National Medical Research Center for Preventive Medicine, Moscow, Russia

Abstract


Arterial hypertension is the leading cause of cardiovascular morbidity and mortality. According to Russian and international studies, prevalence of hypertension is approximately 40%. In the next years an increase in the number of patients can be expected. Hypertension is the main independent risk factor for coronary heart disease for all age groups. Modern antihypertensive drugs can provide good control of blood pressure and reduce the incidence of complications and mortality. By prescribing antihypertensive therapy, it is necessary to achieve the target level of blood pressure, for most patients ≤130/80 mm Hg. When prescribing combination therapy, preference should be given to fixed combinations. Approximately 10% of patients with hypertension have resistance to therapy. Such patients often need an extended diagnostic search to exclude pseudoresistance and secondary hypertension. One of the main causes of pseudoresistance is poor adherence to therapy. Patients with resistant hypertension have a higher risk of adverse outcomes compared with patients without this type of disease.

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About the authors

Yulia V. Evsyutina

National Medical Research Center for Preventive Medicine

Email: evsyutina.yulia@gmail.com
Moscow, Russia
Cand. Sci. (Med.)

References

  1. WHO. Raised blood pressure. https://www.who.int/gho/ncd/risk_ factors/blood_pressure_prevalence_text/en/
  2. Муромцева Г.А., Концевая А.В., Константинов В.В. и др. Распространенность факторов риска неинфекционных заболевании в россиискои популяции в 2012-2013 гг. Результаты исследования ЭССЕ-РФ. Кардиоваскулярная терапия и профилактика. 2014; 13 (6): 4-11.
  3. Chow C.K, Teo K.K, Rangarajan S et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities
  4. Whelton P, He J, Appel L et al. Primary prevention of hypertension: clinical and public health advisory from the national high blood pres-sure education program. J Am Med Assoc 2002; 288: 1882-8.
  5. Zhou D, Xi B, Zhao M et al. Uncontrolled hypertension increases risk of allcause and cardiovascular disease mortality in US adults: the NHANES III Linked Mortality Study. Sci Rep 2018; 8 (1): 9418.
  6. Musini V.M, Tejani A.M, Bassett K et al. Pharmacotherapy for hypertension in adults 60 years or older. Cochrane Database of Systematic Reviews 2019; 6: CD000028.
  7. Williams B, Mancia G, Spiering W et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 2018; 39 (33): 3021-104.
  8. Чазова И.Е., Жернакова Ю.В. от имени экспертов. Клинические рекомендации. Диагностика и лечение артериальнои гипертонии. Системные гипертензии. 2019; 16 (1): 6-31.
  9. Lewington S, Clarke R, Qizilbash N et al. Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903-13.
  10. Franklin S.S, Larson M.G, Khan S.A et al. Does the relation of blood pressure to coronary heart disease risk change with aging? The Framingham Heart Study. Circulation 2001; 103: 1245-9.
  11. Miura K, Daviglus M.L, Dyer A.R et al. Relationship of blood pressure to 25-year mortality due to coronary heart disease, cardiovascular diseases, and all causes in young adult men: the Chicago Heart Association Detection Project in Industry. Arch Intern Med 2001; 161: 1501-8.
  12. Daugherty S.L, Powers J.D, Magid D.J et al. Incidence and prognosis of resistant hypertension in hypertensive patients. Circulation 2012; 125: 1635-42.
  13. Sim J.J, Bhandari S.K, Shi J et al. Comparative risk of renal, cardiovascular, and mortality outcomes in controlled, uncontrolled resistant, and nonresistant hypertension. Kidney Int 2015; 88: 622-32.
  14. Thomas G, Xie D, Chen H.Y et al. Prevalence and prognostic significance of apparent treatment resistant hypertension in chronic kid-ney disease: report from the Chronic Renal Insufficiency Cohort Study. Hypertension 2016; 67: 387-96.
  15. Smith S.M, Huo T, Delia Johnson B et al. Cardiovascular and mortality risk of apparent resistant hypertension in women with suspected myocardial ischemia: a report from the NHLBI-sponsored WISE Study. J Am Heart Assoc 2014; 3: e000660
  16. Smith S.M, Gong Y, Handberg E et al. Predictors and outcomes of resi-stant hypertension among patients with coronary artery disease and hypertension. J Hypertens 2014; 32: 635-43.
  17. Jin C.N, Liu M, Sun J.P et al. The prevalence and prognosis of resistant hypertension in patients with heart failure. PLoS One. 2014; 9: e114958
  18. Irvin M.R, Booth J.N, Shimbo D et al. Apparent treatment-resistant hy-pertension and risk for stroke, coronary heart disease, and all-cause mortality. J Am Soc Hypertens 2014; 8: 405-13.
  19. Egan B.M, Kai B, Wagner C.S et al. Blood pressure control provides less cardiovascular protection in adults with than without apparent treatment-resistant hypertension. J Clin Hypertens (Greenwich) 2016; 18: 817-24.
  20. Carey R.M, Calhoun D.A, Bakris G.L et al. Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association. Hypertension 2018; 72 (5): e53-e90.

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