L.А. Mishchenko, on behalf of the group of researchers Risk factors and socio-economic status in patients with newly diagnosed arterial hypertension: the results of the START II study

The aim – to determine the profile of newly diagnosed patients with arterial hypertension (AH) in real general practitioners’ clinical practice; to estimate the changes of working capacity and patient’s health due to prescribed AH treatment; to study the relationship between blood pressure (BP) control and the level of education, level of income and professional status.

Material and methods. In this multicenter, open-label epidemiological study START II 2024 newly diagnosed and/or untreated patients were included in 11 regional centers of Ukraine and Kyiv. During the inclusion visit the assessment of demographic, socio-economic indicators, lifestyle characteristics, anamnestic data and physical examination were performed. After these procedures, the doctors prescribed antihypertensive therapy at their own discretion. In most cases, this was the original fixed combination of perindopril and amlodipine. Its effectiveness (according to office BP measurements) was evaluated after one and three months of treatment. In addition, at the final visit (3 months of treatment), a questionnaire was conducted to examine the patient’s health changes due to prescribed AH treatment.

Results. Among newly diagnosed and/or untreated patients, 54.9 % were under 55 years old and 58 % were female. According to anamnesis, diabetes occurred in 8.9 % of patients, hypercholesterolemia – in 77.9 % of cases, the status of active smoker was reported by 25.7 % of patients. 23 % respondents assessed their level of physical activity as high and 27 % – as low. 65 % of patients considered their salt intake to be moderate, only 26 % considered it high and 9 % – low. In the structure of the patients, 48 % had higher education, mainly married – 75 % and working – 71 %, but the high level of income was noted only in 8 %. The use of a fixed combination of perindopril / amlodipine after 3 months contributed to a decrease of systolic blood pressure by 31.1 mm Hg, diastolic BP – by 14.7 mm Hg. The target levels of BP were reached in 78 % patients, therapy was more effective in patients <55 years old – 84 % vs. 73 % in the group > 55 years. In addition to age, additional negative factors in achieving blood pressure control were obesity, low level of physical activity and low level of income.

Conclusions. Women and persons under 55 years of age present the majority of newly diagnosed and/or untreated hypertensive patients in urban population of Ukraine. Most of these patients have low or moderate levels of physical activity, as well as by high or moderate level of salt intake. Almost half of patients have higher education, about 70 % are married and working, but the majority (92 %) have low and average level of income. The usage of fixed combination of perindopril/amlodipine as an initial therapy contributed to the achievement of target BP in 78 % of patients.

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