Key result
Ukrainian primary care data shows ~37% of established hypertension patients remain untreated during military conflict.
Why the study?
To determine clinical features and prescribing patterns in patients with high blood pressure in primary care in Ukraine during a full-scale military conflict.
Observational (n=1,183)
During the military conflict in Ukraine, a significant proportion of primary care hypertension patients remain untreated, and prescribing patterns often deviate from European guidelines by favoring monotherapy and older generics.
Highlights potential gaps in hypertension care amid conflict; leaves open whether targeted interventions can improve access and guideline adherence.
Objective: To determine the features of clinical manifestations of AH in patients with high blood pressure (BP) at the stage of primary care in Ukraine in conditions of a full-scale military conflict and the fprescribing therapy Design and method: The study included 1200 adults (18 to 80 years old) with established hypertension of the 1st–2nd stage (BP < 160/110 mm Hg). At the inclusion visit, doctors, at their discretion, prescribed patients with mild uncomplicated hypertension a free combination Ramipril, amlodipine or hydrochlorothiazide. Results: 1183 participants (men/women (%) - 49.3/50.7) aged 57.4±0.4 years, BMI - 28.9±0.2 kg/m2, cholesterol - 5.9±0.04 mmol/l, eGFR - 83.5±0.3 ml/min/1.73 m2 were available for analysis. Diabetes - 18.9%, 2.7% had a positive orthostatic test, office SBP/DBP - 158.0±0.4/92.8±0.3 mm Hg. The frequency of detection of untreated patients with hypertension in the primary care setting was 37%. Among the treated patients, 41% received monotherapy, 59% — combination therapy (39% — free combinations, 61% — fixed combinations in one tablet — often captopril with hydrochlorothiazide). Before inclusion in the study at the family doctor stage, the vast majority of patients who were treated were prescribed drugs that block RAS: ACE inhibitors and ARBs (96/17%) - more than 100%, 36% - thiazides, calcium channel blockers was low (26%) and 30% - BB. decrease in office SBP to 129 and diastolic blood pressure - to 79 mm Hg. Conclusions: In Ukraine, initial therapy more often begins with monotherapy, rather than with combination therapy, as in Europe. Due to interruptions in the supply of original drugs in the context of military conflict, doctors switch to more affordable generics and simplify treatment regimens. Rapid- and short-acting drugs, as well as combination agents based on them, are often used. The frequency of prescribing calcium channel blockers was low (26%), and angiotensin II receptor blockers was only 17%. A significant proportion of patients (more than 30%) in the primary care setting were not covered by antihypertensive therapy, despite the already established diagnosis of hypertension.
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Rekovets et al. (2026) conducted an observational in Arterial hypertension (n=1,183). Antihypertensive therapy prescribing patterns was evaluated on Frequency of untreated hypertension and prescribing patterns. In primary care in Ukraine during military conflict, 37% of patients with established hypertension were untreated, and among treated patients, 41% received monotherapy and 59% combination therapy.
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