A Cross-sectional Survey of Hypertension Diagnosis and Treatment Practices Among Physicians in Yaroslavl Region, Russia

Mozheyko, Maria; Eregin, Sergey; Vigdorchik, Alexey; Hughes, David

doi:10.1007/s12325-012-0064-2

Cited by 13 publications

(28 citation statements)

References 13 publications

(7 reference statements)

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“…A cross‐sectional survey was conducted to assess baseline BP control rates and medical practices . This was conducted over a period of 2 months (from May to June 2011).…”

Section: Assessment Of the Problemmentioning

confidence: 99%

Changes in Hypertension Treatment in the Yaroslavl Region of Russia: Improvements Observed Between 2 Cross‐Sectional Surveys

Mozheyko

Eregin²,

Vigdorchik³

et al. 2013

J of Clinical Hypertension

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This prospective before-and-after survey of hypertensive patients visiting government-run outpatient health facilities in the Yaroslavl Region of Russia assessed blood pressure (BP)–related endpoints following initiation of a comprehensive health system improvement program for hypertension. Two cross-sectional surveys, one at baseline and the other approximately 1 year after program initiation, evaluated the primary measure of BP control rate. Secondary measures included mean BP levels and distribution, cardiovascular risk factors, and associated conditions, heart rate levels, and antihypertensive therapy. From the 2011 survey (n=1794) to the 2012 survey (n=2992), BP control rate (<140/90 mm Hg) significantly increased from 16.8% to 23.0%, reflecting a 37% relative improvement (P<.0001). Mean BP level was significantly reduced from 151/90 mm Hg to 147/88 mm Hg (P<.0001). Severe uncontrolled hypertension (systolic BP ≥180 mm Hg) was reduced from 9.7% to 6.4% (P<.0001). Implementing a guidelines-based treatment protocol with medical and patient education programs resulted in physician behavior change and improved patient BP control.

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“…A cross‐sectional survey was conducted to assess baseline BP control rates and medical practices . This was conducted over a period of 2 months (from May to June 2011).…”

Section: Assessment Of the Problemmentioning

confidence: 99%

Changes in Hypertension Treatment in the Yaroslavl Region of Russia: Improvements Observed Between 2 Cross‐Sectional Surveys

Mozheyko

Eregin²,

Vigdorchik³

et al. 2013

J of Clinical Hypertension

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“…Demographic characteristics (ie, age and gender) and baseline risk factors of our population are generally consistent with that of the hypertensive Russian population [15]. To achieve an SBP control rate of 40% and 60%, the required adherence rate to the antihypertensive combination pill was estimated at 29.4% and 65.9%, respectively.…”

Section: Resultsmentioning

confidence: 55%

“…Reasons for suboptimal hypertensive management in Russia include additional comorbidities (eg, smoking, left ventricular hypertrophy, obesity, dyslipidemia,) [15], poor treatment adherence (eg, patients not taking their medication regularly) [16], [17], and nonadherence (eg, unwillingness to change smoking, diet, and exercise patterns or show up for appointments) [18]. ‘Therapeutic inertia’ of physicians also contributes to poor management of hypertension in Russia, with documented low rates of combination therapy and thiazide diuretics use [19], [20].…”

Section: Introductionmentioning

confidence: 99%

“…With a disease-model simulation, we forecast how various treatment programs aimed at increasing BP control would affect CV outcomes. Systolic blood pressure (SBP) control rate was used because of the high rate of SBP hypertension in Russia [15], the strong association between systolic hypertension and adverse cardiovascular outcomes [21], and to better align with available data. In addition, we investigated what additional benefit adding lipid control and smoking cessation to BP control would generate in terms of reduced CV events.…”

Section: Introductionmentioning

confidence: 99%

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Simulating the Impact of Improved Cardiovascular Risk Interventions on Clinical and Economic Outcomes in Russia

Shum¹,

Alperin²,

Шальнова

et al. 2014

PLoS ONE

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ObjectivesRussia faces a high burden of cardiovascular disease. Prevalence of all cardiovascular risk factors, especially hypertension, is high. Elevated blood pressure is generally poorly controlled and medication usage is suboptimal. With a disease-model simulation, we forecast how various treatment programs aimed at increasing blood pressure control would affect cardiovascular outcomes. In addition, we investigated what additional benefit adding lipid control and smoking cessation to blood pressure control would generate in terms of reduced cardiovascular events. Finally, we estimated the direct health care costs saved by treating fewer cardiovascular events.MethodsThe Archimedes Model, a detailed computer model of human physiology, disease progression, and health care delivery was adapted to the Russian setting. Intervention scenarios of achieving systolic blood pressure control rates (defined as systolic blood pressure <140 mmHg) of 40% and 60% were simulated by modifying adherence rates of an antihypertensive medication combination and compared with current care (23.9% blood pressure control rate). Outcomes of major adverse cardiovascular events; cerebrovascular event (stroke), myocardial infarction, and cardiovascular death over a 10-year time horizon were reported. Direct health care costs of strokes and myocardial infarctions were derived from official Russian statistics and tariff lists.ResultsTo achieve systolic blood pressure control rates of 40% and 60%, adherence rates to the antihypertensive treatment program were 29.4% and 65.9%. Cardiovascular death relative risk reductions were 13.2%, and 29.6%, respectively. For the current estimated 43,855,000-person Russian hypertensive population, each control-rate scenario resulted in an absolute reduction of 1.0 million and 2.4 million cardiovascular deaths, and a reduction of 1.2 million and 2.7 million stroke/myocardial infarction diagnoses, respectively. Averted direct costs from current care levels ($7.6 billion [in United States dollars]) were $1.1 billion and $2.6 billion, respectively.

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“…To our knowledge, there is only one study that has examined the linkage between obesity and hypertension in four of the five BRICS countries [18]. We came across two studies from India [19,20], four studies from China [21][22][23][24], one study from South Africa [25], and two studies from Russia [26,27] that have examined the association between obesity and hypertension/heart disease and have found a significant positive association between them. With reference to studies on obesity and diabetes, we came across three studies only from China [21,23,24].…”

Section: Introductionmentioning

confidence: 99%

Association between Obesity and Selected Morbidities: A Study of BRICS Countries

2013

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Objective: Over the past few decades, obesity has reached epidemic proportions, and is a major contributor to the global burden of chronic diseases and disability. There is little evidence on obesity related co-morbidities in BRICS countries. The first objective is to examine the factors associated with overweight and obesity in four of the five BRICS countries (China, India, Russia and South Africa). The second is to examine the linkage of obesity with selected morbidities.

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A Cross-sectional Survey of Hypertension Diagnosis and Treatment Practices Among Physicians in Yaroslavl Region, Russia

Cited by 13 publications

References 13 publications

Changes in Hypertension Treatment in the Yaroslavl Region of Russia: Improvements Observed Between 2 Cross‐Sectional Surveys

Changes in Hypertension Treatment in the Yaroslavl Region of Russia: Improvements Observed Between 2 Cross‐Sectional Surveys

Simulating the Impact of Improved Cardiovascular Risk Interventions on Clinical and Economic Outcomes in Russia

Association between Obesity and Selected Morbidities: A Study of BRICS Countries

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