ABSTRACT
AIM: To study barriers made by the patients for adequate treatment of arterial hypertension. MATERIAL AND METHODS: The ARGUS-2 trial was made in 15 centers of 13 cities of Russia. Anonymous questionnaire survey covered 1298 patients (796 outpatients and 502 inpatients). The patients answered the following questions: 1) what are basic problems of life with hypertension; 2) compliance with intake of antihypertensive drugs; 3) causes of missed intakes of the drugs; 4) opposition to intake of drugs by the patients. Questioning procedure was preset by the trial protocol. RESULTS: Only 37.4% (38.9% outpatients, 34.6% inpatients) were the treatment adopters. Drug intake was missed most frequently because offorgetting. The problems of life with hypertension were differently interpreted by patients and physicians: for the latter main problems were financial and routine while AH complications were on the 6-7 place. The latter were of primary importance for the patients while financial problems took place 4-6 Barriers to regular intake for the patients were poor self-control and unawareness about side effects of the drugs. CONCLUSION: Complience of the patient can be improved only by complex approach: improvement of education, higher motivation, active involvement of patients into the treatment process, better contacts between the physician and the patient.
Subject(s)
Antihypertensive Agents/therapeutic use , Hypertension/drug therapy , Patient Compliance/statistics & numerical data , Female , Humans , Hypertension/psychology , Male , Middle Aged , Patient Education as Topic , Physician-Patient Relations , Retrospective Studies , Surveys and Questionnaires , Treatment Outcome , Validation Studies as TopicABSTRACT
Open noncomparative multicenter study of tolerability and efficacy of a retard form of indapamide (1.5 mg o.d. for 3 months) in patients older then 55 years was conducted in 14 centers in Russia. Numbers of patients included into was analysis of safety and tolerability were 1277 and 1121, respectively. After 3 months systolic, diastolic and pulse blood pressure (BP) decreased by 20.2, 13.2, 27.5% (supine) and by 19.4, 11.8, 26.9% (standing), respectively. There were no significant changes of heart rate. Effect of treatment was considered positive in 92.4% of patients. Normalization of blood pressure occurred in 51.8% of patients (in 46.2% and 53.4% among men and women, respectively, p=0.0252; in 55.7% and 48% among patients aged <65 and >65 years, respectively). In patients with type II diabetes rates of positive effect and achievement of target BP <130/85 mm Hg were 60.8% and 31.4%, respectively. Hypokaliemia (3.0-3.5 mmol/l) was registered in 43 patients (3.4%), age of 27 of these patients was 65 years. There were no pronounced changes of blood serum levels of creatinine, glucose and uric acid. Significant lowering of atherogeneity cholesterol index occurred in the whole group while both this index and total cholesterol significantly decreased in patients with baseline hypercholesterolemia. Thus in patients older that 55 years monotherapy with retard form of indapamide was demonstrated to be safe and effective antihypertensive intervention.