Significance of risk factors correction for treatment and prevention of arterial hypertension in outpatient conditions

Aim. To evaluate the significance of risk factors correction for treatment effectiveness improvement and prevention of arterial hypertension in outpatient conditions.

Methods. The study was conducted in two phases over the period of 2011-2015 in Baku outpatient clinics. At the beginning of the first part of work 547 patients with controlled hypertension were followed up, by the end of study 437 patients remained followed up, 196 men and 241 women, aged from 23 to 68 years, disease duration was from 4 months to 14 years. At the beginning of the second part of the study measures for hypertension prevention were taken in 916 patients with normal blood pressure (788 patients completed the study).

Results. In patients with long-term course of the disease, maintaining a stable target blood pressure (<130/80 mm Hg) was possible with great difficulty, despite the antihypertensive therapy. The main reasons were occasional visits to the doctor, and low compliance to treatment, lack of risk factors awareness and their correction necessity. The antihypertensive therapy combined with risk factors correction resulted in the blood pressure normalization during the entire follow-up period. In the second part of the study, it was shown that the motivation to the risk factors correction prevented the formation of hypertension new cases (in the first group - only 5.1±1.6% of new clinically not apparent hypertension cases which were effectively cured). In the group with a partial motivation of the major risk factors modification 11.4±1.7% of new cases of clinically not apparent hypertension (χ2=6.08; p <0.02) and 2.4±0.8% cases of symptomatic hypertension occurred over the 3 years. In the group of patients, who were not motivated to correct risk factors 18.9±2.4% of new cases of clinically not apparent hypertension (χ2=6.47; p <0.02) and 6.6±1.5% of severe arterial hypertension cases (χ2=6.51; p <0.02) were formed over the 3 years. The lack of motivation reduced the hypertension treatment effectiveness: in the clinically not apparent forms it was 61.2±7.0% (χ2=5.92; p <0.02), and in clinically apparent forms - 29.4±11.4% (χ2=4.81; p <0.02).

Conclusion. Approach to secondary prevention of hypertension at the population level was evaluated, the basis of which consisted of the outpatient network readiness to the continuous blood pressure monitoring, scientific rationale of the dominant risk factors, explanatory work on the risk factors modification and health status self-control among the population; significance of risk factors correction was found.