Physicians and medical students’ knowledge assessment in matters of classification and definition of arterial hypertension based on the multicenter PHYSTARH-II study results

Relevance. Arterial hypertension (AH) is a significant risk factor for cardiovascular diseases. Despite advancements in the diagnosis and treatment of AH, the level of knowledge among physicians and students remains insufficient, necessitating further study.
The aim of the study. To assess awareness of doctors and senior medical students regarding the definition, classification and diagnosis of arterial hypertension.
Materials and Methods. Data from the second phase of the PHYSTARH project (2019-2023) were analyzed – anonymous surveys of 494 physicians from 10 regions of Russian Federation and 426 students from 10 universities in Russian Federation and Kyrgyzstan. The questionnaire was based on clinical guidelines. The results were compared with data from 2017–2019. Statistical methods and tests used included the Kolmogorov-Smirnov test, Mann-Whitney U test, Kruskal-Wallis test, Pearson correlation, median test for independent samples, ANOVA modeling, and regression scatter plot analysis. Differences were considered significant at p-values <0.05.
Results. The overall level of knowledge proved to be insufficient. The average level of correctness (completeness) of answers (LCA) was 58.4% for students and 62.4% for physicians (compared to 49.4% and 55.3% in 2017-2019, respectively). The worst results were obtained in questions about home blood pressure monitoring and the definition of resistant, masked, and isolated ambulatory hypertension.
Conclusion. The knowledge of students and physicians regarding key aspects of arterial hypertension requires improvement. Additional educational programs are essential.

1. Kobalava Zh.D., Konradi A.O., Nedogoda S.V., et al. 2024 Clinical practice guidelines for Hypertension in adults. Russian Journal of Cardiology. 2024;29(9):6117. (In Russ.) https://doi.org/10.15829/1560-4071-2024-6117

2. Novak V.D., Haisheva L.A. Aspects of arterial hypertension in young adults with obesity. South Russian Journal of Therapeutic Practice. 2024;5(3):14-20. (In Russ.) https://doi.org/10.21886/2712-8156-2024-5-3-14-20

3. Balanova Yu.A., Kontsevaya A.V., Myrzamatova A.O., Mukaneeva D.K., Khudyakov M.B., Drapkina O.M. Economic Burden of Hypertension in the Russian Federation. Rational Pharmacotherapy in Cardiology. 2020;16(3):415-423. (In Russ.) https://doi.org/10.20996/1819-6446-2020-05-03

4. Bontsevich R.A., Vovk Y.R., Gavrilova A.A., et al. Knowledge of senior students in the definition, classification, and approaches to the treatment of arterial hypertension. Final results of the PHYSTARH project. Final results of the PHYSTARH project. Systemic Hypertension. 2021;18(4):169-17. https://doi.org/10.26442/2075082X.2021.4.200897

5. Bontsevich R.A., Vovk Y.R., Gavrilova A.A., et al. Etiopathogenesis, diagnosis, and approaches to the treatment of arterial hypertension: an assessment of the physicians’ basic knowledge. Final results of the PHYSTARH project. Systemic Hypertension. 2021;18(1):25-30. (In Russ.) https://doi.org/10.26442/2075082X.2021.1.200346

6. Bontsevich R.A., Gavrilova A.A., Vovk Y.R., Adonina A.V., et al. The Assessment of Physicians’ and Senior Medical Students’ Knowledge in the Field of Community-Acquired Pneumonia: Preliminary Results of the KNOCAP-II Project (2017-2019). Medicni perspektivi. 2020; 25(1):59-65. https://doi.org/10.26641/2307-0404.2020.1.200402

7. Kobalava Zh.D., Konradi A.O., Nedogoda S.V., Shlyakhto E.V., et al. Arterial hypertension in adults. Clinical guidelines 2020. Russian Journal of Cardiology. 2020;25(3):3786. (In Russ.) https://doi.org/10.15829/1560-4071-2020-3-3786

8. Williams B., Mancia G., Spiering W., et al. 2018 Practice Guidelines for the management of arterial hypertension of the European Society of Hypertension and the European Society of Cardiology: ESH/ESC Task Force for the Management of Arterial Hypertension. Journal of Hypertension. 2018;36(12):2284-2309. https://doi.org/10.1097/HJH.0000000000001961

9. Chazova I.E., Zhernakova Yu.V. Diagnosis and treatment of arterial hypertension [Guidelines. Systemic Hypertension. 2019;16(1):6-31. (In Russ.) https://doi.org/10.26442/2075082X.2019.1.190179

10. 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. 2016;387(10022):957-967. https://doi.org/10.1016/S0140-6736(15)01225-8

11. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/ PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71(6):1269-1324. https://doi.org/10.1161/HYP.0000000000000066

12. Mancia G., Fagard R., Narkiewicz K., et al. Task Force Members, 2013. 2013 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; 31(7):1281-357. PMID:23817082. https://doi.org/10.1097/01.hjh.0000431740.32696.cc

13. Williams B., Mancia G., Spiering W., et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021-104. https://doi.org/10.1093/eurheartj/ehy339

14. Britov AN, Bystrova MM. Refractory hypertension – modern approaches to diagnostics and treatment. Rational Pharmacotherapy in Cardiology. 2010;6(2):206-211. (In Russ.). https://doi.org/10.20996/1819-6446-2010-6-2-206-211

15. Bontsevich R.A. Educational pharmacoepidemiology and "Real-World Knowledge". Real-World Data & Evidence. 2024;4(4):44-52. (In Russ.) https://doi.org/10.37489/2782-3784-myrwd-062