REAL-WORLD AMBULATORY AND CLINICAL MANAGEMENT OF HIGH-RISK PATIENTS WITH ARTERIAL HYPERTENSION

Abstract

To analyze ambulatory and clinical tactics in target blood pressure (BP) achievement, 60 ambulatory medical cards and 60 hospital medical histories of patients with arterial hypertension (AH) were analyzed. Target BP levels were registered in 60% of ambulatory patients. Despite the fact that 93,3% of the patients needed more aggressive antihypertensive treatment, only in 37%, such an attempt (increasing the dose and/or administering combined therapy) had been done. The mean number of medications had decreased during the control year. Thiazide diuretics (TD) and calcium antagonists (CA) were rarely administered. By the end of the control year, target BP levels were achieved in 15% only. Therapy change frequency in those achieving and not achieving target BP levels varied from 0 to 14 (on average, 3,8), mostly due to “incorrect” prescriptions. Target BP level achievers received ACE inhibitors and TD more often. The main reason for hospitalization was uncontrolled AH (67,5%) due to irregular regimen of pharmaceutical therapy (64,9%). During the hospitalization, target BP levels were achieved in 97,5%, at Day 9 on average. After admission, most patients received combined three-component therapy, including TD and CA. The АВС/VEN-analysis demonstrated low prevalence of effective medication administration and a three-fold increase in the second-choice medication use. The results obtained confirm the potential for target BP level achievement in high and very high-risk AH patients, and demonstrated real-world mistakes in ambulatory management of AH.