May Measurement Month 2017 in Russia: hypertension treatment and control-Europe

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative by the International Society of Hypertension aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programs worldwide. The most recent publication compared data from three surveys performed in Russian population aged 25-64 showed that the prevalence of hypertension increased by approximately 20% from 2003 to 2013. This study presents screening data collected in 2017 though the MMM17 initiative in Russia. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2017 in 19 Russian cities. Blood pressure measurement, the definition of hypertension, and statistical analysis followed the standard MMM protocol. The recruitment of MMM17 participants in Russia occurred in shopping malls, colleges and universities, supermarkets, business centres, parks, and squares. Russian young cardiologists as an official section of Russian Society of Cardiology was actively involved. A total of 5660 individuals were screened. After multiple imputation, 2709 (47.9%) had hypertension. Of individuals not receiving antihypertensive medication, 753 (20.3%) were hypertensive. Of individuals receiving antihypertensive medication, 1094 (55.9%) had uncontrolled BP. Comparing with the worldwide results of MMM17 screening, Russian participants had a higher proportion of hypertension, comparable antihypertensive prescription rate, and worse hypertension control. Thus, the MMM17 project appears to be an important step in evaluating hypertension burden in Russia and emphasizes the further need to improve hypertension awareness, treatment, and control

ОЦЕНКА ПРИВЕРЖЕННОСТИ К ЗДОРОВОМУ ОБРАЗУ ЖИЗНИ СРЕДИ САМОСТОЯТЕЛЬНО ПРАКТИКУЮЩИХ ВРАЧЕЙ И ОБУЧАЮЩИХСЯ (СТУДЕНТОВ-МЕДИКОВ, ИНТЕРНОВ И КЛИНИЧЕСКИХ ОРДИНАТОРОВ)

Introduction. The role of healthy lifestyles in the prevention of chronic non-communicable diseases is very important. Lifestyle of medical personnel, especially future doctors, may have great influence on healthy lifestyle compliance of patients. The objective of our study was to compare the prevalence of cardiovascular risk factors among doctors and students of medical educational institutions who underwent screening during The Russian Congress of Cardiology in 2016. Material and methods. During the Russian National Congress of Cardiology (Ekaterinburg, 20-23 September 2016), the participants were screened for the presence of cardiovascular risk factors. Participants filled out the questionnaire on the social status, nutrition, physical activity, smoking status, frequency of alcohol consumption, therapy. Anthropometry was performed in accordance with standard procedures. Blood pressure (BP) was measured on the right hand in a sitting position after a 5-minute rest with the automatic tonometer OMRON (Japan). The level of cholesterol and blood glucose was measured by express method using EasyTouch® GCHb (Taiwan). Results. The screening included 535 participants aged 18-78 years, the majority of whom (80 %) were women. There were 193 students, 342 doctors. Compared with students, doctors were significantly more likely to have sufficient intake of vegetables, fruits (50 vs 70 %) and fish (76 vs 88%), p<0.05, and comparable levels of salt overtaking (39 vs 34 %) and hypodynamia (35% in both groups). Only 10% of students and 7% of doctors smoked. The expected increase in the prevalence of biological risk factors in accordance with the age was significantly more common in doctors: hypercholesterolemia (63 vs 30 %), hyperglycemia (25 vs 14 %), hypertension (36 vs 5 %), obesity (according to WC – 45 vs 10 %, according to BMI – 19 vs 6 %), p<0.05. The profile of the most common risk factors did not differ among doctors and students: hypercholesterolemia and overweight in both groups took the leading positions. Also in accordance with the age, there were more often complaints of snoring-24% in doctors and 7% in students.Conclusion. The students had a less favorable profile of behavioral factors in diet compared to doctors, and despite of the expected age differences, a high prevalence of hypercholesterolemia and overweight was revealed. Obviously, it is necessary to strengthen educational work in this area at the stage of training of nurses and doctors to preserve the health of both medical personnel and their patients.Введение. Роль здорового образа жизни в рамках профилактики развития хронических неинфекционных заболеваний очень важна. Большое влияние на приверженность пациентов к здоровому образу жизни может иметь образ жизни медицинского персонала и, особенно, будущих врачей.Цель исследования – сравнить распространенность сердечно-сосудистых факторов риска среди врачей и студентов медицинских образовательных учреждений, прошедших скрининговое обследование во время Российского кардиологического конгресса в 2016 г. Материал и методы. Во время Национального конгресса кардиологов (г. Екатеринбург, 20–23 сентября 2016 г.) участники были скринированы на предмет наличия сердечно-сосудистых факторов риска. Участники заполнили опросник относительно социального статуса, характера питания и двигательной активности, статуса курения, частоты потребляемого алкоголя, приема терапии. Антропометрия выполнялась в соответствии со стандартными процедурами. Артериальное давление (АД) измерялось на правой руке в сидячем положении после 5-минутного отдыха автоматическим тонометром OMRON (Япония). Уровень холестерина и глюкозы крови измеряли экспресс-методом с помощью EasyTouch® GCHb (Тайвань).Результаты исследования. В рамках скрининга были обследованы 535 участников в возрасте 18–78 лет, большинство из которых (80 %) составили женщины. Студентов было 193, врачей – 342. По сравнению со студентами у врачей значимо чаще отмечалось достаточное потребление овощей, фруктов (50 vs 70 %) и рыбы (76 vs 88 %), р<0,05, и сопоставимый уровень злоупотребления солью (39 vs 34 %) и гиподинамии (35 % в обеих группах). Лишь 10 % студентов и 7 % врачей курили. Ожидаемым был рост распространенности биологических факторов риска с возрастом – у врачей значимо чаще встречалась гиперхолестеринемия (63 vs 30 %), гипергликемия (25 vs 14 %), артериальная гипертензия (36 vs 5 %), ожирение (согласно ОТ – 45 vs 10 %, согласно ИМТ – 19 vs 6 %), р<0,05. Профиль наиболее часто встречающихся факторов риска был сопоставим у врачей и студентов: лидирующие позиции заняли гиперхолестеринемия и избыточная масса тела в обеих группах. Также с возрастом чаще отмечались жалобы на храп – 24 % для врачей и 7 % для студентов.Заключение. У студентов был отмечен менее благоприятный профиль поведенческих факторов в области питания по сравнению с врачами, и, несмотря на ожидаемые возрастные различия, была отмечена достаточно высокая распространенность гиперхолестеринемии и избыточной массы тела. Очевидно, необходимо усилить просветительскую работу в данной сфере на этапе обучения среднего медперсонала и врачей для сохранения здоровья как медицинского персонала, так и их пациентов.

Hypertension control during the COVID-19 pandemic: results of the MMM2021 in Russia

Repetitive quarantines and social restrictions during the coronavirus disease 2019 (COVID-19) pandemic have negatively affected the population health in general, and the control of hypertension (HTN) in particular.Aim. To evaluate the control of HTN in the Russian population during the COVID-19 period based on the results of screening for HTN May Measurement Month 2021 (MMM2021).Material and methods. During May-August 2021, 2491 participants from 11 Russian regions took part in the screening. Participation was voluntary without restrictions on sex. All participants were over 18 years of age. During the screening, blood pressure (BP) was measured three times using automatic and mechanical BP monitors. In addition, a questionnaire was filled out on behavioral risk factors, comorbidities and therapy. HTN was diagnosed with systolic BP ≥140 mmHg and/ or diastolic blood pressure ≥90 mmHg and/or taking antihypertensive therapy. The questionnaire included questions about prior COVID-19, vaccinations and their impact on the intake of antihypertensive drugs.Results. The analysis included data from 2461 respondents aged 18 to 92, of which 963 were men (39,1%). The proportion of hypertensive patients was 41,0%, while among them 59,0% took antihypertensives and 30,9% were effectively treated. In comparison with pre-pandemic period according to MMM2018-2019, the higher proportion of HTN patients in the Russian sample was revealed during MMM2021 (41,0% vs 31,3%, p<0,001) with a comparable proportion of patients receiving antihypertensive therapy (60,7% vs 59,0%, p=0,05) and treatment efficacy (28,7% vs 30,9%, p=0,36). Monotherapy was received in 44,7% of cases, while dual and triple combination therapy — in 30,9% and 14,1%, respectively. The majority of respondents (~90%) did not adjust their antihypertensive therapy during the COVID-19 pandemic.Conclusion. According to HTN screening in Russia, there is persistent ineffective control of HTN, which may be due to both the worsening pattern of behavioral risk factors, limited access to healthcare during COVID-19, and the inertia of physicians and low adherence of patients due to the asymptomatic HTN course in the majority

HEALTH OF THE CARDIOLOGISTS: WHO IF NOT THEY?

Aim. To assess the prevalence of cardiovascular risk factors among clinicians attended the Russian National Congress of Cardiology (Ekaterinburg, September 20-23, 2016).Material and methods. During the Congress, 535 participants were screened on the presence of cardiovascular risk factors. Participants filled the questionnaire on social status, food preferences and activity, smoking, alcohol consumption, medications intake. Anthropometry was done according to standards. Blood pressure (BP) was measured on the right arm, sitting, after 5-minute rest, by automatic tonometer OMRON (Japan). Cholesterol level and blood glucose were measured by express-method with EasyTouch® GCHb (Taiwan). For comparison with the general population, the data from ESSE-RF study was included.Results. Food preferences in doctors were shifted towards healthier comparing to general population: quite high prevalence of enough fish, vegetables and fruits, and low level of salt overconsumption; hypodynamia level was comparable with populational. During the last 10 years, there was two-fold decrease of smoking prevalence, and increase of hypercholesterolemia, and obesity and hypertension prevalence remained same. Adherence to antihypertension and hypolipidemic treatment is still low. Cardiovascular risk by SCORE among doctors is not high.Conclusion. In clinicians participating in scientific-educational events (half of them — cardiologists), a healthier profile was found, of the risk factors, comparing to general population. The only exception was hypodynamia which is probably a cause of obesity prevalent among medical society. During the last decade, there is a decrease of smoking prevalence noted, but there is no increase in antihypertension therapy adherence, and there is an increase of hypercholesterolemia among clinician

ASSESSMENT OF HEALTHY LIFESTYLE COMPLIANCE AMONG PRIVATE-PRACTICE DOCTORS AND STUDENTS (MEDICAL STUDENTS, INTERNS AND CLINICAL RESIDENTS)

Introduction. The role of healthy lifestyles in the prevention of chronic non-communicable diseases is very important. Lifestyle of medical personnel, especially future doctors, may have great influence on healthy lifestyle compliance of patients. The objective of our study was to compare the prevalence of cardiovascular risk factors among doctors and students of medical educational institutions who underwent screening during The Russian Congress of Cardiology in 2016. Material and methods. During the Russian National Congress of Cardiology (Ekaterinburg, 20-23 September 2016), the participants were screened for the presence of cardiovascular risk factors. Participants filled out the questionnaire on the social status, nutrition, physical activity, smoking status, frequency of alcohol consumption, therapy. Anthropometry was performed in accordance with standard procedures. Blood pressure (BP) was measured on the right hand in a sitting position after a 5-minute rest with the automatic tonometer OMRON (Japan). The level of cholesterol and blood glucose was measured by express method using EasyTouch® GCHb (Taiwan). Results. The screening included 535 participants aged 18-78 years, the majority of whom (80 %) were women. There were 193 students, 342 doctors. Compared with students, doctors were significantly more likely to have sufficient intake of vegetables, fruits (50 vs 70 %) and fish (76 vs 88%), p<0.05, and comparable levels of salt overtaking (39 vs 34 %) and hypodynamia (35% in both groups). Only 10% of students and 7% of doctors smoked. The expected increase in the prevalence of biological risk factors in accordance with the age was significantly more common in doctors: hypercholesterolemia (63 vs 30 %), hyperglycemia (25 vs 14 %), hypertension (36 vs 5 %), obesity (according to WC – 45 vs 10 %, according to BMI – 19 vs 6 %), p<0.05. The profile of the most common risk factors did not differ among doctors and students: hypercholesterolemia and overweight in both groups took the leading positions. Also in accordance with the age, there were more often complaints of snoring-24% in doctors and 7% in students.Conclusion. The students had a less favorable profile of behavioral factors in diet compared to doctors, and despite of the expected age differences, a high prevalence of hypercholesterolemia and overweight was revealed. Obviously, it is necessary to strengthen educational work in this area at the stage of training of nurses and doctors to preserve the health of both medical personnel and their patients

May Measurement Month 2019: adherence to treatment and hypertension control in Russia

The International Society of Hypertension and the World Hypertension League initiated a blood pressure screening study called May Measurement Month 2019 (MMM19) to improve the detection of elevated blood pressure (BP) and to assess BP control in patients with hypertension (HTN).Aim. To assess adherence to treatment of the hypertensive population according to MMM19 campaign in Russia.Material and methods. During May 2019, 5394 people from 21 regions of Russia took part in the screening. Participation was voluntary and did not imply gender restrictions; all subjects were over 18 years of age. During the screening, BP was measured three times using electronic and mechanical sphygmomanometers, as well as a questionnaire on the diabetes, history of cardiovascular events, smoking, and alcohol consumption was filled. Information was also collected on the date of last BP check and the administration of statins, acetylsalicylic acid and antihypertensive drugs. Data on height and body weight was obtained from respondents.Results. The analysis included data from 5274 participants aged 18 to 96 years (men — 1834 (34,8%)). Median age was 25 years, quartiles — 20 and 49 years. According to MMM19 data, the proportion of HTN patients in the Russian population was 31,9%, and with the exception of participants under 25 years old — 51,5%. Patients with HTN over 25 years old take antihypertensive therapy in 73,6%; 38,6% are characterized by irregular drug intake. Only 11,8% of men and 17,2% of women reach the target blood pressure <130/80 mm Hg. Only 20-30% of patients who used 4-5 antihypertensives reached the target BP level.Conclusion. According to MMM19 in Russia, only a third of high-risk patients measured BP over the past 12 months. There is also low adherence to antihypertensive therapy and inadequate control of HTN. Patients with HTN and a history of cardiovascular events are more likely to take antihypertensives regularly