Potential of a registry in evaluation of treatment of patients with essential hypertension in primary care (using the example of polyclinic located in Saratov region)

Gerasimov, Stanislav N.; Alexandrova, Irina N.

doi:10.15275/cardioit.2015.0403

Cited by 2 publications

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“…Of the total sample recruited to the study, 93 patients (51%) achieved the goal BP. Clinical characteristics of the patients according to BP control are presented in Table ( 1). Systolic BP (SBP) and diastolic BP (DBP) levels [data presented as Me (LQ, UQ)] in the controlled group were 120 (115, 130) mm Hg and 70 (65, 80) mm Hg, respectively.…”

Section: Characteristics Of the Patients With Controlled And Uncontromentioning

confidence: 99%

“…However, the cause of a visit is usually not hypertension per se, because this disorder is predominantly asymptomatic. Patients with hypertension measure their blood pressure (BP) at home systematically, and even in rural areas of Russia, they take antihypertensive drugs quite regularly [1]. Despite that, BP remains uncontrolled even in those who visit a physician [2].…”

Section: Introductionmentioning

confidence: 99%

“…Patients with hypertension measure their blood pressure (BP) at home systematically, and even in rural areas of Russia, they take antihypertensive drugs quite regularly [1]. Despite that, BP remains uncontrolled even in those who visit a physician [2]. Nevertheless, a proper long-term BP control is the essential goal of the hypertension treatment [3].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Factors Affecting the Goal Blood Pressure in Hypertensive Patients of a Rural Polyclinic in Russia

Posnenkova¹,

Gerasimov²,

Popova³

et al. 2017

TOHYPERJ

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Background:Primary care units in rural areas of the Russian Federation experience difficulties in long-term follow-up of chronic cardiovascular diseases, such as hypertension. Identification of outpatient clinical traits affecting the goal blood pressure (BP) may optimize the choice of treatment pathways.Objective:To identify the patient-related factors affecting the achievement of the goal BP in the course of hypertension treatment at a rural polyclinic.Methods:We analyzed the data on 182 patients with essential hypertension (64.6 ± 11.3 yo; 48.5% men), who were treated in polyclinic settings of a rural settlement in the Saratov Region of the Russian Federation. Outpatient medical records were used as a source of clinical data. Repeat patients with hypertension diagnosis specified in their medical records, visiting a therapeutist or cardiologist on two randomly selected workdays, were enrolled in our study. The first appointment took place during 1-31 July, 2015 (n = 88), while the second visit occurred on 1- 31 July, 2016 (n = 94). Eleven district therapeutists, two general practitioners and the only cardiologist of the polyclinic participated in the study. Discriminant function analysis was used to identify factors affecting the achievement of the goal blood pressure in the patients. Basic demographic and anamnesis data, risk factors, medical treatment type and lifestyle modification measures, if any, which exhibited statistical significance in univariate analysis (p<0.05), were selected for multi-factor discriminant analysis.Results:The goal BP was achieved in 93 patients (51%). The patients with the goal BP differed from those with uncontrolled hypertension in various ways. They were less often women (53.8% vs. 69.7%, p = 0.028), more frequently had prior myocardial infarction (22.6% vs. 10.1%, p = 0.024), more rarely suffered from other forms of stable CAD (55.9% vs. 73%, p = 0.016), as well as took fewer thiazide-like diuretics (9.7% vs 21.3%, p = 0.03). It is worth noting that fewer antihypertensive medications were prescribed to the patients with the goal BP as opposed to those with poor BP control (1.63 ± 0.12 vs. 1.98 ± 0.11, p = 0.018).Resulting discriminant model exhibited high predictive power. The ratio of odds for the model was 5.4 (95% CI: 2.7-10.7), р<0.001. The single factor correlating significantly with the achievement of the goal BP was preceding myocardial infarction (OR 2.6, 95% CI: 1.1 - 6.6, р=0.032), while prescription of two or more antihypertension drugs was associated with poor BP control (OR 0.4, 95% CI: 0.2 - 0.7, р=0.003).Conclusion:In the hypertensive patients with a history of myocardial infarction versus those without it, treated at a rural polyclinic, BP was more likely to be controlled. Administration of multiple antihypertensive drugs was associated with poor BP control.

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Section: Characteristics Of the Patients With Controlled And Uncontromentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Factors Affecting the Goal Blood Pressure in Hypertensive Patients of a Rural Polyclinic in Russia

Posnenkova¹,

Gerasimov²,

Popova³

et al. 2017

TOHYPERJ

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“…At this stage it helped to get a picture of Htn treatment at the polyclinic from a patient's view. By comparing it with previously received results of analysis of ambulatory cards [14], it becomes possible to work out measures on improvement of medical care of hypertensives in the specific primary care institution. For example, it is reasonable to organize in the polyclinic special monitoring system for hypertensives to carry out systematic control of amendable risk factors and taking antihypertensive drugs.…”

Section: Discussionmentioning

confidence: 99%

Treatment Assessment Among Hypertensive Patients of a Rural Polyclinic in Russia: The Results of Structured Questionnaire

Posnenkova¹,

Gerasimov²,

Popova³

et al. 2018

TOHYPERJ

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Background: Information on treatment obtained from hypertensive patients could add the data of medical records and reveal the problems addressed to hypertensives’ attitudes and behavior. Objective: To evaluate patients’ knowledge on hypertension and treatment behavior at a rural polyclinic with the help of structured questionnaire. Methods: We interviewed 83 patients with essential hypertension (64.6±9.6 yo; 30% - men) who referred to a polyclinic of a rural settlement in the Saratov region of the Russia. Consecutive patients with hypertension diagnosis specified in their medical records, visiting a therapeutist or cardiologist on one randomly selected workday, were enrolled in our study. The appointment took place during 1-31 July 2015. Eleven district therapeutists, two general practitioners and the only cardiologist of the polyclinic participated in the study. Structured questionnaire for patients with elevated Blood Pressure (BP) proposed by S.N. Gerasimov et al. (2015) was used for interviewing. The questionnaire included 16 questions addressed to the following issues: Awareness of hypertension and risk factors, BP self-monitoring, non-pharmacological and pharmacological treatment, adherence to antihypertensive therapy, referrals to medical care. Results: Ninety percent of respondents have known previously about BP elevation. Ninety four percent of patients had a tonometer at home. Eighty four percent of hypertensives measured their BP no rare than once a week, and fifty four percent did it every day. Eighty eight percent of study participants took antihypertensive drugs regularly. Only 36% of patients could be classified as adherent to therapy according to the Morisky-Green scale. Ninety two percent of respondents received one or more advices on lifestyle modification. Eighty two percent underwent diet counseling. Two-third of participants were advised to reduce their weight. About half of hypertensives were asked by the doctor to increase their physical activity. One-third of patients received smoking cessation advice, and the same part of enrollees received advice on alcohol consumption. The majority of patients (62.7%) were interested in organization of special follow-up program. Conclusion: With the help of structured questionnaire we revealed high frequency of BP self-measurement among visitors of rural polyclinic in Saratov region whereas the adherence to antihypertensive medication was low. We observed good level of knowledge on non-pharmacologic treatment interventions and revealed patients’ interest in special follow-up program. Such program should be addressed to the increase of patients’ adherence to treatment.

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Potential of a registry in evaluation of treatment of patients with essential hypertension in primary care (using the example of polyclinic located in Saratov region)

Cited by 2 publications

References 3 publications

Clinical Factors Affecting the Goal Blood Pressure in Hypertensive Patients of a Rural Polyclinic in Russia

Clinical Factors Affecting the Goal Blood Pressure in Hypertensive Patients of a Rural Polyclinic in Russia

Treatment Assessment Among Hypertensive Patients of a Rural Polyclinic in Russia: The Results of Structured Questionnaire

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