Comparative study risk factors of cardiovascular disease among subjects with arterial hypertension in the population of the Ryazan region (study ESSE of the Russian Federation 2)

Aim. To study the prevalence of risk factors (RFs) such as dyslipidemia, impaired glucose metabolism, high heart rate (HR), obesity, smoking, stress, anxiety, and depression among patients with a confirmed diagnosis of hypertension (HTN) and individuals with elevated office blood pressure (BP) but without a diagnosis of HTN.

Material and methods. In the Ryazan region, as part of the state assignment of the Ministry of Health of the Russian Federation (the 2nd study under the ESSE program – “Epidemiology of cardiovascular diseases and their risk factors in the regions of the Russian Federation”), 1,632 people were examined, of whom those whose blood pressure did not fall below 140/90 mm Hg when measured twice were selected, (713 individuals). They were divided into 2 groups. Group A consisted of patients with a confirmed diagnosis of HTN, taking at least one antihypertensive medication (467 individuals, 62.7 % women, the median age was 52.0 years), and Group B consisted of individuals with elevated office BP but without a confirmed diagnosis of HTN and not taking antihypertensive medications (246 individuals, 41.1 % women, the median age was 44.0 years). A comparative assessment of RFs was conducted among them.

Results. A high prevalence of dyslipidemia was observed in the groups without statistical difference between them at 86.1 and 83.4 %, respectively (p > 0.05). However, frequency of impaired glucose metabolism was higher in patients of Groups A than that of Group B – 40.7 and 36.5 %, respectively (p = 0.004). The median body mass index (BMI) in Group A was 30.1 (26.8–33.4) kg/m2 , which was statistically significantly higher than the median in Group B, 29.3 (25.9–32.4) kg/m2 (p = 0.013). In Groups A and B, 13.9 and 16.6 % of individuals had normal BMI, 34.7 and 41.5 % had overweight, and 51.4 and 41.9 % had obesity, respectively, with no statistically significant difference between the groups in these measures. The smoking frequency was lower in Group A than in Group B, at 20.8 and 37.4 %, respectively (p < 0.001). The median HR in Group A was 73.0 (67.0–79.5) bpm and it was statistically significantly lower as compared with that of Group B –76.0 (70.0–82.0) bpm (p < 0.001), while the median of stress level (14.0 and 13.0 arbitrary units, p = 0.008), anxiety levels (6.0 and 4.5 arbitrary units, p < 0.001), and depression levels (5.0 and 4.0 arbitrary units, p < 0.001) were significantly higher in patients with HTN.

Conclusion. A high prevalence of dyslipidemia, excess body weight/obesity, and impaired glucose metabolism was found in both groups. However, in Group A as compared with with Group B, statistically significantly higher levels of fasting glucose, HBa1c, BMI, stress, anxiety, and depression were observed, as well as a lower frequency of smoking and increased HR. The higher smoking frequency among women and the lower prevalence of anxiety and depression in the Ryazan Region population with HTN as compared with nationwide studies may indicate regional characteristics of these RFs.

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