Arterial hypertension in Ryazan region: data of the third section of the EPOHA study

Aim. To study the nine-year dynamics of prevalence, risk factors, approaches to the treatment of arterial hypertension (AH) in the Ryazan region according to a representative sample survey, to assess the impact of risk factors and cardiovascular diseases on achieving blood pressure (BP) control.

Material and methods. A representative sample of the population of the Ryazan region, created in 2002 by the method of step-by-step randomization, was reexamined in 2007 and 2016. The group of AH included people with blood pressure >140/90 mm Hg. with double measurement or normal blood pressure, receiving antihypertensive therapy. The role of risk factors (age, smoking, alcohol abuse, salt, obesity, burdened heredity, low physical activity) and cardiovascular diseases was analyzed.

Results. In 2016, the prevalence of AH was 43,9%, the number of people receiving antihypertensive drugs — 89,5%, those who are treated effectively — 373%, which is higher than in 2007 (39,3%, 799% and 16,6%, respectively). Smoking (RR 1,23; 1,11-1,37, p=0,005), salt abuse (RR 1,11; 1,01-1,23, p=0,04) and obesity (RR 1,16; 1,06¬1,27 p=0,003) negatively effect on the effectiveness of AH treatment. Treatment of AH is more effective in the absence of cardiovascular diseases (35,0% vs. 26,8%), signs of chronic heart failure (24,9% vs. 34,9%) and intermittent claudication (8,3% vs. 31,7%), p <0,001.

Conclusion. Over nine years, the standardized by age prevalence of AH has increased significantly, the number of individuals taking antihypertensive drugs and the treatment effectively, the structure of the drugs taken has changed positively. Smoking, obesity, salt abuse and the presence of diseases of the cardiovascular system adversely affect the effectiveness of therapy.

Study participants: Yepikhina E. A., Biryukova Zh. A., Larina T. A., Ivushkina L. I., Kozakova Yu. V., Motsnaya O. A., Surova A. I., Skorobogatova S. Yu., Tolmacheva E. A., Golubeva I. V., Smagina E. V., Kiseleva E. A., Bulavchenkova O. N., Shvykova T. A., Bashmakova G. N., Soloveva N. N., Davydkina S.A., Gorbunova L. A., Khoteenkova N. V., Dukova E. V., Varlamova L. A., Vorobyova G. A., Korzhevskaya A. A., Tabolkina A. A., Nechaeva G. P., Vybornova E. Z., Kashapova L. M., Tarasova A. I., Ryazantseva L. L., Yakovleva N. S., Semenets A. A., Chikova N. A., Muravyova G.V., Chizhikova M. I.

1. Fomin IV, Polyakov DS, Badin YV, et al. Arterial hypertension in the European part of the Russian Federation from 1998 to 2007: what have we achieved at the population level? Russ Heart J. 2016;15 (5):369-78. (In Russ.) doi:10.18087/rhj.2016.5.2240.

2. Oganov RG, Timofeeva TN, Koltunov IE, et al. Epidemiology of arterial hypertension in Russia. The results of 2003-2010 Federal monitoring. Cardiovascular Therapy and Prevention. 2011;10 (1):9-13. (In Russ.)

3. Filippov EV. Monitoring behavioral risk factors for chronic noncommunicable diseases in 2014. IP Pavlov Russian Medical Biological Herald. 2015;7:72-83. (In Russ.)

4. Yakushin SS, Filippov EV. Risk factors for cardiovascular diseases in the Ryazan region (according to the MERIDIAN-RO study). Science of young (Eruditio Juvenium). 2013;4:91-105. (In Russ.)

5. Badin YV, Fomin IV, Belenkov YN, et al. EPOCHA-AH 1998-2017. Dynamics of prevalence, awareness of arterial hypertension, treatment coverage, and effective control of blood pressure in the European part of the Russian Federation. Kardiologiia. 2019;59 (1S):34-42. (In Russ.) doi:1018087/cardio.2445.

6. Chow CK, Teo KK, Rangarajan S, at al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA. 2013;310 (9):959-68. doi:10.1001/jama.2013.184182.

7. NCD Risk Factor Collaboration. Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participants. Lancet. 2017;389:37-55. doi:10.1016/S0140-6736 (16) 31919-5.

8. European Cardiovascular Disease Statistics. Ed.: Susanne Lоgstrup; European Heart Network-Brussels (Belgium), 2017. p. 52-76.

9. Shalnova SA, Deev AD, Balanova UA, et al. Dynamics of arterial hypertension in Russia: is there any progress in the appointment of antihypertensive therapy? (Results of research 1993-2013). Russ Heart J. 2015;14 (6):389-95. (In Russ.) doi:10.18087/rhj.2015.6.2145.