An international multicenter observational non-interventional prospective study of the efficacy of azilsartan medoxomil in overweight or obese patients with arterial hypertension (CONSTANT).

BACKGROUND: Control of arterial hypertension in obese or overweight patients is complicated since obesity directly contributes to increased blood pressure, requiring new, highly effective antihypertensive drugs. This study evaluates the efficacy of azilsartan medoxomil in real clinical practice. METHODS: An international multicenter observational non-interventional prospective study of azilsartan medoxomil was conducted in 64 clinical centers in the Russian Federation and 5 centers in the Republic of Kazakhstan. This study included 1945 obese or overweight patients with arterial hypertension. Azilsartan medoxomil was prescribed in accordance with the approved instruction for use. The decision to prescribe the drug, dose adjustment and monitoring target BP achievement belonged to the attending physicians according to their routine clinical practice. The observation period took about 6 months. RESULTS: The average duration of taking the medicine was 26.1 ± 4 weeks. By the fourth visit, the use of azilsartan medoxomil either in a monotherapy regimen or in free combinations resulted in a pronounced decrease in systolic and diastolic blood pressure by 30.5 ± 13.4 and 14 ± 9.4 mmHg, respectively (p < .001 compared to baseline value). A positive response to therapy was observed in 92.6% of cases (95% CI: 91.3-93.7%). Target blood pressure was achieved by 86.4% of cases (95% CI: 84.8-87.9%). During the study period 43 adverse events were recorded, the most common of which were arterial hypotension and dizziness. CONCLUSIONS: Over the study time of 1945 patients, significant changes in blood pressure levels over time were noted, and a high frequency of response to the azilsartan therapy was observed. Adverse events related to the study drug were of mild or moderate intensity and did not require discontinuation of therapy. Thus, azilsartan medoxomil demonstrated a good safety profile and provided effective blood pressure control for overweight or obese patients with hypertension in real clinical practice.

Overweight and Obesity in the Russian Population: Prevalence in Adults and Association with Socioeconomic Parameters and Cardiovascular Risk Factors.

OBJECTIVE: To evaluate the prevalence and geographic distribution of overweight and obesity in Russian adults aged 25-64 years as well as the association between chronic risk factors and obesity. METHODS: Data were obtained from the survey "Epidemiology of Cardiovascular Diseases and Its Risk Factors in Some Regions of the Russian Federation" (ESSE-RF). This is a large cross-sectional multicenter population-based study that included interviews and medical examination (anthropometry, blood pressure [BP] measurement, and laboratory analysis) applied in 2012-2014. RESULTS: The sample included 20,190 adults (response rate 79.4%) aged 25-64 years. Approximately one third of participants (30.3%) had obesity and another third (34.3%) were classified as overweight. BMI increased with age in both sexes. The prevalence of obesity between regions ranged from 24.4 to 35.5%. Overweight and obesity levels decreased with higher education (men only). Overall obesity rates were higher in rural than urban populations, but rates of overweight were similar in rural and urban populations. Participants with obesity were more likely to have BP > 160/100 mm Hg (odds ratio > 2.0) and also > 140/90 mm Hg, raised blood glucose, and high triglycerides. CONCLUSION: The prevalence of overweight and obesity in Russian adults aged 25-64 years is not evenly distributed geographically, but it is comparable to that of other European countries. Individuals with obesity were also more likely to have indicators of poor cardiovascular and metabolic health.

Metabolically healthy obese and metabolically unhealthy non-obese phenotypes in a Russian population.

INTRODUCTION: The aim of the study was to estimate the prevalence of metabolically healthy obese (MHO) and metabolically unhealthy non-obese (MUNO) phenotypes in Russian population. DESIGN AND METHODS: In cross-sectional epidemiology survey "Epidemiology of cardiovascular diseases and its risk factors in some regions of the Russian Federation" a random sampling of 21,121 subjects (25-65 years), stratified by age and sex was involved. Anthropometry, blood pressure (BP) measurement and fasting blood-tests (glucose, lipids) were performed according to standard protocols. Criteria for MHO-body mass index (BMI) ≥30 kg/m2 and ≤2 of markers: HDL < 1.30 (females)/1.04 (males) mmol/l; triglycerides ≥1.7 mmol/l; glucose ≥5.6 mmol/l or treatment; waist >88 (females)/102 (males) cm and BP ≥ 130/85 mm Hg or therapy. Criteria for MUNO was BMI < 30 kg/m2 and ≥2 markers listed above. Simple tabulations, descriptive statistics, post-stratification weights and logistic regression were used for analyses. RESULTS: MHO phenotype was detected in 2856 (41.5%) obese people; MUNO phenotype-in 4762 (34.4%) non-obese subjects. Aging was negatively associated with MHO and positively with MUNO prevalence. Gender was registered as determinant only of MUNO probability. No dramatic differences in lifestyle risk factors between 3 BMI groups (lean, overweight, obese) were found out. CONCLUSION: Half of obese Russian inhabitants are metabolically healthy. At the same time, metabolic abnormalities were detected in one third of non-obese participants with a shift to male gender.