CARDIOVASCULAR RISK FACTORS PROFILE IN HYPERTENSIVE PATIENTS TREATING WITH DUAL COMBINATIONS

Objective: to evaluate the characteristics of cardiovascular risk factors (CV RF), the structure and efficacy of dual antihypertensive therapy (AHT), and adherence to treatment in civilian hypertensive patients (pts) in the context of armed conflict in Ukraine. Design and method: The study was conducted in seven regions in central, eastern, and western Ukraine and included 1,616 pts treated with dual combinations of antihypertensive medicines. CV RF (smoking status, alcohol consumption, physical activity), concomitant cardiovascular diseases (CVD), diabetes mellitus (DM), and obesity were estimated. Blood pressure (BP) was evaluated by office measurements. The 8-item Morisky Medication Adherence Scale (MMAS-8) assessed adherence adherence. Results: The average age of the pts was 63.8 ± 0.3 years; 41.9% were males. The prevalence of smoking was 27.9%, obesity - 38.6%, and DM - 24.5%. A low level of physical activity (< 2000 steps/day) was reported by 31.2% of participants, while daily alcohol consumption was reported only by 1% of respondents. A significantly higher percentage of smoking and alcohol consumption was observed among men, while women had a lower level of physical activity. 16.2% of pts had CVD, 8.7% - stroke/TIA, and 8.3% - myocardial infarction or revascularization. An average BP was 158/91 mm Hg, and target office BP (< 140/80 mmHg) was registered only in 25.9% pts. Combinations of ACE inhibitors or ARBs with a diuretic were taken in 42.7% and 31.4% pts, respectively. Only 6.4% and 9.4% of pts took combinations of ACE inhibitors or ARBs with calcium channel blockers, respectively. Combinations of ACE inhibitors with beta-blockers were used in 9% of pts. Fixed dose combinations were taken by 84.5% of pts, although 72.0% were non-adherent to treatment, 26.9% had a moderate level adherence, and only 1% were truly adherent to AHT. Conclusions: civilian hypertensive pts living in Ukraine under conditions of armed conflict are characterized by a significant prevalence of CV RF, a high prevalence of uncontrolled hypertension with low adherence to dual antihypertensive therapy, and a high-frequency concomitant CVD, DM, and obesity.