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Оценка качества обследования больных артериальной гипертонией в первичном звене здравоохранения (по данным российского Регистра артериальной гипертонии)
Оценка качества обследования больных артериальной гипертонией в первичном звене здравоохранения (по данным российского Регистра артериальной гипертонии)
Ощепкова Е.В., Лазарева Н.В., Чазова И.Е. Оценка качества обследования больных артериальной гипертонией в первичном звене здравоохранения (по данным российского Регистра артериальной гипертонии). Системные гипертензии. 2017; 14 (2): 29–34. DOI: 10.26442/2075-082X_14.2.29-34
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Аннотация
Цель исследования – оценка качества обследования больных артериальной гипертонией (АГ), проводимая врачами амбулаторно-поликлинического звена здравоохранения.
Материалы и методы. Исследование проведено методом регистра АГ (компьютерная программа с удаленным доступом, медицинские данные вводились из амбулаторных карт больных АГ). Проанализирована выборка, состоящая из 29 126 больных АГ, наблюдаемых в поликлиниках и кардиодиспансерах 22 регионов Российской Федерации в 2010–2014 гг. Мужчин было 35%, женщины были старше на 3,7 года (60,9±12,5 и 64,6±12,0 года соответственно, р<0,05). После трудоспособного возраста мужчин (60 лет и старше) и женщин (55 лет и старше) было 60 и 78% соответственно.
Результаты. У 43% больных была 1-я степень АГ, 12% – 2-я, 3% – 3-я. У 38% больных уровень артериального давления ниже 140/90 мм рт. ст., у 4% отсутствовали показатели артериального давления в амбулаторных картах, 80% пациентов находились на антигипертензивной терапии.
Анализ обследования больных АГ выявил, что у 63% уточнялся семейный анамнез сердечно-сосудистых заболеваний, статус курения – у 78,1%, опрошены 45% пациентов в отношении употребления алкоголя, опрос об уровне физической активности проводился у 83,8%, окружность талии измерена у 26,4%. Измерение роста и массы тела проводилось у 46,5% больных АГ. Общий холестерин определялся у 86,4%, холестерин липопротеидов высокой плотности – 25,5%, триглицериды – 38,6%, глюкоза плазмы натощак – 85,3%, креатинин – 58,7%. Электрокардиография проводилась у 100% больных, эхокардиография – 28,9%, дуплексное сканирование брахиоцефальных артерий – в 1% случаев. У мужчин с АГ достоверно чаще диагностирована хроническая сердечная недостаточность (44,4%), ишемическая болезнь сердца (45,6%) и Q-инфаркт миокарда (20,5%); у женщин с АГ – хроническая сердечная недостаточность (35,2%), ишемическая болезнь сердца (26,7%) и Q-инфаркт миокарда (5,5%). Сахарный диабет типа 2 диагностирован у 12,1% мужчин и 17,8% женщин с АГ.
Выводы. Исследование методом регистра выборки больных АГ, наблюдающихся в первичном звене здравоохранения в 2010–2014 гг., показало неоптимальное обследование больных АГ и недостаточное выполнение Российских рекомендаций «Диагностика и лечение артериальной гипертонии». Необходима дальнейшая работа по обучению врачей – терапевтов, общей практики, семейных и кардиологов методам диагностики и лечения больных АГ в соответствии с Российскими рекомендациями по АГ.
Ключевые слова: артериальная гипертония, Регистр артериальной гипертонии, диагностика.
Materials and methods. The study was carried out with the Arterial Hypertension Register method (a software with remote access, medical data inputs were made from medical records of patients with AH). The study included a selection of 29 126 patients with AH under care in primary health care in 22 regions of Russia in 2010–2014. 35% were males, females were older by 3.7 years (60.9±12.5 years and 64.6±12.0 years respectively, р<0.05).
Results. 1 stage AH was observed in 43% of patients; 2 stage – in 12%; 3 stage – in 3%. BP<140/90 mm Hg was registered in 38% of patients. 80% of patients were under antihypertensive therapy. 4% of patients with AH lacked BP data in their medical records.
Analysis of examinations of patients with AH showed that 63% of patients had data on family medical history of cardiovascular diseases in their medical cards; 78.1% – data on smoking status; 45% – on alcohol consumption; 83.8% – on physical activity level; 26.4% – on waist circumference; 46.5% – on height and bodyweight. Total cholesterol was identified in 86.4%, HDL cholesterol – in 25.5%, triglycerids – in 38.6%, glucose – in 85.3% and creatinine in 58.7% of patients with AH. ECG examination was done on 100% of patients, echo-cardiography – on 28.9%, duplex screening of brachiocephalic arteries – on 1% of patients with AH.
Chronic heart failure (44.4%), сoronary artery disease (45.6%) and Q-wave myocardial infarction in anamnesis (20.5%) were statistically more frequently observed in males. In females CHF was observed in 35.2% of patients, CAD – in 26.7% and Q-wave MI in anamnesis – in 5.5% of pts. II type diabetes mellitus was observed in 12.1% of males and in 17.8% of females with AH.
Conclusion. The Register method study on a selection of patients with AH under care in primary health care in 2010–2014 shows that their examination with regard to medical history taking, cardiovascular risk factors and target organ damage assessment in patients with AH is nonoptimal. Further efforts are needed to educate physician primary care physician, family doctors and cardiologists on the methods of diagnostics and treatment of patients with AH according to the Russian guidelines on AH.
Key words: arterial hypertension, arterial hypertension register, target organ damage, cardiovascular risk factors.
Материалы и методы. Исследование проведено методом регистра АГ (компьютерная программа с удаленным доступом, медицинские данные вводились из амбулаторных карт больных АГ). Проанализирована выборка, состоящая из 29 126 больных АГ, наблюдаемых в поликлиниках и кардиодиспансерах 22 регионов Российской Федерации в 2010–2014 гг. Мужчин было 35%, женщины были старше на 3,7 года (60,9±12,5 и 64,6±12,0 года соответственно, р<0,05). После трудоспособного возраста мужчин (60 лет и старше) и женщин (55 лет и старше) было 60 и 78% соответственно.
Результаты. У 43% больных была 1-я степень АГ, 12% – 2-я, 3% – 3-я. У 38% больных уровень артериального давления ниже 140/90 мм рт. ст., у 4% отсутствовали показатели артериального давления в амбулаторных картах, 80% пациентов находились на антигипертензивной терапии.
Анализ обследования больных АГ выявил, что у 63% уточнялся семейный анамнез сердечно-сосудистых заболеваний, статус курения – у 78,1%, опрошены 45% пациентов в отношении употребления алкоголя, опрос об уровне физической активности проводился у 83,8%, окружность талии измерена у 26,4%. Измерение роста и массы тела проводилось у 46,5% больных АГ. Общий холестерин определялся у 86,4%, холестерин липопротеидов высокой плотности – 25,5%, триглицериды – 38,6%, глюкоза плазмы натощак – 85,3%, креатинин – 58,7%. Электрокардиография проводилась у 100% больных, эхокардиография – 28,9%, дуплексное сканирование брахиоцефальных артерий – в 1% случаев. У мужчин с АГ достоверно чаще диагностирована хроническая сердечная недостаточность (44,4%), ишемическая болезнь сердца (45,6%) и Q-инфаркт миокарда (20,5%); у женщин с АГ – хроническая сердечная недостаточность (35,2%), ишемическая болезнь сердца (26,7%) и Q-инфаркт миокарда (5,5%). Сахарный диабет типа 2 диагностирован у 12,1% мужчин и 17,8% женщин с АГ.
Выводы. Исследование методом регистра выборки больных АГ, наблюдающихся в первичном звене здравоохранения в 2010–2014 гг., показало неоптимальное обследование больных АГ и недостаточное выполнение Российских рекомендаций «Диагностика и лечение артериальной гипертонии». Необходима дальнейшая работа по обучению врачей – терапевтов, общей практики, семейных и кардиологов методам диагностики и лечения больных АГ в соответствии с Российскими рекомендациями по АГ.
Ключевые слова: артериальная гипертония, Регистр артериальной гипертонии, диагностика.
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Materials and methods. The study was carried out with the Arterial Hypertension Register method (a software with remote access, medical data inputs were made from medical records of patients with AH). The study included a selection of 29 126 patients with AH under care in primary health care in 22 regions of Russia in 2010–2014. 35% were males, females were older by 3.7 years (60.9±12.5 years and 64.6±12.0 years respectively, р<0.05).
Results. 1 stage AH was observed in 43% of patients; 2 stage – in 12%; 3 stage – in 3%. BP<140/90 mm Hg was registered in 38% of patients. 80% of patients were under antihypertensive therapy. 4% of patients with AH lacked BP data in their medical records.
Analysis of examinations of patients with AH showed that 63% of patients had data on family medical history of cardiovascular diseases in their medical cards; 78.1% – data on smoking status; 45% – on alcohol consumption; 83.8% – on physical activity level; 26.4% – on waist circumference; 46.5% – on height and bodyweight. Total cholesterol was identified in 86.4%, HDL cholesterol – in 25.5%, triglycerids – in 38.6%, glucose – in 85.3% and creatinine in 58.7% of patients with AH. ECG examination was done on 100% of patients, echo-cardiography – on 28.9%, duplex screening of brachiocephalic arteries – on 1% of patients with AH.
Chronic heart failure (44.4%), сoronary artery disease (45.6%) and Q-wave myocardial infarction in anamnesis (20.5%) were statistically more frequently observed in males. In females CHF was observed in 35.2% of patients, CAD – in 26.7% and Q-wave MI in anamnesis – in 5.5% of pts. II type diabetes mellitus was observed in 12.1% of males and in 17.8% of females with AH.
Conclusion. The Register method study on a selection of patients with AH under care in primary health care in 2010–2014 shows that their examination with regard to medical history taking, cardiovascular risk factors and target organ damage assessment in patients with AH is nonoptimal. Further efforts are needed to educate physician primary care physician, family doctors and cardiologists on the methods of diagnostics and treatment of patients with AH according to the Russian guidelines on AH.
Key words: arterial hypertension, arterial hypertension register, target organ damage, cardiovascular risk factors.
Полный текст
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2. Bor’ba s arterial’noi gipertoniei. Prevention of hypertension. Doklad Komiteta ekspertov VOZ. Vsemirnaya organizatsiya zdravookhraneniya. Report of WHO Expert Committee. World Health Organization Geneve, 1996.
3. Chazov E.I. Rukovodstvo po arterial’noi gipertonii. Guidelines for hypertension. Moscow; Media-Medika, 2005.
4. Chazova I.E. Oshchepkova E.V. Chikhladze N.M. Arterial’naya gipertoniya (printsipy diagnostiki i lecheniya). Arterial hypertension (principles of diagnosis and treatment). Moscow, 2005.
5. Britov A.N., Oganov RG. The national program to combat arterial hypertension in the USSR. Therapeutic archive. 1985; 11: 67.
6. Oganov R.G., Chazova L.V., Britov A.N. Kardiologich. vestn. 1986; 9 (1): 11. [in Russian]
7. Heart disease and Strokestatistics – 2012 update: a report from the American Heart Association. Circulation 2012; 125: 2–220.
8. Chazova I.E., Zhernakova Iu.V., Oshchepkova E.V. i dr. Rasprostranennost' FR serdechno-sosudistykhzabolevanii v rossiiskoi populiatsii bol'nykh arterial'noi gipertoniei. Kardiologiia. 2014; 10: 4–12. [in Russian]
9. Chazova I.E., Oshchepkova E.V. Itogi realizatsii Federal'noi tselevoi programmy po profilaktike i lecheniiu arterial'noi gipertenzii v Rossiiv 2002–2012 gg. Vestn. Rossiiskoi Akademii meditsinskikh nauk. 2013; 2: 4–11. [in Russian]
10. Shal'nova S.A., Deev A.D., Vikhireva O.V. i dr. Rasprostranennost' arterial'noi gipertonii v Rossii: informirovannost', lechenie, kontrol'. Profilaktika zabolevanii i ukreplenie zdorov'ia. 2001; 2: 3–7. [in Russian]
11. Heart disease and Stroke statistics – 2016 update: a report from the American Heart Association. Circulation 2016; 133.
12. Wolf-Maier K, Cooper RS, Banegas JR et al. Hypertension prevalence and blood pressure levels in 6 European countries, Canada and the United States. JAMA 2003; 289: 2363–9.
13. Pereira M, Lunet N, Azevedo A, Barros H. Differences in prevalence, awareness, treatment and control of hypertension between developing and developed countries. J Hypertens 2009; 27: 963–75.
14. Klinicheskie rekomendatsii «Diagnostika i lechenie arterial'noi gipertonii». Rabochaia gruppa po podgotovke teksta: Chazova I.E., Oshchepkova E.V., ZhernakovaIu.V. Kardiologicheskii vestn. 2015; 1: 5–30. [in Russian]
15. 2013 ESH/ESC Guidelines for the management of arterial hypertension. J Hypertens 2013; 31 (7): 1281–357.
16. Dovgalevskii P.Ya., Oshchepkova E.V., Gridnev V.I. Register arterial hypertension. Ther Arch 2007; 1: 46–8.
17. Natsional'nye rekomendatsii «Khronicheskaia bolezn' pochek: osnovnye printsipy skrininga, diagnostiki, profilaktiki i podkhody k lecheniiu». Rabochaia gruppa po podgotovke teksta: Smirnov A.V., Shilov E.M. i dr. Nefrologiia. 2012; 16 (1): 89–115. [in Russian]
18. Federal'naia sluzhba gosudarstvennoi statistiki. http://www.gks.ru/ [in Russian]
19. US Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010.
20. Brotons C, Bulc M, Sammut MR et al. Attitudes toward preventive services and lifestyle: the views of primary care patients in Europe. The EUROPREVIEW patient study. Fam Pract 2012; 29 (Suppl. 1): i168–76.
21. Gual A, Zarco J et al. Early screening and brief intervention in alcohol misuse to improve the treatment of hypertension in primary care. Med Clin (Barc) 2016; 146 (2): 81–5.
22. Cláudia Rayanna Silva Mendes et al. Self-care comparison of hypertensive patients in primary and secondary health care services. Acta Paul Enferm 2015; 28 (6): 580–6.
23. Lein S, Burke LE, Bray GA et al. On behalf of the American Heart Association Council on Nutrition, Physical Activity, and Metabolism. Clinical implications of obesity with specific focus on cardiovascular disease: a statement for professionals from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism. Circulation 2004; 110: 2952–67.
24. Poirier P, Giles TD, Bray GA et al. On behalf of the American Heart Association; Obesity Commit- tee of the Council on Nutrition, Physical Activity, and Metabolism. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 2006; 113: 898–918.
25. Tedrow UB, Conen D, Ridker PM et al. The long- and short-term impact of elevated body mass index on the risk of new atrial fibrillation the WHS (women’s health study). J Am Coll Cardiol 2010; 55: 2319–27.
26. Reiner Z, Catapano AL, de Backer G et al. ESC/EAS. Guidelines for the management of dyslipidaemias: The Task Force for the management of dyslipidaemias of the European Society of Cardiology ESC) and the European Atherosclerosis Society (EAS). Eur Heart J 2011; 32: 1769–818.
27. Henry RM, Kostense PJ, Bos G et al. Mild renal insufficiency is associated with increased cardiovascular mortality: the Hoorn Study. Kidney Int 2002; 62: 1402–7.
28. Oshchepkova E.V., Dolgusheva Iu.A., Zhernakova Iu.V. i dr. Rasprostranennost' narusheniia funktsii pochek pri arterial'noi gipertonii (po dannym epidemiologicheskogo issledovaniia ESSE-RF). Systemic Hypertension. 2015; 12 (3): 19–24. [in Russian]
29. Da Silva LS, Cotta RMM, Moreira TR et al. Hidden prevalence of chronic kidney disease in hypertensive patients: the strategic role ofprimaryhealthcare. J Publichealth 2016; 140: 250–7.
30. Coresh J, Selvin E, Stevens LA et al. Prevalence of chronic kidney disease in the United States. JAMA 2007; 298: 2038–47.
31. Asia pacific Cohort Studies Collaboration. The effects of diabetes on the risk of major cardiovascular diseases and death in the Asia-Pacific region. Diabetes Care 2003; 26: 360–6.
32. Kim M-J, Lim N-K, Park H-Y. Relationship between prehypertension and chronic kidney disease in middle-aged people in Korea: the Korean genome and epidemiology study. BMC Public Health 2012; 12: 960.
33. Klag MJ, Whelton PK, Randall BL et al. End-stage renal disease in African-American and white men.16-year MRFIT findings. JAMA 1997; 277 (16): 1293–8.
34. Martinez MA, Sancho T. Prevalence of left ventricular hypertrophy in patients with mild hypertension in primary care: impact of echocardiography on cardiovascular risk stratification. Am J Hypertens 2003; 6 (Issue 7): 556–63.
35. Saltykova MM, Oshchepkova EV, Ataullakhanova DM et al. Electro cardiographs diagnosis of hypertrophyof left ventricular myocardium in patients with hypertension. Therapeutic Archive. 2006; 78 (12): 40–5.
36. Boitsov S.A., Kalinina A.M. Dispanserizatsiia vzroslogo naseleniia kak mekhanizm vyiavleniia serdechno-sosudistykh zabolevanii i formirovaniia dispansernogo nabliudeniia. Vestn. Roszdravnadzora. 2015; 5: 11–9. [in Russian]
37. Oshchepkova E.V., Lazareva N.V., Saltykova D.F., Tereshchenko S.N. Pervye rezul'taty Rossiiskogo Registra KhSN. Kardiologiia. 2015; 55: 22–8. [in Russian]
2. Bor’ba s arterial’noi gipertoniei. Prevention of hypertension. Doklad Komiteta ekspertov VOZ. Vsemirnaya organizatsiya zdravookhraneniya. Report of WHO Expert Committee. World Health Organization Geneve, 1996.
3. Chazov E.I. Rukovodstvo po arterial’noi gipertonii. Guidelines for hypertension. Moscow; Media-Medika, 2005.
4. Chazova I.E. Oshchepkova E.V. Chikhladze N.M. Arterial’naya gipertoniya (printsipy diagnostiki i lecheniya). Arterial hypertension (principles of diagnosis and treatment). Moscow, 2005.
5. Britov A.N., Oganov RG. The national program to combat arterial hypertension in the USSR. Therapeutic archive. 1985; 11: 67.
6. Оганов Р.Г., Чазова Л.В., Бритов А.Н. Кардиологич. вестн. 1986; 9 (1): 11. / Oganov R.G., Chazova L.V., Britov A.N. Kardiologich. vestn. 1986; 9 (1): 11. [in Russian]
7. Heart disease and Strokestatistics – 2012 update: a report from the American Heart Association. Circulation 2012; 125: 2–220.
8. Чазова И.Е., Жернакова Ю.В., Ощепкова Е.В. и др. Распространенность ФР сердечно-сосудистых заболеваний в российской популяции больных артериальной гипертонией. Кардиология. 2014; 10: 4–12. / Chazova I.E., Zhernakova Iu.V., Oshchepkova E.V. i dr. Rasprostranennost' FR serdechno-sosudistykhzabolevanii v rossiiskoi populiatsii bol'nykh arterial'noi gipertoniei. Kardiologiia. 2014; 10: 4–12. [in Russian]
9. Чазова И.Е., Ощепкова Е.В. Итоги реализации Федеральной целевой программы по профилактике и лечению артериальной гипертензии в России в 2002–2012 гг. Вестн. Российской академии медицинских наук. 2013; 2: 4–11. / Chazova I.E., Oshchepkova E.V. Itogi realizatsii Federal'noi tselevoi programmy po profilaktike i lecheniiu arterial'noi gipertenzii v Rossiiv 2002–2012 gg. Vestn. Rossiiskoi Akademii meditsinskikh nauk. 2013; 2: 4–11. [in Russian]
10. Шальнова С.А., Деев А.Д., Вихирева О.В. и др. Распространенность артериальной гипертонии в России: информированность, лечение, контроль. Профилактика заболеваний и укрепление здоровья. 2001; 2: 3–7. / Shal'nova S.A., Deev A.D., Vikhireva O.V. i dr. Rasprostranennost' arterial'noi gipertonii v Rossii: informirovannost', lechenie, kontrol'. Profilaktika zabolevanii i ukreplenie zdorov'ia. 2001; 2: 3–7. [in Russian]
11. Heart disease and Stroke statistics – 2016 update: a report from the American Heart Association. Circulation 2016; 133.
12. Wolf-Maier K, Cooper RS, Banegas JR et al. Hypertension prevalence and blood pressure levels in 6 European countries, Canada and the United States. JAMA 2003; 289: 2363–9.
13. Pereira M, Lunet N, Azevedo A, Barros H. Differences in prevalence, awareness, treatment and control of hypertension between developing and developed countries. J Hypertens 2009; 27: 963–75.
14. Клинические рекомендации «Диагностика и лечение артериальной гипертонии». Рабочая группа по подготовке текста: Чазова И.Е., Ощепкова Е.В., Жернакова Ю.В. Кардиологич. вестн. 2015; 1: 5–30. / Klinicheskie rekomendatsii «Diagnostika i lechenie arterial'noi gipertonii». Rabochaia gruppa po podgotovke teksta: Chazova I.E., Oshchepkova E.V., ZhernakovaIu.V. Kardiologicheskii vestn. 2015; 1: 5–30. [in Russian]
15. 2013 ESH/ESC Guidelines for the management of arterial hypertension. J Hypertens 2013; 31 (7): 1281–357.
16. Dovgalevskii P.Ya., Oshchepkova E.V., Gridnev V.I. Register arterial hypertension. Ther Arch 2007; 1: 46–8.
17. Национальные рекомендации «Хроническая болезнь почек: основные принципы скрининга, диагностики, профилактики и подходы к лечению». Рабочая группа по подготовке текста: Смирнов А.В., Шилов Е.М. и др. Нефрология. 2012; 16 (1): 89–115. / Natsional'nye rekomendatsii «Khronicheskaia bolezn' pochek: osnovnye printsipy skrininga, diagnostiki, profilaktiki i podkhody k lecheniiu». Rabochaia gruppa po podgotovke teksta: Smirnov A.V., Shilov E.M. i dr. Nefrologiia. 2012; 16 (1): 89–115. [in Russian]
18. Федеральная служба государственной статистики. http://www.gks.ru/ / Federal'naia sluzhba gosudarstvennoi statistiki. http://www.gks.ru/ [in Russian]
19. US Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010.
20. Brotons C, Bulc M, Sammut MR et al. Attitudes toward preventive services and lifestyle: the views of primary care patients in Europe. The EUROPREVIEW patient study. Fam Pract 2012; 29 (Suppl. 1): i168–76.
21. Gual A, Zarco J et al. Early screening and brief intervention in alcohol misuse to improve the treatment of hypertension in primary care. Med Clin (Barc) 2016; 146 (2): 81–5.
22. Cláudia Rayanna Silva Mendes et al. Self-care comparison of hypertensive patients in primary and secondary health care services. Acta Paul Enferm 2015; 28 (6): 580–6.
23. Lein S, Burke LE, Bray GA et al. On behalf of the American Heart Association Council on Nutrition, Physical Activity, and Metabolism. Clinical implications of obesity with specific focus on cardiovascular disease: a statement for professionals from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism. Circulation 2004; 110: 2952–67.
24. Poirier P, Giles TD, Bray GA et al. On behalf of the American Heart Association; Obesity Commit- tee of the Council on Nutrition, Physical Activity, and Metabolism. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 2006; 113: 898–918.
25. Tedrow UB, Conen D, Ridker PM et al. The long- and short-term impact of elevated body mass index on the risk of new atrial fibrillation the WHS (women’s health study). J Am Coll Cardiol 2010; 55: 2319–27.
26. Reiner Z, Catapano AL, de Backer G et al. ESC/EAS. Guidelines for the management of dyslipidaemias: The Task Force for the management of dyslipidaemias of the European Society of Cardiology ESC) and the European Atherosclerosis Society (EAS). Eur Heart J 2011; 32: 1769–818.
27. Henry RM, Kostense PJ, Bos G et al. Mild renal insufficiency is associated with increased cardiovascular mortality: the Hoorn Study. Kidney Int 2002; 62: 1402–7.
28. Ощепкова Е.В., Долгушева Ю.А., Жернакова Ю.В. и др. Распространенность нарушения функции почек при артериальной гипертонии (по данным эпидемиологического исследования ЭССЕ-РФ). Системные гипертензии. 2015; 12 (3): 19–24. / Oshchepkova E.V., Dolgusheva Iu.A., Zhernakova Iu.V. i dr. Rasprostranennost' narusheniia funktsii pochek pri arterial'noi gipertonii (po dannym epidemiologicheskogo issledovaniia ESSE-RF). Systemic Hypertension. 2015; 12 (3): 19–24. [in Russian]
29. Da Silva LS, Cotta RMM, Moreira TR et al. Hidden prevalence of chronic kidney disease in hypertensive patients: the strategic role ofprimaryhealthcare. J Publichealth 2016; 140: 250–7.
30. Coresh J, Selvin E, Stevens LA et al. Prevalence of chronic kidney disease in the United States. JAMA 2007; 298: 2038–47.
31. Asia pacific Cohort Studies Collaboration. The effects of diabetes on the risk of major cardiovascular diseases and death in the Asia-Pacific region. Diabetes Care 2003; 26: 360–6.
32. Kim M-J, Lim N-K, Park H-Y. Relationship between prehypertension and chronic kidney disease in middle-aged people in Korea: the Korean genome and epidemiology study. BMC Public Health 2012; 12: 960.
33. Klag MJ, Whelton PK, Randall BL et al. End-stage renal disease in African-American and white men.16-year MRFIT findings. JAMA 1997; 277 (16): 1293–8.
34. Martinez MA, Sancho T. Prevalence of left ventricular hypertrophy in patients with mild hypertension in primary care: impact of echocardiography on cardiovascular risk stratification. Am J Hypertens 2003; 6 (Issue 7): 556–63.
35. Saltykova MM, Oshchepkova EV, Ataullakhanova DM et al. Electro cardiographs diagnosis of hypertrophyof left ventricular myocardium in patients with hypertension. Therapeutic Archive. 2006; 78 (12): 40–5.
36. Бойцов С.А., Калинина А.М. Диспансеризация взрослого населения как механизм выявления сердечно-сосудистых заболеваний и формирования диспансерного наблюдения. Вестн. Росздравнадзора. 2015; 5: 11–9. / Boitsov S.A., Kalinina A.M. Dispanserizatsiia vzroslogo naseleniia kak mekhanizm vyiavleniia serdechno-sosudistykh zabolevanii i formirovaniia dispansernogo nabliudeniia. Vestn. Roszdravnadzora. 2015; 5: 11–9. [in Russian]
37. Ощепкова Е.В., Лазарева Н.В., Салтыкова Д.Ф., Терещенко С.Н. Первые результаты Российского Регистра ХСН. Кардиология. 2015; 55: 22–8. / Oshchepkova E.V., Lazareva N.V., Saltykova D.F., Tereshchenko S.N. Pervye rezul'taty Rossiiskogo Registra KhSN. Kardiologiia. 2015; 55: 22–8. [in Russian]
________________________________________________
2. Bor’ba s arterial’noi gipertoniei. Prevention of hypertension. Doklad Komiteta ekspertov VOZ. Vsemirnaya organizatsiya zdravookhraneniya. Report of WHO Expert Committee. World Health Organization Geneve, 1996.
3. Chazov E.I. Rukovodstvo po arterial’noi gipertonii. Guidelines for hypertension. Moscow; Media-Medika, 2005.
4. Chazova I.E. Oshchepkova E.V. Chikhladze N.M. Arterial’naya gipertoniya (printsipy diagnostiki i lecheniya). Arterial hypertension (principles of diagnosis and treatment). Moscow, 2005.
5. Britov A.N., Oganov RG. The national program to combat arterial hypertension in the USSR. Therapeutic archive. 1985; 11: 67.
6. Oganov R.G., Chazova L.V., Britov A.N. Kardiologich. vestn. 1986; 9 (1): 11. [in Russian]
7. Heart disease and Strokestatistics – 2012 update: a report from the American Heart Association. Circulation 2012; 125: 2–220.
8. Chazova I.E., Zhernakova Iu.V., Oshchepkova E.V. i dr. Rasprostranennost' FR serdechno-sosudistykhzabolevanii v rossiiskoi populiatsii bol'nykh arterial'noi gipertoniei. Kardiologiia. 2014; 10: 4–12. [in Russian]
9. Chazova I.E., Oshchepkova E.V. Itogi realizatsii Federal'noi tselevoi programmy po profilaktike i lecheniiu arterial'noi gipertenzii v Rossiiv 2002–2012 gg. Vestn. Rossiiskoi Akademii meditsinskikh nauk. 2013; 2: 4–11. [in Russian]
10. Shal'nova S.A., Deev A.D., Vikhireva O.V. i dr. Rasprostranennost' arterial'noi gipertonii v Rossii: informirovannost', lechenie, kontrol'. Profilaktika zabolevanii i ukreplenie zdorov'ia. 2001; 2: 3–7. [in Russian]
11. Heart disease and Stroke statistics – 2016 update: a report from the American Heart Association. Circulation 2016; 133.
12. Wolf-Maier K, Cooper RS, Banegas JR et al. Hypertension prevalence and blood pressure levels in 6 European countries, Canada and the United States. JAMA 2003; 289: 2363–9.
13. Pereira M, Lunet N, Azevedo A, Barros H. Differences in prevalence, awareness, treatment and control of hypertension between developing and developed countries. J Hypertens 2009; 27: 963–75.
14. Klinicheskie rekomendatsii «Diagnostika i lechenie arterial'noi gipertonii». Rabochaia gruppa po podgotovke teksta: Chazova I.E., Oshchepkova E.V., ZhernakovaIu.V. Kardiologicheskii vestn. 2015; 1: 5–30. [in Russian]
15. 2013 ESH/ESC Guidelines for the management of arterial hypertension. J Hypertens 2013; 31 (7): 1281–357.
16. Dovgalevskii P.Ya., Oshchepkova E.V., Gridnev V.I. Register arterial hypertension. Ther Arch 2007; 1: 46–8.
17. Natsional'nye rekomendatsii «Khronicheskaia bolezn' pochek: osnovnye printsipy skrininga, diagnostiki, profilaktiki i podkhody k lecheniiu». Rabochaia gruppa po podgotovke teksta: Smirnov A.V., Shilov E.M. i dr. Nefrologiia. 2012; 16 (1): 89–115. [in Russian]
18. Federal'naia sluzhba gosudarstvennoi statistiki. http://www.gks.ru/ [in Russian]
19. US Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010.
20. Brotons C, Bulc M, Sammut MR et al. Attitudes toward preventive services and lifestyle: the views of primary care patients in Europe. The EUROPREVIEW patient study. Fam Pract 2012; 29 (Suppl. 1): i168–76.
21. Gual A, Zarco J et al. Early screening and brief intervention in alcohol misuse to improve the treatment of hypertension in primary care. Med Clin (Barc) 2016; 146 (2): 81–5.
22. Cláudia Rayanna Silva Mendes et al. Self-care comparison of hypertensive patients in primary and secondary health care services. Acta Paul Enferm 2015; 28 (6): 580–6.
23. Lein S, Burke LE, Bray GA et al. On behalf of the American Heart Association Council on Nutrition, Physical Activity, and Metabolism. Clinical implications of obesity with specific focus on cardiovascular disease: a statement for professionals from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism. Circulation 2004; 110: 2952–67.
24. Poirier P, Giles TD, Bray GA et al. On behalf of the American Heart Association; Obesity Commit- tee of the Council on Nutrition, Physical Activity, and Metabolism. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 2006; 113: 898–918.
25. Tedrow UB, Conen D, Ridker PM et al. The long- and short-term impact of elevated body mass index on the risk of new atrial fibrillation the WHS (women’s health study). J Am Coll Cardiol 2010; 55: 2319–27.
26. Reiner Z, Catapano AL, de Backer G et al. ESC/EAS. Guidelines for the management of dyslipidaemias: The Task Force for the management of dyslipidaemias of the European Society of Cardiology ESC) and the European Atherosclerosis Society (EAS). Eur Heart J 2011; 32: 1769–818.
27. Henry RM, Kostense PJ, Bos G et al. Mild renal insufficiency is associated with increased cardiovascular mortality: the Hoorn Study. Kidney Int 2002; 62: 1402–7.
28. Oshchepkova E.V., Dolgusheva Iu.A., Zhernakova Iu.V. i dr. Rasprostranennost' narusheniia funktsii pochek pri arterial'noi gipertonii (po dannym epidemiologicheskogo issledovaniia ESSE-RF). Systemic Hypertension. 2015; 12 (3): 19–24. [in Russian]
29. Da Silva LS, Cotta RMM, Moreira TR et al. Hidden prevalence of chronic kidney disease in hypertensive patients: the strategic role ofprimaryhealthcare. J Publichealth 2016; 140: 250–7.
30. Coresh J, Selvin E, Stevens LA et al. Prevalence of chronic kidney disease in the United States. JAMA 2007; 298: 2038–47.
31. Asia pacific Cohort Studies Collaboration. The effects of diabetes on the risk of major cardiovascular diseases and death in the Asia-Pacific region. Diabetes Care 2003; 26: 360–6.
32. Kim M-J, Lim N-K, Park H-Y. Relationship between prehypertension and chronic kidney disease in middle-aged people in Korea: the Korean genome and epidemiology study. BMC Public Health 2012; 12: 960.
33. Klag MJ, Whelton PK, Randall BL et al. End-stage renal disease in African-American and white men.16-year MRFIT findings. JAMA 1997; 277 (16): 1293–8.
34. Martinez MA, Sancho T. Prevalence of left ventricular hypertrophy in patients with mild hypertension in primary care: impact of echocardiography on cardiovascular risk stratification. Am J Hypertens 2003; 6 (Issue 7): 556–63.
35. Saltykova MM, Oshchepkova EV, Ataullakhanova DM et al. Electro cardiographs diagnosis of hypertrophyof left ventricular myocardium in patients with hypertension. Therapeutic Archive. 2006; 78 (12): 40–5.
36. Boitsov S.A., Kalinina A.M. Dispanserizatsiia vzroslogo naseleniia kak mekhanizm vyiavleniia serdechno-sosudistykh zabolevanii i formirovaniia dispansernogo nabliudeniia. Vestn. Roszdravnadzora. 2015; 5: 11–9. [in Russian]
37. Oshchepkova E.V., Lazareva N.V., Saltykova D.F., Tereshchenko S.N. Pervye rezul'taty Rossiiskogo Registra KhSN. Kardiologiia. 2015; 55: 22–8. [in Russian]
Авторы
Е.В.Ощепкова, Н.В.Лазарева*, И.Е.Чазова
Институт клинической кардиологии им. А.Л.Мясникова ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15а
*n.lazareva@list.ru
National Medical Research Center for Cardiology of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
*n.lazareva@list.ru
Институт клинической кардиологии им. А.Л.Мясникова ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15а
*n.lazareva@list.ru
________________________________________________
National Medical Research Center for Cardiology of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
*n.lazareva@list.ru
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