M.I. Lutay Management of ischemic heart disease with concomitant arterial hypertension in Ukraine. The results of the PRESTIGE study.

The analysis of quality of the evaluation and usage of drug therapy in patients with coronary heart disease with concomitant hypertension in outpatient clinics of Ukraine large cities was conducted in the PRESTIGE study. Methods for evaluation of patients included ECG at rest (98.3 %), echocardiography (83.7 %), ambulatory ECG monitoring (47.8 %), exercise test (24.4 %), ambulatory blood pressure monitoring (28.7 %), coronary
angiography (20.0 %), determining of microalbuminuria and glomerular filtration rate (21.9 and 13.8 % respectively). Analysis of medical prescriptions in the PRESTIGE study suggests that the choice of the main
groups of drugs and drugs used in clinical practice is very close to the international guidelines. The frequency of use of antithrombotic and lipid-lowering (statin) agents, в-blockers and ACE inhibitors (medicines that improve the prognosis of patients with coronary artery disease) are comparable with data from recent international registries. However, the effectiveness of therapy in the light of generally accepted criteria remains critically insufficient. Despite treatment, the target cholesterol was achieved in only 23 % of patients, and target levels of blood pressure (130/85 mm Hg) in only 12.5 % of patients. In 63.4 % of patients, including those receiving BB, heart rate remained more than 70 bmp. Referral of patients with ischemic heart disease to myocardial revascularization should be recognized as insufficient tactics and the number of interventions performed is inadequate. Factors that could enhance the efficacy of therapy would be the application of adequate doses of drugs, monitoring and control for achieving of target levels of key indicators (LDL cholesterol, blood pressure, heart rate), as well as increasing patients’ adherence to treatment.

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