What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension and hyperlipidemia (n=1068). Intervention: Pharmacological treatment. Primary outcome: Prevalence of hypertension.

What question did this study set out to answer?

To determine the prevalence, awareness, treatment, and control rates of hypertension and hyperlipidemia in adult men and evaluate pharmacological regimens against international guidelines.

June 2, 2016BMC Cardiovascular Disorders21 citationsOpen Access

Pharmacological treatment of hypertension and hyperlipidemia in Izhevsk, Russia

MCMarta CybulskyMcGill University SCSarah CookLondon School of Hygiene & Tropical Medicine АKА. V. KontsevayaNational Research Center for Preventive Medicine

Key Result

Hypertension and hyperlipidemia were highly prevalent (61% and 45%, respectively) among working-age men in Izhevsk, Russia, with very low rates of pharmacological treatment and control.

Key Points

To determine the prevalence, awareness, treatment, and control rates of hypertension and hyperlipidemia in adult men and evaluate pharmacological regimens against international guidelines.
Conducted a cross-sectional survey of 1,068 men aged 25–60 years in Izhevsk, Russia (2008–2009) as part of the Izhevsk Family Study II.
Measured blood pressure, total cholesterol, and clinician-recorded medication use, comparing drug regimens against Russian and Canadian clinical practice guidelines.
Hypertension prevalence was 61% (age-standardised 51%); among aware individuals (66%), 50% received treatment, but only 17% achieved target control, with 59% reporting irregular medication use.
Hyperlipidemia prevalence was 45% (age-standardised 40%), yet less than 2% of affected individuals received lipid-lowering therapy, despite prescribed drug classes matching standard clinical guidelines.

Study Design

Type

Cross-Sectional (n=1,068)

Multicenter

Structured PICO

Population

1,068 working-age men (25-60 years) from Izhevsk, Russia.

Intervention

Pharmacological treatment of hypertension and hyperlipidemia

Outcome

Prevalence, treatment, and control rates of hypertension and hyperlipidemia

In a typical Russian city, the prevalence of hypertension and hyperlipidemia among working-age men is high, but treatment and control rates are extremely low, highlighting a major gap in cardiovascular prevention despite guideline-concordant prescribing.

Limitations

Small sample size for hyperlipidemia treatment analysis
No data on hyperlipidemia awareness
Lack of information on complementary and alternative medicine use
Self-reported medication use
Blood pressure measured on a single occasion
Non-fasting blood samples used for lipid measurements
Limited generalizability (only working-age men in one city)
Data collected in 2008-2009 may not reflect current practices
Small sample size, particularly affecting hyperlipidemia investigations
Less extensive data collection for hyperlipidemia compared to hypertension (e.g., no awareness questions)

Abstract

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death in Russia. Hypertension and hyperlipidemia are important risk factors for CVD that are modifiable by pharmacological treatment and life-style changes. We aimed to characterize the extent of the problem in a typical Russian city by examining the prevalence, treatment and control rates of hypertension and hyperlipidemia and investigating whether the specific pharmacological regimes used were comparable with guidelines from a country with much lower CVD rates. METHODS: The Izhevsk Family Study II included a cross-sectional survey of a population sample of 1068 men, aged 25-60 years conducted in Izhevsk, Russia (2008-2009). Blood pressure and total cholesterol were measured and self-reported medication use was recorded by a clinician. We compared drug treatments with the Russian and Canadian treatment guidelines for hypertension and hyperlipidemia. RESULTS: The prevalence of hypertension was 61 % (age-standardised prevalence 51 %), with 66 % of those with hypertension aware of their diagnosis and 50 % of those aware taking treatment. 17 % of those taking treatment achieved blood pressure control. The majority (59 %) of those taking treatment were not doing so regularly. Prevalence of hyperlipidemia was 45 % (age-standardised prevalence 40 %), however less than 2 % of those with hyperlipidemia were taking any treatment. Types of lipid-lowering and anti-hypertensive medications prescribed were broadly in line with Russian and Canadian guidelines. CONCLUSION: The prevalence of hypertension and hyperlipidemia is high in Izhevsk while the proportion of those treated and attaining treatment targets is very low. Prescribed medications were concurrent with those in Canada, but adherence is a major issue.

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