В обзоре проведен анализ результатов крупных эпидемиологических исследований, направленных на оценку распространенности одного из самых грозных факторов риска сердечно-сосудистых заболеваний – артериальной гипертензии с позиции социально-экономических факторов («Эпидемиология сердечно-сосудистых заболеваний и их факторов риска в Российской Федерации», ЭССЕ, Prospective Urban and Rural Epidemiological Study, PURE). Приводится сравнительная характеристика как показателей распространенности артериальной гипертензии, так и уровня осведомленности населения о ее наличии, приверженности лечению и контролю артериального давления среди жителей стран с различным социально-экономическим уровнем. Сделан вывод о том, что, несмотря на проведение профилактических мер, разрыв между выявлением артериальной гипертензии, последующим контролем артериального давления и приверженностью лечению в большинстве стран мира остается большим, что свидетельствует о необходимости более тщательного анализа возможных причин и разработки новейших профилактических мер.
This review analyzes and summarizes the results of major epidemiological studies aimed at assessing the prevalence of arterial hypertension, one of the most significant cardiovascular risk factors according to the socioeconomic factors (the ESSE study, the PURE study). Comparative characteristics of both the prevalence of arterial hypertension and the level of awareness among the population about the presence of arterial hypertension, adherence to treatment and control of blood pressure among residents of countries with different socio-economic levels are given. We concluded that despite the implementation of preventive measures, the gap between the diagnosis of arterial hypertension, the subsequent control of blood pressure and adherence to treatment in most countries remains rather large. This indicates the need for a more thorough analysis of possible causes and the development of new preventive measures.
1. World Health Organization. Global health risks: Mortality and burden of disease attributable to selected major risks. Geneva: World Health Organization, 2009.
2. Lawes CM, Hoorn SV, Rodgers A. Global burden of blood-pressure-related disease, 2001. Lancet 2008; 371 (9623): 1513–8.
3. Chow CK, Teo KK, Rangarajan S et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA 2013; 310 (9): 959–68.
4. Nieuwlaat R, Schwalm JD, Khatib R et al. Why are we failing to implement effective therapies in cardiovascular disease? Eur Heart J 2013; 34 (17): 1262–9.
5. Baker R, Camosso-Stefinovic J, Gillies C et al. Tailored interventions to overcome identified barriers to change: Effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2010; 3.
6. Бойцов С.А., Баланова Ю.А., Шальнова С.А. и др. Артериальная гипертония среди лиц 25–64 лет: распространенность, осведомленность, лечение и контроль. По материалам исследования ЭССЕ. Кардиоваскулярная терапия и профилактика. 2014; 4 (14): 4–14. / Boitsov S.A., Balanova Yu.A., Shal'nova S.A. i dr. Arterial'naia gipertoniia sredi lits 25–64 let: rasprostranennost', osvedomlennost', lechenie i kontrol'. Po materialam issledovaniia ESSE. Kardiovaskuliarnaia terapiia i profilaktika. 2014; 4 (14): 4–14. [in Russian]
7. Максимов С.А., Табакаев М.В., Артамонова Г.В. Интегральная оценка риска ишемической болезни сердца в эпидемиологических исследованиях (ЭССЕ-РФ в Кемеровской области). Сообщение II: социально-экономические детерминанты. Профилактич. медицина. 2016; 1 (19): 24–9. / Maksimov S.A., Tabakaev M.V., Artamonova G.V. Integral'naia otsenka riska ishemicheskoi bolezni serdtsa v epidemiologicheskikh issledovaniiakh (ESSE-RF v Kemerovskoi oblasti). Soobshchenie II: sotsial'no-ekonomicheskie determinanty. Profilaktich. meditsina. 2016; 1 (19): 24–9. [in Russian]
8. Результаты второго этапа мониторинга эпидемиологической ситуации по артериальной гипертонии в Российской Федерации (2005–2007 гг.), проведенного в рамках федеральной целевой программы «Профилактика и лечение артериальной гипертонии». Информационно-статистич. сб. М., 2008. / Rezul'taty vtorogo etapa monitoringa epidemiologicheskoi situatsii po arterial'noi gipertonii v Rossiiskoi Federatsii (2005–2007 gg.), provedennogo v ramkakh federal'noi tselevoi programmy “Profilaktika i lechenie arterial'noi gipertonii“. Informatsionno-statistich. sb. M., 2008. [in Russian]
9. Mancia G, Fagard R, Narkiewicz K et al. ESH/ESC Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31: 1281–357.
10. Wolf-Maier K, Cooper R, Banegas J. Hypertension prevalence and blood pressure levels in 6 European countries, Canada and the United States. JAMA 2003; 289: 2363–9.
11. Шальнова С.А., Баланова Ю.А., Константинов В.В. и др. Артериальная гипертония: распространенность, осведомленность, прием антигипертензивных препаратов и эффективность лечения среди населения Российской Федерации. Рос. кардиологич. журн. 2006; 4: 45–50. / Shal'nova S.A., Balanova Iu.A., Konstantinov V.V. i dr. Arterial'naia gipertoniia: rasprostranennost', osvedomlennost', priem antigipertenzivnykh preparatov i effektivnost' lecheniia sredi naseleniia Rossiiskoi Federatsii. Ros. kardiologich. zhurn. 2006; 4: 45–50. [in Russian]
12. Kearney P, Whelton M, Reynolds K et al. Worldwide prevalence of hypertension: a systematic review. J Hypertens 2004; 22: 11–9.
13. He J, Gu D, Chen J et al. Premature deaths attributable to blood pressure in China. Lancet 2009; 374 (9703): 1765–72.
14. Palafox B, McKee M, Balabanova D et al. Wealth and cardiovascular health: a cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries. Int J Equity Health 2016; 15 (1): 199.
15. World Bank. How we classify countries. Accessed 2011.
16. Staessen JA, Wang JG, Thijs L. Cardiovascular protection and blood pressure reduction: A meta-analysis. Lancet 2001; 358: 1305–15.
17. Ettehad D, Emdin CA, Kiran A et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet 2015; 387 (10 022): 957–67.
18. Chazova IE, Zhernakova YuV, Oshchepkova EV et al. Prevalence of Cardiovascular Risk Factors in Russian Population of Patients With Arterial Hypertension. Kardiologia 2014; 10: 4–12.
19. Yusuf S, Teo KK, Pogue J et al. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med Massachusetts Med Soc 2008; 358 (15): 1547–59.
20. Heidenreich PA, Trogdon JG, Khavjou OA et al. Forecasting the Future of Cardiovascular Disease in the United States. A Policy Statement From the American Heart Association. Circulation 2011; 123: 933–44.
21. Galdas PM, Cheater F, Marshall P. Men and health help-seeking behaviour. J Adv Nurs 2005; 49 (6): 616–23.
22. Ostchega Y, Dillon CF, Hughes JP et al. Trends in hypertension prevalence, awareness, treatment, and control in older US adults: data from the National Health and Nutrition Examination Survey 1988 to 2004. J Am Geriatr Soc 2007; 55 (7): 1056–65.
23. Gee ME, Campbell NR, Gwadry-Sridhar F et al. Antihypertensive medication use, adherence, stops, and starts in Canadians with hypertension. Can J Cardiol 2012; 28 (3): 383–9.
24. Kusuma SY. Migrants’ perceptions on barriers to treatment seeking for hypertension: A qualitative study from Delhi, India. Ethnomed 2010; 44 (3): 173–6.
25. Meng X, Dong G, Wang D et al. Prevalence, awareness, treatment, control, and risk factors associated with hypertension in urban adults from 33 communities of China: the CHPSNE study. J Hypertens 2011; 7 (29): 1303–10.
26. Khatib R, Schwalm J-D, Yusuf S et al. Patient and Healthcare Provider Barriers to Hypertension Awareness, Treatment and Follow Up: A Systematic Review and Meta-Analysis of Qualitative and Quantitative Studies. PLoS ONE 2014; 9 (1): e84238.
27. Anthony H, Valinsky L, Inbar Z et al. Perceptions of hypertension treatment among patients with and without diabetes. BMC Fam Pract 2012; 13: 24.
28. Ford CD, Kim MJ, Dancy BL et al. Perceptions of hypertension and contributing personal and environmental factors among rural southern African, Аmerican women. Ethn Dis 2009; 19 (4): 407–13.
29. Ogedegbe G, Harrison M, Robbins L et al. Barriers and facilitators of medication adherence in hypertensive African, Аmericans: A qualitative study. Ethn Dis 2004; 14 (1): 3–12.
30. Schafheutle EI, Hassell K, Noyce PR et al. Access to medicines: Cost as an influence on the views and behaviour of patients. Health Soc Care Community 2002; 10 (3): 187–95.
31. Parker WA, Steyn NP, Levitt NS et al. Health promotion services for patients having non-comminicable diseases: Feedback from patients and health care providers in cape town, south africa. BMC Public Health 2012; 12: 503.
32. Horowitz CR, Tuzzio L, Rojas M et al. How do urban African Аmericans and Latinos View the influence of Diet on Hypertension? J Health Care Poor Underserved 2004; 15 (4): 631–44.
33. Wexler R, Elton T, Pleister A et al. Barriers to blood pressure control as reported by African American patients. J Natl Med Assoc 2009; 101 (6): 597–603.
34. Aroian KJ, Peters RM, Rudner N et al. Hypertension prevention beliefs of hispanics. J Transcult Nurs 2012; 23 (2): 134–42.
35. Greer TM. Perceived racial discrimination in clinical encounters among African American hypertensive patients. J Health Care Poor Underserved 2010; 21 (1): 251–63.
36. Murimi MW, Harpel T. Practicing preventive health: The underlying culture among low-income rural populations. J Rural Health 2010; 26 (3): 273–82.
37. Fongwa MN, Evangelista LS, Hays RD et al. Adherence treatment factors in hypertensive Аfrican Аmerican women. Vasc Health Risk Manag 2008; 4 (1): 157–66.
38. Peters DH, Garg A, Bloom G et al. Poverty and access to health care in developing countries. Ann NY Acad Sci 2008; 1136: 161–71.
39. Barnes DM, Lu JH. Mexican immigrants’ and mexican аmericans’ perceptions of hypertension. Qual Health Res 2012; 22 (12): 1685–93.
40. Pham TM, Rosenthal MP, Diamond JJ. Hypertension, cardiovascular disease, and health care dilemmas in the philadelphia vietnamese community. Fam Med 1999; 31 (9): 647–51.
41. Arrieta MI, Foreman RD, Crook ED et al. Providing continuity of care for chronic diseases in the aftermath of katrina: From field experience to policy recommendations. Dis Med Pub Health Prep 2009; 3 (3): 174–82.
42. Lim SS, Vox T, Flaxman AD et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease. Lancet 2012; 380 (9859): 2224–60.
________________________________________________
1. World Health Organization. Global health risks: Mortality and burden of disease attributable to selected major risks. Geneva: World Health Organization, 2009.
2. Lawes CM, Hoorn SV, Rodgers A. Global burden of blood-pressure-related disease, 2001. Lancet 2008; 371 (9623): 1513–8.
3. Chow CK, Teo KK, Rangarajan S et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA 2013; 310 (9): 959–68.
4. Nieuwlaat R, Schwalm JD, Khatib R et al. Why are we failing to implement effective therapies in cardiovascular disease? Eur Heart J 2013; 34 (17): 1262–9.
5. Baker R, Camosso-Stefinovic J, Gillies C et al. Tailored interventions to overcome identified barriers to change: Effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2010; 3.
6. Boitsov S.A., Balanova Yu.A., Shal'nova S.A. i dr. Arterial'naia gipertoniia sredi lits 25–64 let: rasprostranennost', osvedomlennost', lechenie i kontrol'. Po materialam issledovaniia ESSE. Kardiovaskuliarnaia terapiia i profilaktika. 2014; 4 (14): 4–14. [in Russian]
7. Maksimov S.A., Tabakaev M.V., Artamonova G.V. Integral'naia otsenka riska ishemicheskoi bolezni serdtsa v epidemiologicheskikh issledovaniiakh (ESSE-RF v Kemerovskoi oblasti). Soobshchenie II: sotsial'no-ekonomicheskie determinanty. Profilaktich. meditsina. 2016; 1 (19): 24–9. [in Russian]
8. Rezul'taty vtorogo etapa monitoringa epidemiologicheskoi situatsii po arterial'noi gipertonii v Rossiiskoi Federatsii (2005–2007 gg.), provedennogo v ramkakh federal'noi tselevoi programmy “Profilaktika i lechenie arterial'noi gipertonii“. Informatsionno-statistich. sb. M., 2008. [in Russian]
9. Mancia G, Fagard R, Narkiewicz K et al. ESH/ESC Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31: 1281–357.
10. Wolf-Maier K, Cooper R, Banegas J. Hypertension prevalence and blood pressure levels in 6 European countries, Canada and the United States. JAMA 2003; 289: 2363–9.
11. Shal'nova S.A., Balanova Iu.A., Konstantinov V.V. i dr. Arterial'naia gipertoniia: rasprostranennost', osvedomlennost', priem antigipertenzivnykh preparatov i effektivnost' lecheniia sredi naseleniia Rossiiskoi Federatsii. Ros. kardiologich. zhurn. 2006; 4: 45–50. [in Russian]
12. Kearney P, Whelton M, Reynolds K et al. Worldwide prevalence of hypertension: a systematic review. J Hypertens 2004; 22: 11–9.
13. He J, Gu D, Chen J et al. Premature deaths attributable to blood pressure in China. Lancet 2009; 374 (9703): 1765–72.
14. Palafox B, McKee M, Balabanova D et al. Wealth and cardiovascular health: a cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries. Int J Equity Health 2016; 15 (1): 199.
15. World Bank. How we classify countries. Accessed 2011.
16. Staessen JA, Wang JG, Thijs L. Cardiovascular protection and blood pressure reduction: A meta-analysis. Lancet 2001; 358: 1305–15.
17. Ettehad D, Emdin CA, Kiran A et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet 2015; 387 (10 022): 957–67.
18. Chazova IE, Zhernakova YuV, Oshchepkova EV et al. Prevalence of Cardiovascular Risk Factors in Russian Population of Patients With Arterial Hypertension. Kardiologia 2014; 10: 4–12.
19. Yusuf S, Teo KK, Pogue J et al. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med Massachusetts Med Soc 2008; 358 (15): 1547–59.
20. Heidenreich PA, Trogdon JG, Khavjou OA et al. Forecasting the Future of Cardiovascular Disease in the United States. A Policy Statement From the American Heart Association. Circulation 2011; 123: 933–44.
21. Galdas PM, Cheater F, Marshall P. Men and health help-seeking behaviour. J Adv Nurs 2005; 49 (6): 616–23.
22. Ostchega Y, Dillon CF, Hughes JP et al. Trends in hypertension prevalence, awareness, treatment, and control in older US adults: data from the National Health and Nutrition Examination Survey 1988 to 2004. J Am Geriatr Soc 2007; 55 (7): 1056–65.
23. Gee ME, Campbell NR, Gwadry-Sridhar F et al. Antihypertensive medication use, adherence, stops, and starts in Canadians with hypertension. Can J Cardiol 2012; 28 (3): 383–9.
24. Kusuma SY. Migrants’ perceptions on barriers to treatment seeking for hypertension: A qualitative study from Delhi, India. Ethnomed 2010; 44 (3): 173–6.
25. Meng X, Dong G, Wang D et al. Prevalence, awareness, treatment, control, and risk factors associated with hypertension in urban adults from 33 communities of China: the CHPSNE study. J Hypertens 2011; 7 (29): 1303–10.
26. Khatib R, Schwalm J-D, Yusuf S et al. Patient and Healthcare Provider Barriers to Hypertension Awareness, Treatment and Follow Up: A Systematic Review and Meta-Analysis of Qualitative and Quantitative Studies. PLoS ONE 2014; 9 (1): e84238.
27. Anthony H, Valinsky L, Inbar Z et al. Perceptions of hypertension treatment among patients with and without diabetes. BMC Fam Pract 2012; 13: 24.
28. Ford CD, Kim MJ, Dancy BL et al. Perceptions of hypertension and contributing personal and environmental factors among rural southern African, Аmerican women. Ethn Dis 2009; 19 (4): 407–13.
29. Ogedegbe G, Harrison M, Robbins L et al. Barriers and facilitators of medication adherence in hypertensive African, Аmericans: A qualitative study. Ethn Dis 2004; 14 (1): 3–12.
30. Schafheutle EI, Hassell K, Noyce PR et al. Access to medicines: Cost as an influence on the views and behaviour of patients. Health Soc Care Community 2002; 10 (3): 187–95.
31. Parker WA, Steyn NP, Levitt NS et al. Health promotion services for patients having non-comminicable diseases: Feedback from patients and health care providers in cape town, south africa. BMC Public Health 2012; 12: 503.
32. Horowitz CR, Tuzzio L, Rojas M et al. How do urban African Аmericans and Latinos View the influence of Diet on Hypertension? J Health Care Poor Underserved 2004; 15 (4): 631–44.
33. Wexler R, Elton T, Pleister A et al. Barriers to blood pressure control as reported by African American patients. J Natl Med Assoc 2009; 101 (6): 597–603.
34. Aroian KJ, Peters RM, Rudner N et al. Hypertension prevention beliefs of hispanics. J Transcult Nurs 2012; 23 (2): 134–42.
35. Greer TM. Perceived racial discrimination in clinical encounters among African American hypertensive patients. J Health Care Poor Underserved 2010; 21 (1): 251–63.
36. Murimi MW, Harpel T. Practicing preventive health: The underlying culture among low-income rural populations. J Rural Health 2010; 26 (3): 273–82.
37. Fongwa MN, Evangelista LS, Hays RD et al. Adherence treatment factors in hypertensive Аfrican Аmerican women. Vasc Health Risk Manag 2008; 4 (1): 157–66.
38. Peters DH, Garg A, Bloom G et al. Poverty and access to health care in developing countries. Ann NY Acad Sci 2008; 1136: 161–71.
39. Barnes DM, Lu JH. Mexican immigrants’ and mexican аmericans’ perceptions of hypertension. Qual Health Res 2012; 22 (12): 1685–93.
40. Pham TM, Rosenthal MP, Diamond JJ. Hypertension, cardiovascular disease, and health care dilemmas in the philadelphia vietnamese community. Fam Med 1999; 31 (9): 647–51.
41. Arrieta MI, Foreman RD, Crook ED et al. Providing continuity of care for chronic diseases in the aftermath of katrina: From field experience to policy recommendations. Dis Med Pub Health Prep 2009; 3 (3): 174–82.
42. Lim SS, Vox T, Flaxman AD et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease. Lancet 2012; 380 (9859): 2224–60.
1 ФГБНУ «НИИ комплексных проблем сердечно-сосудистых заболеваний». 650002, Россия, Кемерово, Сосновый бульвар, д. 6;
2 ФГБОУ ВО «Кемеровский государственный медицинский университет» Минздрава России. 650029, Россия, Кемерово, ул. Ворошилова, д. 22а *ya.kristi89@yandex.ru
1 Research Institute for Complex Issues of Cardiovascular Disease. 650002, Russian Federation, Kemerovo, Sosnovyi bul'var, d. 6;
2 Kemerovo State Medical University of Ministry of Health of the Russian Federation. 650029, Russian Federation, Kemerovo, ul. Voroshilova, d. 22a *ya.kristi89@yandex.ru