urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.24.1.7BOTFNTurmj-1721Research ArticleОригинальные статьи | Original articlesOriginal articlesАнализ фармакотерапии артериальной гипертензии у мультиморбидных пациентовAnalysis of Pharmacotherapy of Arterial Hypertension in Multimorbid Patientshttps://orcid.org/0000-0001-7826-9657ИзможероваН. В.IzmozherovaN. V.

Надежда Владимировна Изможерова — доктор медицинских наук, доцент, заведующий кафедрой фармакологии и клинической фармакологии, директор института клинической фармакологии и фармации

Екатеринбург

Nadezhda V. Izmozherova — Doctor of Sciences (Medicine), Associate Professor, Head of the Department of Pharmacology and Clinical Pharmacology, Director of the Institute of Clinical Pharmacology and Pharmacy

Ekaterinburg

nadezhda_izm@mail.ruhttps://orcid.org/0000-0001-6216-2468ПоповА. А.PopovA. A.

Артём Анатольевич Попов — доктор медицинских наук, доцент, заведующий кафедрой госпитальной терапии, институт клинической медицины

Екатеринбург

Artem A. Popov — Doctor of Sciences (Medicine), Associate Professor, Head of the Department of Hospital Therapy, Institute of Clinical Medicine

Ekaterinburg

art_popov@mail.ruhttps://orcid.org/0000-0003-2847-6863КурындинаА. А.KuryndinaA. A.

Анна Андреевна Курындина — кандидат медицинских наук, доцент кафедры фармакологии и клинической фармакологии, институт клинической фармакологии и фармации

Екатеринбург

Anna A. Kuryndina — Candidate of Sciences (Medicine), Associate Professor of the Department of Pharmacology and Clinical Pharmacology, Institute of Clinical Pharmacology and Pharmacy

Ekaterinburg

kurri-anna@yandex.ruhttps://orcid.org/0000-0003-4680-9254ГавриловаЕ. И.GavrilovaE. I.

Елена Игоревна Гаврилова — кандидат медицинских наук, доцент кафедры фармакологии и клинической фармакологии, институт клинической фармакологии и фармации

Екатеринбург

Elena I. Gavrilova — Candidate of Sciences (Medicine), Associate Professor of the Department of Pharmacology and Clinical Pharmacology, Institute of Clinical Pharmacology and Pharmacy

Ekaterinburg

egavrilova7@gmail.comhttps://orcid.org/0000-0001-7312-415XШамбатовМ. А.ShambatovM. A.

Мураз Акбар оглы Шамбатов — кандидат медицинских наук, доцент кафедры фармакологии и клинической фармакологии, институт клинической фармакологии и фармации

Екатеринбург

Muraz A. Shambatov — Candidate of Sciences (Medicine), Associate Professor of the Department of Pharmacology and Clinical Pharmacology, Institute of Clinical Pharmacology and Pharmacy

Ekaterinburg

Muraz.shambatov@rambler.ruhttps://orcid.org/0000-0001-7907-2629БахтинВ. М.BakhtinV. M.

Виктор Михайлович Бахтин — кандидат медицинских наук, ассистент кафедры фармакологии и клинической фармакологии, институт клинической фармакологии и фармации

Екатеринбург

Viktor M. Bakhtin — Candidate of Sciences (Medicine), Assistant of the Department of Pharmacology and Clinical Pharmacology, Institute of Clinical Pharmacology and Pharmacy

Ekaterinburg

bakhtin.v95@mail.ruУральский государственный медицинский университетРоссияUral State Medical UniversityRussian Federation2025020320252417–25Copyright © Изможерова Н.В., Попов А.А., Курындина А.А., Гаврилова Е.И., Шамбатов М.А., Бахтин В.М., 20252025Изможерова Н.В., Попов А.А., Курындина А.А., Гаврилова Е.И., Шамбатов М.А., Бахтин В.М.Izmozherova N.V., Popov A.A., Kuryndina A.A., Gavrilova E.I., Shambatov M.A., Bakhtin V.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1721

Введение. Артериальная гипертензия (АГ) — самое частое хроническое неинфекционное заболевание. Выявление АГ увеличивается с возрастом — более 60 % и 75 % у людей старше 60 и 75 лет соответственно. Цель исследования — оценить адекватность ведения амбулаторных мультиморбидных пациентов с АГ разных возрастных групп.Материалы и методы. Проведено одномоментное исследование 323 амбулаторных пациентов (92 (28,5 %) мужчин и 231 (71,5 %) женщины) с верифицированным диагнозом АГ. Выборка разделена на 3 возрастные группы: 1 — средний возраст; 2 — пожилой возраст; 3 — старческий возраст. Оценены частота достижения целевых значений артериального давления (АД), структура антигипертензивной терапии и частота назначения гиполипидемической терапии, антиагрегантов.Результаты. Тяжесть АГ не различалась в зависимости от возраста. В группах 2 и 3 у пациентов преобладал очень высокий уровень кардиоваскулярного риска. В структуре антигипертензивной терапии во всех группах преобладали блокаторы ренин-ангиотензин-альдостероновой системы (94,1 %). Частота назначения антагонистов кальция возрастала в старших возрастных группах. Большинство пациентов получало антигипертензивную терапию ежедневно. При этом целевые уровни АД достигнуты преимущественно по уровням систолического АД (60 %), только в 22 % случаев по уровням диастолического АД. Липид-снижающую терапию и антиагреганты преимущественно получали пациенты старших возрастных групп.Обсуждение. Полученные результаты согласуются с данными предшествующих исследований и могут быть экстраполированы на общую популяцию.Заключение. АГ у лиц пожилого и старческого возраста ассоциируется с высоким уровнем коморбидности и большей долей лиц с очень высоким уровнем кардиоваскулярного риска. Достижение целевых уровней АД в старших возрастных группах возможно в случае назначения комбинированной терапии. Сочетание АГ с клиническими проявлениями атеросклероза или гиперхолестеринемией требует своевременного назначения комбинированной антигипертензивной, липид-снижающей и антитромбоцитарной терапии.

Introduction. Arterial hypertension (AH) is the most common chronic non-communicable disease, especially among individuals over 60 years old, where its prevalence exceeds 60%. The relationship between blood pressure (BP) levels and the risk of cardiovascular events is observed across all age groups. The aim of the study was to assess the adequacy of antihypertensive therapy in outpatient multimorbid patients of different age groups.Materials and methods. The study included 323 outpatient patients with verified AH (92 men and 231 women). Patients were divided into three age groups: middle-aged, elderly, and old age. The frequency of achieving target BP levels, the structure of antihypertensive therapy, and the prescription of lipid-lowering and antiplatelet agents were evaluated.Results. The severity of AH did not differ between the groups. In the elderly groups, patients with high cardiovascular risk and comorbidities such as type 2 diabetes and osteoarthritis predominated. The most frequently prescribed medications were inhibitors of the renin-angiotensin-aldosterone system (94.1%). Target BP levels were mainly achieved due to systolic pressure (60%), while diastolic pressure was only controlled in 22% of cases.Discussion. The results are consistent with previous studies.Conclusion. AH in elderly patients is associated with high comorbidity and cardiovascular risk. Achieving target BP levels is possible with combination therapy, including renin-angiotensin-aldosterone system blockers and calcium antagonists. Additional treatment strategies are needed to reduce the residual risk of cardiovascular diseases.

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The authors declare that there are no conflicts of interest present.