O. M. Bilovol, I. I. Kniazkova, V. O. Golovachova, N. V. Kuzminova, D. О. Kіrienko, O. M. Kіrienko, L. P. Abramova

ANTIHYPERTENSIVE THERAPY EFFECTIVENESS DEPENDING ON ADHERENCE TO TREATMENT IN OUTPATIENT PRACTICE IN PATIENTS WITH STAGE 1-2 ARTERIAL HYPERTENSION

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About the author:	O. M. Bilovol, I. I. Kniazkova, V. O. Golovachova, N. V. Kuzminova, D. О. Kіrienko, O. M. Kіrienko, L. P. Abramova
Heading	CLINICAL MEDICINE
Type of article	Scentific article
Annotation	The purpose of the study was to assess the influence of antihypertensive therapy used in outpatient practice in patients with grade 1–2 arterial hypertension on parameters of central hemodynamics and organ protection in conditions of low adherence to treatment. The prospective study included 93 outpatients with newly diagnosed hypertension of grades 1–2 without a history of cardiovascular complications, including 49 men and 44 women (mean age 52.3±3.8 years). Depending on the prescribed antihypertensive therapy, the patients were divided into 3 groups: 1st – 15 patients who were prescribed monotherapy, 2nd – 40 – free combination and 3rd – 38 – fixed combination of two antihypertensive drugs. It was established that the appointment of patients with stage 1–2 hypertension in outpatient practice with antihypertensive therapy (monotherapy, various two-component combinations of antihypertensive drugs) for 6 months allowed achieving target blood pressure levels, which contributed to the improvement of left ventricular systolic function, a decrease in the degree of left ventricular hypertrophy and a nephroprotective effect. With low adherence of patients with stage 1–2 hypertension to treatment, the effectiveness of antihypertensive therapy and its cardioprotective and nephroprotective properties were significantly reduced. This indicates the significant relevance of determining adherence to treatment in real clinical practice, which will allow taking these provisions into account when drawing up programs of preventive measures to prevent cardiovascular complications in this cohort of patients.
Tags	arterial hypertension,antihypertensive therapy,adherence to treatment,organ protection
Bibliography	Aggarwal R, Chiu N, Wadhera RK, Moran AE, Raber I, Shen C, et al. Racial/Ethnic Disparities in Hypertension Prevalence, Awareness, Treatment, and Control in the United States, 2013 to 2018. Hypertension. 2021;78(6):1719-1726. doi:  10.1161/HYPERTENSIONAHA.121.17570. Aune A, Ohldieck A, Halvorsen LV, Brobak KM, Olsen E, Rognstad S, et al. Gender Differences in Cardiac Organ Damage in Arterial Hypertension: Assessing the Role of Drug Nonadherence. High Blood Press Cardiovasc Prev. 2024;31(2):157-166. doi:  10.1007/s40292-024-00632-6. Burnier M, Azizi M, Magne J, Prejbisz A, Cunha V, Gupta, P. et al. Patient perceptions, motivations and barriers to treatment adherence in hypertension: results of a questionnaire-based survey in five European countries. Blood Press. 2025;34(1):2513434. doi: 10.1080/08037051.2025.2513434. Carrillo-Larco RM, Guzman-Vilca WC, Bernabe-Ortiz A. Mean blood pressure according to the hypertension care cascade: Analysis of six national health surveys in Peru. Lancet Reg Health Am. 2021 Sep;1:None. doi: 10.1016/j.lana.2021.100016.  Cherkun MP, Katerenchuk IP. Comparative assessment of quality of life parameters in rural and urban residents with comorbid hypertension. World of Medicine and Biology. 2023; №2(84): 167-171. DOI 10.26724/2079-8334-2023-2-84-167-171. Gardezi SKM, Aitken WW, Jilani MH. The Impact of Non-Adherence to Antihypertensive Drug Therapy. Healthcare (Basel). 2023;11(22):2979. doi: 10.3390/healthcare11222979. Lee EKP, Poon P, Yip BHK, Bo Y, Zhu MT, Yu CP, et al. Global Burden, Regional Differences, Trends, and Health Consequences of Medication Nonadherence for Hypertension During 2010 to 2020: A Meta-Analysis Involving 27 Million Patients. J Am Heart Assoc. 2022;11(17):e026582. doi: 10.1161/JAHA.122.026582. Mahmood S, Jalal Z, Hadi MA, Khan TM, Haque MS, Shah KU. Prevalence of non-adherence to antihypertensive medication in Asia: a systematic review and meta-analysis. Int J Clin Pharm. 2021;43(3):486-501. doi: 10.1007/s11096-021-01236-z. Mancia G, Kreutz R, Brunström M, Burnier M, Grassi G, Januszewicz A, et al. 2023 ESH guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens. 2023;41(12):1874–2071. doi: 10.1097/HJH.0000000000003480. McEvoy JW, McCarthy CP, Bruno RM, Brouwers S, Canavan MD, Ceconi C, et al. ESC Scientific Document Group. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024;45(38):3912-4018. doi:  10.1093/eurheartj/ehae178. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223-237. doi:  10.1038/s41581-019-0244-2.  Ogungbe O, Byiringiro S, Adedokun-Afolayan A, Seal SM, Dennison Himmelfarb CR, Davidson PM, et al. Medication Adherence Interventions for Cardiovascular Disease in Low- and Middle-Income Countries: A Systematic Review. Patient Prefer Adherence. 2021;15:885-897. doi: 10.2147/PPA.S296280. Ojangba T, Boamah S, Miao Y, Guo X, Fen Y, Agboyibor C, et al. Comprehensive effects of lifestyle reform, adherence, and related factors on hypertension control: A review. J Clin Hypertens (Greenwich). 2023;25(6):509-520. doi: 10.1111/jch.14653.  Ranzani OT, Kalra A, Di Girolamo C, Curto A, Valerio F, Halonen JI, et al. Urban-rural differences in hypertension prevalence in low-income and middle-income countries, 1990-2020: A systematic review and meta-analysis. PLoS Med. 2022;19(8):e1004079. doi: 10.1371/journal.pmed.1004079.  Virani SS, Newby LK, Arnold SV, Bittner V, Brewer LC, Demeter SH, et al. AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2023;148(9):e9-e119. doi:  10.1161/CIR.0000000000001168.
Publication of the article	«World of Medicine and Biology» №2(92), 2025 year, 030-034 pages, index UDK 616.12-008.331.1-085.225.2-035:614.212
DOI	10.26724/2079-8334-2025-2-92-30-34