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Rational Pharmacotherapy in Cardiology

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PATIENTS WITH COMBINATION OF CHRONIC HEART FAILURE, HYPERTENSION AND HISTORY OF MYOCARDIAL INFARCTION: CLINICAL AND ANAMNESTIC CHARACTERISTICS, ADMINISTRATION OF ACE INHIBITORS, ANGIOTENSIN RECEPTOR BLOCKERS, -BLOCKERS AND ADHERENCE TO THE DRUG THERAPY (DATA OF OUTPATIENT REGISTRY RECVASA)

https://doi.org/10.20996/1819-6446-2017-13-2-207-212

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Abstract

Aim. To assess the clinical and anamnestic characteristics, the prescription rate of angiotensin converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) and β-blockers in the outpatient practice, adherence to drug therapy in patients with a combination of chronic heart failure (CHF), hypertension (HT) and history of myocardial infarction (MI) in the frame of Cardiovascular Disease Registry (RECVASA). Material and methods. Data analysis in groups of patients with a combination of CHF, HT and the history of MI (n=406) and patients with a combination of CHF, HT and ischemic heart disease (IHD) without history of MI (n=1897) was performed in the frame of RECVASA registry. The structure of the associated cardiovascular and concomitant non-cardiac diseases, the severity of the clinical manifestations of CHF, IHD and HT, the prescription rate of the ACEI/ARB and β-blockers, the adherence to drug therapy (according to the Morisky-Green test) were studied in groups. Results. Patients with a combination of CHF, HT and IHD with or without MI history significantly differed in the proportion of men (47.8% vs 24.9%, respectively), prevalence of atrial fibrillation (25.9% vs 20.5%, respectively), diabetes mellitus (27.3% vs 15.7%, respectively) and the stroke history (17.2% vs 10.7%, respectively). The mean age (69.9±11.0 vs 70.3±11.0 years, respectively), as well as the prevalence of the history of respiratory diseases, chronic kidney disease, digestive diseases, obesity and anemia, did not differ significantly. Patients with a combination of CHF, HT and post-infarction cardiosclerosis (PICS) compared with patients without PICS significantly more often had CHF class 3-4 NYHA (62% vs 47.9%, respectively), HT of degree 3 (92.5% vs 84.2%, respectively), stable angina class 3-4 (84.4% vs 66.4%, respectively). Patients with PICS significantly (p<0.05) more often received β-blockers (56.7% vs 42.2%, respectively), a combination of ACEI/ARB plus β-blockers (44.6% vs 35.1%, respectively), but less often – monotherapy with ACEI/ARB (73.7% vs 77.6%, respectively). The proportion of patients with adherence to treatment (4 points on the Morisky-Green scale) was greater in patients with PICS (37.2% vs 30.6%, respectively; p<0.05). Conclusion. Patients with CHF in combination with HT and PICS compared with patients without PICS had more prevalence of atrial fibrillation, diabetes mellitus and stroke history, more severe course of CHF, HT and IHD, greater prescription rate of β-blockers, combinations of ACEI/ARB plus β-blockers, but less prescription rate only ACEI/ARB, higher adherence to treatment. The prescription rate of prognostically significant ACEI/ARB and β-blockers in these patients is inadequate, and only one third of patients are adherent to treatment.

About the Authors

M. M. Loukianov
State Research Centre for Preventive Medicine
Russian Federation

Mikhail M. Loukianov – MD, PhD, Leading Researcher, Department of Clinical Cardiology and Molecular Genetics 

Petroverigsky per. 10, Moscow, 101990




A. N. Kozminsky
I.P. Pavlov Ryazan State Medical University
Russian Federation

Alexander N. Kozminsky – Assistant, Simulation Training Center 

Vysokovoltnaya ul. 9, Ryazan, 390026




S. Yu. Martsevich
State Research Centre for Preventive Medicine
Russian Federation

Sergey Yu. Martsevich – MD, PhD, Professor, Head of Department of Preventive Pharmacotherapy 

Petroverigsky per. 10, Moscow, 101990




S. S. Yakushin
I.P. Pavlov Ryazan State Medical University
Russian Federation

Sergey S. Yakushin – MD, PhD, Professor, Head of Chair of Hospital Therapy 

Vysokovoltnaya ul. 9, Ryazan, 390026




A. N. Vorobyev
I.P. Pavlov Ryazan State Medical University
Russian Federation

Alexander N. Vorobyev – MD, PhD, Assistant, Chair of Hospital Therapy 

Vysokovoltnaya ul. 9, Ryazan, 390026




A. V. Zagrebelnyy
State Research Centre for Preventive Medicine
Russian Federation

Alexander V. Zagrebelnyy – MD, PhD, Senior Researcher, Department of Preventive Pharmacotherapy 

Petroverigsky per. 10, Moscow, 101990




R. P. Myasnikov
State Research Centre for Preventive Medicine
Russian Federation

Roman P. Myasnikov – MD, PhD, Researcher, Department of Clinical Cardiology and Molecular Genetics 

Petroverigsky per. 10, Moscow, 101990




K. G. Pereverzeva
I.P. Pavlov Ryazan State Medical University
Russian Federation

Kristina G. Pereverzeva – MD, Assistant, Chair of Hospital Therapy 

Vysokovoltnaya ul. 9, Ryazan, 390026




E. A. Pravkina
I.P. Pavlov Ryazan State Medical University
Russian Federation

Ekaterina A. Pravkina – MD, Assistant, Chair of Hospital Therapy 

Vysokovoltnaya ul. 9, Ryazan, 390026




E. Yu. Andreenko
State Research Centre for Preventive Medicine
Russian Federation

Elena Yu. Andreenko – MD, PhD, Senior Researcher, Department of Clinical Cardiology and Molecular Genetics 

Petroverigsky per. 10, Moscow, 101990




E. N. Belova
State Research Centre for Preventive Medicine
Russian Federation

Ekaterina N. Belova – Programmer, Laboratory of Biostatistics, Department of Epidemiology of Chronic Non-Communicable Diseases 

Petroverigsky per. 10, Moscow, 101990




A. D. Deev
State Research Centre for Preventive Medicine
Russian Federation

Alexander D. Deev – PhD (in Physics and Mathematics), Head of Laboratory of Biostatistics, Department of Epidemiology of Chronic Non-Communicable Diseases 

Petroverigsky per. 10, Moscow, 101990




V. G. Klyashtorny
State Research Centre for Preventive Medicine
Russian Federation

Vladislav G. Klyashtorny – PhD (in Biology), Researcher, Laboratory of Biostatistics, Department of Epidemiology of Chronic Non-Communicable Diseases 

Petroverigsky per. 10, Moscow, 101990 




E. V. Kudryashov
State Research Centre for Preventive Medicine
Russian Federation

Egor V. Kudryashov – Programmer, Laboratory of Biostatistics, Department of Epidemiology of Chronic Non-Communicable Diseases 

Petroverigsky per. 10, Moscow, 101990 




S. A. Boytsov
State Research Centre for Preventive Medicine
Russian Federation

Sergey A. Boytsov – MD, PhD, Professor, Corresponding Member of the Russian Academy of Sciences, Head of Department of Clinical Cardiology and Molecular Genetics 

Petroverigsky per. 10, Moscow, 101990 



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For citation:


Loukianov M.M., Kozminsky A.N., Martsevich S.Y., Yakushin S.S., Vorobyev A.N., Zagrebelnyy A.V., Myasnikov R.P., Pereverzeva K.G., Pravkina E.A., Andreenko E.Y., Belova E.N., Deev A.D., Klyashtorny V.G., Kudryashov E.V., Boytsov S.A. PATIENTS WITH COMBINATION OF CHRONIC HEART FAILURE, HYPERTENSION AND HISTORY OF MYOCARDIAL INFARCTION: CLINICAL AND ANAMNESTIC CHARACTERISTICS, ADMINISTRATION OF ACE INHIBITORS, ANGIOTENSIN RECEPTOR BLOCKERS, -BLOCKERS AND ADHERENCE TO THE DRUG THERAPY (DATA OF OUTPATIENT REGISTRY RECVASA). Rational Pharmacotherapy in Cardiology. 2017;13(2):207-212. (In Russ.) https://doi.org/10.20996/1819-6446-2017-13-2-207-212

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ISSN 1819-6446 (Print)
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