Keywords
treatment adherence
men of working age
ambulatory blood pressure monitoring
left ventricular mass index
glomerular filtration rate
albuminuria
How to Cite
Abstract
Introduction. Hypertension (HTN) is one of the most significant factors determining modern non-communicable morbidity and mortality. The global prevalence of non-adherence to HTN therapy ranges from 27% to 40%, and 44% of adults with HTN are unaware of their condition or its severe consequences. The war has led to a deterioration in blood pressure control and an increase in the prevalence of hypertensive disease (HD) in Ukraine.
Aim. To investigate the impact of treatment adherence for hypertensive disease (HD) on the degree of target organ damage in Ukrainian men of working age.
Materials and methods. The study involved 95 men of working age with stage I–II HD, aged 43.04 ± 0.91 years. The participants underwent 24-hour ambulatory blood pressure monitoring (ABPM), assessment of body mass index, echocardiography (Echo-CG), and measurement of blood creatinine levels, glomerular filtration rate (CKD-EPI), and albuminuria levels. Treatment adherence was determined using the Morisky-Green questionnaire.
Results. The correlation we found between a high level of adherence and the restoration of the circadian BP profile indicates effective control of hemodynamic load. High adherence is accompanied by a decrease in parameters indicating left ventricular myocardial hypertrophy (a reduction in left ventricular myocardial mass index to 106.5 g/m² vs. 121.0 g/m² in the low-adherence group). Simultaneously, an improvement in renal filtration function is observed, which is reflected in an increase in glomerular filtration rate (CKD-EPI) to 107.10 mL/min/1.73m² and a decrease in albuminuria, indicating a nephroprotective effect of systemic treatment in young men with good treatment adherence.
Conclusions. The results of the study prove the role of high adherence to HTN treatment in achieving target values and normalizing the 24-hour BP profile. In young men with high adherence to HTN therapy, a pronounced cardioprotective effect was noted, consisting of a reduction in the left ventricular mass index, as well as a nephroprotective effect accompanied by an increase in the glomerular filtration rate and a decrease in albuminuria levels. Timely diagnosis, a personalized approach to prescribing antihypertensive therapy using fixed-dose combinations, and high treatment adherence are key tools for preventing the premature development of arterial hypertension complications in men of working age.
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