A cross-sectional survey of hypertension diagnosis and treatment practices among physicians in Yaroslavl Region, Russia

Abstract

Introduction: In Russia, cardiovascular (CV) mortality is the leading cause of death. With the prevalence of hypertension in adults reaching 40%, hypertension is a key priority for health authorities to improve its prevention, diagnosis, and treatment. This requires an evaluation of current clinical practices in order to develop specific improvement initiatives. Methods: This cross-sectional survey was conducted in 39 outpatient institutions of Yaroslavl region from April to May 2011. A total of 180 physicians (154 general practitioners [GPs]; 26 cardiologists) completed diaries on 10 consecutive patients whose visits were related to hypertension. This survey was approved by the Department of Health and Pharmacy of Yaroslavl region. Results: A total of 1,794 diaries (1,525 from GPs; 269 from cardiologists) were analyzed. The majority of patients were women (60%), mean age was 60 years, and most (97%) were on anti- hypertensive therapy. Mean blood pressure (BP) was 151/90 mmHg and goal BP (<140/90 mmHg) was achieved in 17% of patients. The distribution of patients' systolic BP (SBP) was: 20% controlled (<140 mmHg), 44% SBP 140-159 mmHg, 26% SBP 160-179 mmHg, and 10% SBP ≥180 mmHg. The most common CV risk factors included left ventricular hypertrophy (72% of patients), abdominal obesity (54%), dyslipidemia (48%), family history of early CV events (33%), smoking (24%), and type 2 diabetes (21%). Heart diseases and cerebrovascular diseases were reported in 48% and 15% of patients, respectively, and regular alcohol consumption was mentioned by 37%. Conclusion: The majority of patients with hypertension had additional CV risk factors and associated clinical conditions. Blood pressure control rates in Yaroslavl region are similar to those for Russia as a whole, but much lower than countries that have successfully implemented comprehensive hypertension intervention programs, such as Canada. © The Author(s) 2012.