regency

Hypertension is a disease that is often found in the community and continues to experience an increase in cases of hypertension due to unhealthy lifestyles. The purpose of this study was to determine the level of adherence to the consumption of antihypertensive drugs, describe the increase in patients' blood pressure and explain the relationship between the level of adherence in taking antihypertensive drugs to blood pressure in elderly patients. This study used a prospective quantitative descriptive method at the Sekarjaya Health Center, OKU Regency in May-June 2023. The results of the study found that out of 50 patients, 41 patients had low adherence and 9 patients had moderate adherence. In the classification of hypertension patients, 14 patients (28%) were at the pre-hypertensive level, 27 patients (54%) were at level 1 hypertension and 9 patients (18%) were at level 2 hypertension. Analysis of the relationship of adherence to blood pressure obtained a p value of 0.361. The conclusion of this study was that there was no relationship between compliance with blood pressure in hypertensive patients at the Sekarjaya Health Center, Ogan Komering Ulu Regency. However, the length of illness and forgetting to take medication was influence on compliance with p values of 0.045 and 0.002.&#x0D; Keywords: Hypertension, geriatrics, adherence, health center

A prospective observational study of prescription pattern of antihypertensive drugs in general medicine outpatient department of associated hospital RUHS CMS, Jaipur

Background: The increasing prevalence of hypertension is attributed to population growth, ageing and behavioural risk factors, such as unhealthy diet, harmful use of alcohol, lack of physical activity, excess weight and exposure to persistent stress. The aim of study is the prescribing pattern and the consumption of antihypertensive drugs in isolated hypertensive patients and in hypertensive patients with different co-existing morbidities. Methods: The present study is a Prospective observational study. The study was conducted at Medicine Department of associated hospital of RUHS College of Medical Sciences, Jaipur. Results: A total of 965 patients having hypertension were analyzed, in that 556 patients were male and 409 patients were female. In hypertension patients, angiotensin receptor blockers ARB, diuretics and β- blockers (29.90%) were mostly used classes in three drug therapy. Whereas telmisartan, hydrochlorothiazide and metoprolol (35.05%) were mostly prescribed. Drugs. In hypertension patients, angiotensin receptor blockers ARB, diuretics, β- blockers and calcium channel blockers (56.67%) and calcium channel blockers, angiotensin converting enzyme inhibitors, β-blockers and diuretics (43.33%) were used classes in four drug therapy. Whereas Telmisartan, Hydrochlorothiazide, Nebivolol and Amlodipine (62.5%) were mostly prescribed drugs. Hypertensive Patients with Comorbidity were found in higher prevalence with 276 hypertensive patients (28.60%) along with Diabetes Mellitus most commonly found and 389 hypertensive patients (40.31%) were found to be with No Comorbidity. Conclusions: Present results reveal that antihypertensive medication adherence to JNC-8 recommendations is suboptimal. Therefore, physicians should follow JNC-8 guidelines to improve the patients care because suboptimal adherence leads to adverse clinical outcomes. The present study demonstrated that physicians are not completely adhering to standard guidelines while treating hypertension with co-morbid conditions.

Long-Term Physical Activity Effectively Reduces the Consumption of Antihypertensive Drugs: A Randomized Controlled Trial.

Although physical activity (PA) has been shown to enhance hypertension control, the impact of exercise on the potential decrease of the use of antihypertensive medications remains inadequately researched. The aim was to assess the impact of a two-year PA on the medication requirements of individuals with hypertension. A clinical trial was conducted, involving 130 participants with essential hypertension who took at least one antihypertensive medication. Participants were randomly assigned to either a control group (CG n = 65) or an experimental group (EG n = 65) that underwent a 24-month supervised PA program based on a combination of aerobic and resistance training. The antihypertensive drug load for each participant was determined by adding the ratios of the prescribed daily dose (PDD) to the defined daily dose (DDD) for all antihypertensive medications taken by the participants. The outcome measures were evaluated at 0, 6, 12, 18, and 24 months. A total of 76 participants completed the 24-month assessment, and RM-ANOVA revealed a significantly lower antihypertensive drug load in the EG compared to the CG at 18 (p < 0.017) and 24 months (p < 0.003). A long-term PA program can decrease the antihypertensive drug load in older adults with essential hypertension. The trend of improvement regarding the EG drug load intake and the trend of CG drug load increase, although not significant over time, results in a significant difference between the groups at 18 months and an even greater difference at 24 months. This trend certifies the protective value of PA against the aging process and its related health risk factors.

Drug utilization pattern and cost estimates of antihypertensive drugs in pharmacies BPJS Kesehatan back-referral program in Kudus Regency

Background: Hypertension is one of the main causes of mortality and morbidity in Indonesia. Drug usage, utilization patterns, and cost estimates are important elements in calculating drug needs in the forecasting of drug needs plans for pharmacies. Objective: to determine the pattern of drug use with the Anatomical Therapeuetik Chemical (ATC)/Defined Daily Dose (DDD) and Drug Use 90% (DU90%) methods and the estimated cost of antihypertensives with the use of antihypertensive drugs based on the national formulary. Methods: This research uses observational methods using a cross-sectional design. Retrospective data collection includes prescription from BPJS Kesehatan back-referral program (PRB) which goes into pharmacy A, B, and C for the period 2020. Results: The most widely used drugs at pharmacy A, B and C based on ATC/DDD classification were amlodipine, candesartan, ramipril, hydrochlorothiazide, and lisinopril. Amlodipine was the most frequent drug in the DU segment 90%. The highest cost of using the drug was candesartan 16 mg (Rp 4,381,531). The percentages of adherence to the use of antihypertensive drugs with the national formulary in pharmacy A, B, and C were 73.91%, 80%, and 68.42%, respectively. Conclusion: In general, the highest consumption of antihypertensive drugs in Back-Referral Program (PRB) pharmacies in the area of Kudus Regency, which is included in the DU segment 90%, was amlodipine, and the suitability of drugs with the National Formulary has not reached 100%. Referring to the results of the pattern of use of PRB drugs in this study, it is hoped that there will be better coordination between BPJS Kesehatan and pharmacies regarding the distribution and availability of PRB drugs. Keywords: ATC/DDD, DU 90%, hypertension, national formulary, PRB

A structure of the antihypertensive drugs consumption in the population of several regions of the Russian Federation

Aim to study the characteristics of the consumption of antihypertensive (AG) drugs in the population of several regions of the Russian Federation the Samara region, the Nizhny Novgorod region and the Republic of Tatarstan.&#x0D; Material and methods. The range of AG drugs sold in the retail pharmaceutical market of the Samara and Nizhny Novgorod regions and the Republic of Tatarstan was selected for the study. To manage the obtained data, we used several methods like structural, comparative, logical, predictive, retrospective, graphic, marketing analysis. The results were processed using the normalization method and methods of mathematical statistics.&#x0D; Results. The monopreparations kept the main share of sales in each region: 90.22% in the Samara region, 90.85% in the Nizhny Novgorod region, and 93.72% in the Republic of Tatarstan). In 2021, the leaders in consumption were ACE inhibitors (28.41%, 26.61% and 32.7%, respectively in each region) and -blockers (25.87%, 29.02% and 21.15%). In total, these two subgroups accounted for more than a half of all monopreparations sold, counted in packages. In the subgroup of fixed combinations, the angiotensin II receptor blockers + diuretic were the most popular, which account for 35.38%, 29.73% and 22.13% of drug sales in this subgroup in the Samara, Nizhny Novgorod regions and the Republic of Tatarstan, respectively. In the subgroup of combined antihypertensive drugs, the multicomponent fixed combinations were among the leaders (10.22%, 8.20%, 12.10%, respectively in each region), however, in the total consumption of antihypertensive drugs, they accounted for less than 1%.&#x0D; Conclusion. This study revealed the features of the consumption of drugs prescribed for arterial hypertension in the Samara and Nizhny Novgorod regions, as well as in the Republic of Tatarstan in 2021. We identified the groups of antihypertensive drugs of most demand and found the leaders within these groups. It was established that there was a relationship between the volume of sales of antihypertensive medicines in physical terms (in packages) in the Samara region for the period 20172021 and the population of this region.

THE MAIN TRENDS IN THE POPULATION CONSUMPTION OF MEDICINES PRESCRIBED FOR ARTERIAL HYPERTENSION IN THE RUSSIAN FEDERATION

Arterial hypertension is a widespread disease and a major risk factor for the development of lethal cardiovascular pathologies. To reduce this risk, timely detection of arterial hypertension, control of blood pressure levels and effective drug therapy for high blood pressure are necessary. Relevance. Study of population consumption of drugs used for hypertension in the retail sector of the pharmaceutical market in the Russian Federation for the period from 2017 to 2021. Methods. We used the methods of retrospective, predictive, structural, logical, comparative, graphic, marketing, pharmacoepi- demiological analyzes when conducting this study. The results were processed using the normalization method and methods of mathematical statistics. Results. The analysis of the structure and study of the characteristics of the population consumption of drugs used for arterial hy- pertension in the territory of the Russian Federation for the period 2017-2021 was carried out. The main share of sales falls on monopreparations: 92.04% - in physical terms, 74.55% - in monetary terms. In the rare pharmacy sales of antihypertensive drugs in the Russian Federation, the share of fixed combinations is 7.96% in physical terms and 25.64% in monetary terms. The most popular antihypertensive drugs in both in-kind and monetary terms over the estimated period are ACE inhibitors and β-blockers. In the subgroup of fixed combinations, “angiotensin II receptor blocker + diuretic” and “ACE inhibitor + diuretic” are in the lead. In the total consumption of antihypertensive drugs, the share of multicomponent fixed combinations accounts for only 0.44% in physical terms, but in monetary terms this figure is 2.51%. According to the results of the survey, doctors were more likely to be conservative in prescribing antihypertensive drug therapy, preferring single drugs, and medical specialists receive information about new drugs mainly at conferences, when meeting with medical representatives, and also from the Internet. Conclusion. Based on the results of the study, an educational program for medical and pharmaceutical specialists “Modern range of drugs prescribed for the prevention and treatment of hypertension” was developed.

Impact of an intradialysis virtual-reality-based exercise program on healthcare resources expenditure: a micro-costing analysis

BackgroundEngagement in exercise by haemodialysis (HD) patients has been shown to generate benefits both in terms of improved functional capacity and in the health-related quality of life. The use of non-immersive virtual reality (VR) games represents a new format for the implementation of intradialysis exercise. Some studies have shown that engaging in exercise for 6 months reduces the consumption of antihypertensive drugs and decreases the time spent admitted to hospital among individuals receiving HD treatments. The objective of this study was to evaluate changes in the consumption of healthcare resources and micro-costing for patients on HD who completed a VR exercise program.Materials and methodsDesign: This study is a secondary analysis of a clinical trial. The participants performed an intradialysis exercise program with non-immersive virtual reality for 3 months. The variables were recorded in two periods: 12 months before and 12 months after the start of the exercise program.ResultsThe micro-costing analysis showed a significant decrease in the mean cost, in euros, for the consumption of laboratory tests − 330 (95% CI:[− 533, − 126];p = 0.003), outpatient visits − 351 ([− 566, − 135];p = 0.003), and radiology tests − 111 ([− 209, − 10];p = 0.03) in the 12 months after the implementation of the exercise program relative to the 12 months prior to its start.ConclusionThe implementation of intradialysis exercise programs decreased the expenditure of some healthcare resources. Future studies could help clarify if longer interventions would have a stronger impact on these cost reductions.

The analysis of the consumption level of antihypertensive drugs and statins in a retail pharmacy of the Samara Region in 2015–2020

Objective: to determine the compliance of antihypertensive drugs consumption with the trends of modern pharmacotherapy.Material and methods. The analysis of the consumption level of antihypertensive drugs, their fixed combinations (FC), as well as statins in the retail sector of the pharmaceutical market of the Samara Region in 2015–2020 was carried out. The material of this retrospective study was information about the nomenclature and volume of drug sales in physical and monetary terms for the period under review in one of the retail pharmacies of the Samara Region. The traditional method of pharmacoepidemiological analysis aimed at studying the correctness, completeness and preferences of drug use in real practice is questionnaires for physicians and patients. The main antihypertensive drugs (diuretics, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, β-blockers) and their FC were selected for the analysis.Results. Long-term use of medications aimed at reducing high blood pressure and hypercholesterolemia is seen as an effective strategy for reducing cardiovascular complications and mortality in both primary and secondary prevention. The analysis of sales of basic cardiological drugs in the pharmacy network segment of the Samara Region in 5-year dynamics showed that the consumption of hypotensive drugs and statins makes up 4.72% of the total item sales, with prevalence of angiotensin-converting enzyme inhibitors (28.0%) and β-blockers (23.5%), with insufficient consumption of FC (23.7%), extremely low sales of statins (7.58%).Conclusion. The structure of the studied segment of the pharmaceutical market is conservative with insufficient positive dynamics in the consumption of effective modern drugs and their FC. 

Factors affecting medication adherence in hypertension patients: A literature review

Controlling blood pressure carried out by hypertensive patients is still less than 50%. It is related to the consumption of antihypertensive drugs. Adherence to medication is a critical factor in achieving blood pressure for resistant hypertension, but lifestyle modifications may be necessary to treat milder forms of hypertension. There are several factors that affect the anti-hypertensive medication adherence needs to be known. This study aims to analyze the findings regarding the factors that influence medication adherence in Hypertension sufferers. A literature review is done by looking for literature related to the theme taken. The databases used in the preparation of literature reviews are obtained from databases such as ProQuest, PubMed, EBSCO, and Google scholar. Search focuses on titles, keywords and articles that are appropriate in journals that have been determined from 2011-2021. Keywords used in the search for factor articles, adherence to taking medication and hypertension. The search results found 6 articles that had been selected based on predetermined inclusion and exclusion criteria. According to the review results, drug compliance plays an essential role in the long-term treatment of hypertension and can reduce the risk of complications. The finding of 11 factors influences medication adherence to Hypertension sufferers, including the level of knowledge, the role of health workers, motivation, family-friends support, attendance at the clinic, age, employment status, education level, belief, gender, and duration of suffering from Hypertension. Adherence to taking medication was measured by taking antihypertensive drugs in individuals, dietary behaviour, exercise, participation in posbindu/prolanis, and visits to health services for routine control. Compliance with drug use plays a vital role in the long-term treatment of hypertension to reduce the risk of complications The findings of 11 factors that influence medication adherence in patients with hypertension can be used as benchmarks for nurses to improve health services further to achieve optimal recovery.

Changes in blood pressure according to stature in Mexican adults.

ABSTRACTOBJECTIVE:To determine the possible existence of differences in blood pressure change over time according to stature in Mexican adults.METHODS:We analyzed the National Household Living Standards Survey databases following household members between 2005 and 2009. We selected participants who were between 20 and 40 years old (n = 7,130). We estimated multilevel models with random intercept to analyze differences in blood pressure changes according to stature. We adjusted the models for age, locality size, geographic region, per capita family income, waist-to-height ratio, physical activity, alcohol consumption, smoking, and use of antihypertensive drugs.RESULTS:In both sexes, baseline blood pressure tended to be lower as stature decreased. The differences were maintained in both the crude and adjusted models. In men, the increases in systolic pressure over time tended to be higher as stature increased.CONCLUSIONS:Contrary to what studies observed in high-income countries, in Mexico blood pressure was positively associated with stature.

The Effect of The Number of Drugs Received On The Level of Adherence to Drug Consumption (Morisky, Green, Levine Adherence Scale Questionnaire) of Hypertensive Patients

Hypertension is a chronic disease that requires long-term treatment, where it is very prone to non-adherence in taking antihypertensive drugs. This study aims to determine the effect of the number of drugs received by patients on the level of adherence to the consumption of antihypertensive drugs. This research is a cross-sectional observational study that was conducted in 4 community health centers in Surabaya City. The measurement of adherence in this study used the Indonesian version of the MGLS questionnaire. The number of subjects in this study was 143 which fit the inclusion criteria. The majority of the adherence levels of the study subjects were moderate (MGLS questionnaire). Based on statistical analysis, it is known that there is a significant effect (P = 0.035) of the number of drugs received by patients on the level of drug consumption adherence e as measured using the Indonesian version of the MGLS questionnaire.

QUALITY OF LIFE OF WOMEN IN REPRODUCTIVE AGE WITH HYPERTENSION

The rate of hypertension cases in women is higher than in men. Women with reproductive age riskier because of hormonal contraception. Hypertension would cause complications and decreasing the quality of life. The purpose of this study was to determine the quality of life of women with hypertension at Cipanas Garut Health Center. Method: This type of study was quantitative descriptive research. The number of samples was 70 respondents, that chosen using a purposive sampling technique. The instrument in this study was the Indonesian version of the WHOQOLBREF instrument consisting of 26 questions about the quality of life including physical, psychological, social and environmental domains. The data were analyzed as a percentage. This study found that more than half of the respondents' quality of life was in the moderate category (55.8%). The quality of life of women with hypertension was in the moderate category, which means that the quality of life was not good and not bad. However, moral support and health education are needed from health workers about a good lifestyle, regular consumption of antihypertensive drugs, so that blood pressure is controlled so that women have a good quality of life. Keywords: Hypertension, Quality of Life, women of reproductive age.

COMPLIANCE OF HYPERTENSION PATIENTS IN DOING SELF-CARE: A GROUNDED THEORY STUDY

Hypertensi as a one of non-communicable diseases is need of serious attention and dealt with " nation-wide " given the high prevalence and usually people do not realize that he was suffering from hypertension. Generally only known when they come for treatment to the health service because of illness or other complaints, so hypertension is often known as " the silent killer ". Patient compliance in undergoing hypertension treatment is also a determinant that affects the control of patient's blood pressure . The most important main determinant The effect on adherence to take antihypertensive medication is long suffered from hypertension. This study aims to develop theoretical concepts about strategies to improve patient compliance in self-care for hypertensive patients both pharmacologically and non-pharmacologically. The study design using qualitatively with five participants and purposive sampling. From the results of the study, six themes were obtained : experience of adherence to control, experience of handling symptoms and complications,  experience of taking medication adherence, experience of adherence to managing diets, lack of adherence to exercise, and obstacles to adherence . It is recommended that hypertensive patients can improve compliance for routine antihypertensive drug consumption by making simple schedules and enhancing their self-concept.

Оптимизация амбулаторной лекарственной помощи пациентам с артериальной гипертензией в условиях здравоохранения Республики Казахстан на основе фармакоэкономического анализа

Abstract In the Republic of Kazakhstan, as in the whole world, cardiovascular diseases make the first place in terms of the “contribution” to the morbidity and mortality of the population. Arterial hypertension is the leading modifiable cause of cardiovascular and overall mortality in the world. Purpose of the study: To assess the pharmacoeconomic feasibility of using fixed combinations in the treatment of patients with arterial hypertension in the Republic of Kazakhstan. Methods. Review of domestic and foreign literature on the state of the management of patients with arterial hypertension, ABC / VEN- and frequency analyzes of the consumption of antihypertensive drugs, questioning patients for adherence to therapy and identifying their opinions about convenient therapy regimens, pharmacoeconomic analysis of the use of amlodipine in combination with lisinopril and their fixed combination. Results. In the updated version of the 2018 European Society of Cardiology guidelines, fixed combinations of two drugs in the form of one tablet strengthened their position as first-line therapy. Preferred dual combinations are those of the renin-angiotensin-aldosterone system blockers with calcium channel blockers or diuretics. Analysis of financing and coverage of the population with drugs at the outpatient level within the guaranteed volume of free medical care showed that arterial hypertension is the most costly nosology, while a tendency to inadequate provision of patients with antihypertensive drugs was revealed. The highest costs were associated with fixed combinations, despite the fact that they ranked only 5th in frequency of prescriptions, the most popular was the combination of an angiotensin-converting enzyme inhibitor with a calcium channel blocker (amlodipine / lisinopril). The results of the pharmacoeconomic analysis showed the feasibility of using a fixed combination of amlodipine / lisinopril, which makes it possible to assume the same trend in relation to other fixed combinations. Conclusions. The results obtained indicate the need to provide access for patients with arterial hypertension to fixed combination drugs. At the same time, the inclusion of these drugs in state drug supply programs may be accompanied by an increase in the burden on the health care system budget due to their high cost. The results of pharmacoeconomic studies should be the basis for making managerial decisions in the field of drug circulation. Key words: arterial hypertension, combined antihypertensive therapy, fixed combinations, pharmacoeconomic analysis

Study of Phenomenology of Drug Consumption Patterns of Individuals With Hypertension in Working Areas of Parongpong Health Center West Bandung

In 2016 West Java was the fourth-ranked province as the region with the highest prevalence ofhypertension, which was 29.4% in Indonesia. Failure to treat hypertension was found due tolow compliance in the use of hypertension drugs. Non-compliance with the consumption ofantihypertensive drugs will have an impact on the incidence of uncontrolled blood pressure.Long term Uncontrolled blood pressure can cause complications of the disease and even death.The purpose of this study is to identify the overview of hypertensive patients in consuminghypertension drugs.This study uses a qualitative method with a phenomenological approach through in-depthinterviews on 6 people with hypertension, using semi-structured questions about theirexperience in taking hypertension medication.From this study, it was found that taking medication for a long period caused a feeling oflaziness and boredom in taking medicine, resulting in patients with hypertension who stoppedconsuming medication. Fear of side effects from taking medication for a long time makeshypertensive patients decided to stop the consumption of hypertension medicine.It is hoped that this research can be an input to improve health promotion to reduce the failureof hypertension treatment.

Sexual Dysfunction among Women with Diabetes in a Primary Health Care at Semarang, Central Java Province, Indonesia

Sexual dysfunction is associated with pain during sexual intercourse. Diabetes mellitus (DM) has been reported to be one of the causal factors for sexual dysfunction in women. This cross-sectional study was conducted to describe the status of sexual dysfunction in women with DM in the Tlogosari Kulon Primary Health Care, Semarang, Indonesia, in March 2017. A total of 103 women with DM attending the health center participated in this study. Data were collected using a questionnaire-guided interview and through measurements (blood pressure and random blood glucose test). Results showed that 74.8% of women with DM had sexual dysfunction. The proportion of sexual dysfunction was higher among women in the clinical phase, with uncontrolled blood glucose levels, hypertension grade II, prolonged duration of DM of ≥ 5 years, undergoing insulin treatment, in menopause, grand multiparity, having used the tubectomy contraception method, low physical activity, depression, and consumption of antihypertensive drugs. The aging process, menopausal status, and consumption of antihypertensive drugs will increase the risk for sexual dysfunction in women with DM. It is recommended that women with DM maintain their physical activity, blood sugar levels, blood pressure, and their depression status.