Contemporary Problems of Evaluation of Hypertension Treatment Efficacy: Masked Hypertension and White Coat Hypertension

Aim. To assess the role of obstructive sleep apnea and other cardiovascular (CV) risk factors in the development of the antihypertensive therapy (AHT) efficacy escape phenomenon in patients with arterial hypertension (AH). Materials and methods. The data of 75 patients with AH stage III, grades 13 were proceeded. All patients included in the study underwent night respiratory monitoring. After AHT prescription, blood pressure (BP) was monitored by three measurement methods (office, daily monitoring and self-control of blood pressure) initially, in 1, 3 and 6 months after the inclusion in order to confirm the initial therapy efficacy and to identify or exclude the escape phenomenon. Results. In 36.0% of patients, the escape phenomenon was diagnosed in 1 or 3 months of observation. When comparing the group with the escape phenomenon, an initially higher level of systolic BP was revealed according to office measurements, 24-hour monitoring and self-control BP monitoring (134.04.7 mmHg vs 126.08.5 mmHg; 129.02.3 mmHg vs 121.07.7 mmHg; 131.08.2 mmHg vs 121.56.2 mmHg resp.; р0,05). There were no differences in sleep apnea and CV risk factors between the groups. However in patients with a minimal SpO285% during sleep, there were a higher levels of office systolic BP both before the AHT prescription, and during its use (157.610.4 mmHg vs 152.48.1 mmHg resp., р0,05; 132.06.8 vs 127.18.9 mmHg resp.; р0,05), and mean 24-hour systolic BP (125.75.9 vs 121.68.2 mmHg resp.; р0,05) compared with patients with a minimum SpO285%. Conclusion. The higher BP level in patients with lover nocturnal hypoxemia does not allow us to exclude the delayed negative impact of obstructive sleep apnea, especially severe, on the BP profile in case of initially successful AH control.

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Etiopathogenesis, diagnosis, and approaches to the treatment of arterial hypertension: an assessment of the physicians’ basic knowledge. Final results of the PHYSTARH project

Bontsevich

Vovk

Gavrilova

et al. 2021

System. Hyper.

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Introduction. Arterial hypertension (AH) is a syndrome accompanied by an increase in systolic blood pressure (BP)140 mmHg and/or diastolic BP90 mmHg. It is a progressive pathology that affects the adult employable population and leads to the development of deadly complications. Aim. To compare the level of physicians knowledge in AHs definition, diagnosis and treatment in different centers of Russia. Materials and methods. In the framework of the multicenter study PHYSTARH (the full name of the project Physicians and undergraduates knowledge in arterial hypertension treatment), which was launched in 2017, an anonymous survey was conducted among 425 doctors from 9 cities/regions of Russia (Belgorod Region, Moscow, Krasnodar Territory, the Republic of Adygea, Voronezh, Primorye Territory, Tatarstan, Lipetsk, Chelyabinsk). Results. The study revealed an insufficient level of doctors knowledge in diagnosis and treatment of AH. Less than half of the respondents correctly answered the following questions: determining hypertension by the level of home monitoring of BP (36% of physicians), determining the degree of hypertension for the proposed numerical values (37% of physicians), definition and prevalence of the refractory hypertension (33% of physicians), definition of the masked hypertension (45% of physicians), the need for drug correction of high normal BP (9% of physicians), selection of the main classes of antihypertensive drugs without clinical situations (26% of physicians). Conclusion. The physicians knowledge on AH is unsatisfactory, despite the prevalence of pathology and the availability of clinical guidelines, which, in our view, justifies the need for additional public education programs for doctors in different regions.

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Contemporary Problems of Evaluation of Hypertension Treatment Efficacy: Masked Hypertension and White Coat Hypertension

Cited by 3 publications

References 16 publications

2022 Prevention of chronic non-communicable diseases in Of the Russian Federation. National guidelines

2022 Prevention of chronic non-communicable diseases in Of the Russian Federation. National guidelines

Obstructive sleep apnea syndrome and cardiovascular risk factors in the antihypertensive therapy “escape” phenomenon

Etiopathogenesis, diagnosis, and approaches to the treatment of arterial hypertension: an assessment of the physicians’ basic knowledge. Final results of the PHYSTARH project

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