Dynamics of the factors cardiovascular diseases depending on a dispensary observation status in the regional polyclinic of Krasnodar, 2015-2018

Abstract

Objective: to study the dynamics of risk factors for cardiovascular diseases in patients who are under dispensary observation for the main disease arterial hypertension and coronary heart disease; the frequency of visits to a medical organization, depending on the status of dispensary observation in a cohort of adults in 2015 and 2018. Materials and Methods: on the basis of the outpatient department of the Scientific Research Institute – Krasnodar Regional Hospital No. 1, we analyzed the incidence of CVD in the adult cohort (n = 1170), which passed of the clinical examination twice in 2015 and 2018. The analysis was carried out in groups depending on the status of the dispensary observation («not on dispensary observation», «total on dispensary observation» and «consisting on dispensary observation with CVD»). Results: a decrease in unhealthy diet by 32.21%, 28.78% and 28%, respectively, was shown in the groups «not on dispensary observation», «total on dispensary observation» and «consisting on dispensary observation with CVD» in 2015 and 2018, (χ2 = 80.45, p = 0.001, χ2 = 59.96, p = 0.001 and χ2 = 47.8; p = 0.001). In the groups «not on dispensary observation», «total on dispensary observation» and «consisting on dispensary observation with CVD» in 2015 and 2018, there was a decrease in low physical activity by 50.33%, 24.72% and 21.85%, respectively (χ2 = 79.16, p = 0.001, χ2 = 30.6, p = 0.001 and χ2 = 22.42; p = 0.001). Against the background of the ongoing preventive measures in 2015 – 2018. the cohort showed an increase in overweight and obesity by 19.2% in the «not on dispensary observation» group (χ2 = 4.84, p = 0.028); an increase in the frequency of elevated blood pressure by 48.33% in the «not on dispensary observation» group and a decrease in its frequency in the «consisting on dispensary observation with CVD» by 24% (χ2 = 19.77, p = 0.001, χ2 = 7.1; p = 0.008). Against the background of the ongoing preventive measures from 2015 to 2018, a tendency to reduce the frequency of FR CVD was revealed. A significant decrease in unhealthy diet (p = 0.001), low physical activity (p = 0.001), was registered in individuals who were on dispensary observation according to the main nosology of hypertension. In the group of individuals who were on dispensary observation according to the main nosology, there was a significant decrease in unhealthy diet (p = 0.006) and low physical activity (p = 0.023). In patients who are on dispensary observation with CVD, there was a favorable dynamics in terms of achieving the target values of the level of blood pressure and cholesterol. The revealed tendency to decrease the frequency of visits due to CVD in patients «consisting on dispensary observation» by 32.2%, including» consisting on dispensary observation with CVD» by 33.8% for the period 2015 – 2018. Conclusions: there was a tendency to decrease the frequency of risk factor CVD and the frequency of visits due to CVD in patients «consisting on dispensary observation», which indicates the effectiveness of measures carried out within the observation, regardless of the nosological group of patients.