Erina A M, Rotar O P, Solntsev V N, Shalnova S A, Deev A D, Baranova E I, Konradi O A, Boytsov S A, Shlyakhto E V
Almazov National Medical Research Centre.
National Medical Research Center for Preventive Medicine.
Kardiologiia. 2019 Jun 25;59(6):5-11. doi: 10.18087/cardio.2019.6.2595.
Assessment of prevalence of arterial hypertension (AH), need for prescription of antihypertensive therapy (AHT), and efficacy of AHT in Russian population in accordance with novel guideline of the American College of Cardiology/American Heart Association ("American recommendations") on diagnosis and treatment of AH (2017).
Epidemiological study ESSE-RF (ЭССЕ-РФ) was carried out in 12 regions of Russian Federation (RF) with different climatic-geographic characteristics. Number of examined residents of RF aged 25-65 years was 20 652. The sample was stratified by gender and age. Examination included anthropometry, laboratory tests, blood pressure (BP) measurement with the OMRON tonometer. The SCORE scale was used for evaluation of risk of development of cardiovascular diseases (CVD). In American recommendations AH was defined as follows: 1-st degree - systolic BP (SBP) 130-139 and/or diastolic BP (DBP) 80-89 mm Hg, 2-nd degree - BP ≥140/90 mm Hg and/or presence of AHT. In recommendations of the European Society of Cardiology (2013, 2018) ("European recommendations") AH was defined as BP ≥140/90 mm Hg and/or presence of AHT.
We analyzed data of examination of 20 607 participants - 7806 men (37.9%) and 12 801 women (62.1%). According to European recommendations AH was diagnosed in 10 347 persons (50.2%) - 3987 men (51.1%) men and 6 360 women (49.7%). According to American recommendations AH was registered in 14 853 persons (72.1%) - 6 059 men (77.6%) and 8 794 women (68.7%). AHT received 6324 persons (61.1% of those with AH); according to American recommendations, the onset of AHT was indicated to additional 620 persons with 1-st degree AH because of high CVD risk. Among all participants with AH (on and without AHT) strengthening of AHT for achievement of target BP level was required in 77.8 and 92.6% of patients according to European and American recommendations, respectively.
Application of novel criteria of AH diagnosis from 2017 ACC/AHA guideline to Russian population would increase prevalence of AH up to 72.1%. Onset of AHT would be indicated in 13.8% of patients with 1-st degree AH, while in 93% of patients receiving AHT its strengthening would be required.
根据美国心脏病学会/美国心脏协会关于动脉高血压（AH）诊断和治疗的新指南（“美国建议”，2017年），评估俄罗斯人群中AH的患病率、抗高血压治疗（AHT）的处方需求以及AHT的疗效。
在俄罗斯联邦（RF）具有不同气候地理特征的12个地区开展了ESSE-RF流行病学研究。接受检查的25至65岁RF居民数量为20652人。样本按性别和年龄分层。检查包括人体测量、实验室检测、使用欧姆龙血压计测量血压（BP）。采用SCORE量表评估心血管疾病（CVD）发生风险。在美国建议中，AH定义如下：1级——收缩压（SBP）130 - 139和/或舒张压（DBP）80 - 89 mmHg，2级——血压≥140/90 mmHg和/或进行AHT。在欧洲心脏病学会的建议（2013年、2018年）（“欧洲建议”）中，AH定义为血压≥140/90 mmHg和/或进行AHT。
我们分析了20607名参与者的数据——7806名男性（37.9%）和12801名女性（62.1%）。根据欧洲建议，10347人（50.2%）被诊断为AH——3987名男性（51.1%）和6360名女性（49.7%）。根据美国建议，14853人（72.1%）被登记为AH——6059名男性（77.6%）和8794名女性（68.7%）。6324人接受了AHT（占AH患者的61.1%）；根据美国建议，因CVD高风险，另外620名1级AH患者也开始进行AHT。在所有AH患者（接受和未接受AHT）中，根据欧洲和美国建议，分别有77.8%和92.6%的患者需要强化AHT以达到目标血压水平。
将2017年ACC/AHA指南中AH诊断的新标准应用于俄罗斯人群，会使AH患病率增至72.1%。13.8%的1级AH患者将开始进行AHT，而在93%接受AHT的患者中需要强化治疗。
