Objectives: In Ukraine cardiovascular mortality is one of the highest in Europe. Arterial hypertension (AH) is one of the most important modifiable risk factors and its active control is a cornerstone of primary and secondary prevention.
Design: Secondary prevention assessment was performed in Ukrainian city Lutsk in representative sample of 235 patients after ischemic stroke (PostIS) (age 62,6 ± 10,3 years, 124 men) and 312 patients after myocardial infarction (PostMI) (age 62,2 ± 9,9 years, 218 men) selected from 2229 patients hospitalized in one city hospital. The home-based blood pressure (BP), anthropometric measurements, questionnaire, and laboratory tests were performed.
Results: The trend to higher AH prevalence was found in PostIS patients (88,9% vs 83,6%, p=0,09). AH was treated in the same proportion of patients (88,6 PostIS and in 87,7% PostIM), but BP goals of <140/90 mmHg was reached only in 11,9% PostIS and 21,3% PostIM patients (p=0,007). This finding corresponded with higher BP in PostIS patients (systolic 161,8±28,0 vs 156,0±26,8 mmHg in PostIM, p=0,02, diastolic 95,7±13,7 vs 92,7±15,0 mmHg, p=0,02). Worse AH control in PostIS patients was associated with less tight physician control (35,4% vs 64,7% PostMI patients contacted to doctor during last 3 months, p=0,004), taking less antihypertensive drugs (1,7±0,8 vs 2,0±0,9 in PostMI; p=0,001), lower physical activity (46,0% in PostIS vs 62,0% in PostMI had regular activities; p=0,004). Both groups had similar compliance to treatment (73,0% and 71,9%). No difference in BP self-monitoring, prevalence of obesity, smoking, diabetes, lipids, glucose and hs-CRP levels was detected. Thus, the main reason for the difference between PostIS and PostMI patients is the worse physician control in PostIS patients.
Conclusions: Inadequate AH control was found in both PostIS and PostMI patients. The worse situation in PostIS patients first of all is due to the worse physician control. Active efforts in guidelines implementation should be made to improve situation.