Pharmacoepidemiology of arterial hypertension in Russia: the analysis of physicians acceptance (according to the results of PIFAGOR IV)

The aim is to study the next step of pharmacoepidemiology of arterial hypertension (AH) in Russia to evaluate the structure and frequency of different classes of antihypertensive drugs usage in clinical practice.Material and methods. The prospective pharmacoepidemiological multicenter study (PIFAGOR IV). We interrogated thephysicians, dealing with treatment of AH patients. The collection of questionnaires took place from February to July, 2013. The study included 1105 valid physicians'questionnaires (67,5% therapeutists, 28,1% cardiologists) from 73 cities and towns of Russia.Results. In the structure of antihypertensive drugs for treating patients with AH, the main are 5 classes: inhibitors of angiotensin-converting enzyme - ACE inhibitors (24,2%), β-adrenergic receptor blocking agents - β-AB (18,9%), diuretics (18,9%), calcium antagonists - CA (17,4%) and angiotensin II receptor blockers - ARBsII (16%) reaching 95,4% of the total proportion. Additional proportion of classes iscentral-acting agents - 3,4% and α-AB - 1,2%. Among the ACE inhibitors the main share has 5 drugs: perindopril (20,3%), enalapril (18,3%), lisinopril (18,5%), ramipril (14,2%) and fozinopril (13,6%). In β-AB class the main share has bisoprolol (30,2%), than usual form of release and modified release dosage form (25,2%) of metoprolol (the total share 25,2%) and carvedilol (16%). The 1/2 of diuretics are 54,8% - indapamide, 18,4% - torasemide, hydrochlorothiazide - 19,4%. In CA class the main share hasamlodipine (32,6%), including S-amlodipine (1,8%), and nifedipine in different dosage forms (21,5%),while the proportion of modified-release forms - 14,3% and verapamil in different dosage forms (14,6%) and diltiazem (13%). The main drugs in ARBs II are losartan (37,3%) and valsartan (29,9%). Central-acting agentclass is consisted of moxonidine (74,1%), rilmenidine (8%) and clonidine (18%). Physicians' acceptance of fixed combinations has been increased up to 52,6%, the proportion of CA and ACE inhibitors combinations - up to 29,1%, but the proportion of β-AB and diuretics combination has been decreased by 15,6%. Physicians use the adequate criteria to choose antihypertensive drugs and recommended criteria for evaluating the efficacy of treatment (the blood pressure targets are less than 140/90 mmHg).

β-адреноблокаторы, pharmacoepidemiology of AH, antihypertensive agents, ACE inhibitors, beta adrenergic receptor blocking agents, calcium antagonists, angiotensin II receptor blockers, central-acting agents

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