Pharmacological management of modifiable cardiovascular risk factors (blood pressure and lipids) following diagnosis of myocardial infarction, stroke and diabetes: comparison between population-based studies in Russia and Norway

Abstract

Background: Cardiovascular disease (CVD) mortality is substantially higher in Russia than in neighbouring Norway. We aimed to compare blood pressure-and lipid-lowering medication use and proportion meeting treatment targets between general population samples in the two countries in those with CVD and diabetes. Methods: The study population was adults aged 40-69 years reporting a diagnosis of myocardial infarction (MI), stroke and/or diabetes participating in cross-sectional population-based studies in Russia (Know Your Heart (KYH) 2015-18 N = 626) and Norway (The Tromsø Study 2015-16 (Tromsø 7) N = 1353). Reported medications were coded according to the 2016 WHO Anatomical Therapeutic Chemical Classification system. Treatment targets were defined using the Joint European Societies guidelines for CVD prevention in clinical practice (2016).

Awareness of Hypertension, Hypercholesterolemia, and Diabetes Mellitus and Associated Characteristics in Russian Adults

“…Conversely, participants with hypertension and diabetes mellitus (DM) displayed comparatively higher rates of treatment. Despite our identification of low treatment rates for hypercholesterolemia and relatively favorable treatment rates for hypertension, prior studies report extremely low antihypertensive and lipid-lowering medication adherence in Russia [ 71 ]. On the other hand, self-medication for high blood pressure without having hypertension diagnosed by a doctor is an acknowledged problem in Russia because of the non-prescription sales of antihypertensives [ 71 ].…”

“…Despite our identification of low treatment rates for hypercholesterolemia and relatively favorable treatment rates for hypertension, prior studies report extremely low antihypertensive and lipid-lowering medication adherence in Russia [ 71 ]. On the other hand, self-medication for high blood pressure without having hypertension diagnosed by a doctor is an acknowledged problem in Russia because of the non-prescription sales of antihypertensives [ 71 ]. As for antidiabetics, their intake by those not aware of having DM might be explained by the common prescription of glucose-lowering medication to those at the so-called prediabetes stage [ 72 ].…”