Analysis of 17 Factors Potentially Related to Hypertension Control in the Siberian Urban Sample

Aim        To identify non-pharmacological factors associated with ineffective blood pressure (BP) control among individuals with arterial hypertension (AH) in a Siberian urban population sample.

Material and methods          A considerable proportion of individuals with AH does not achieve BP goals. BP control is influenced by a number of non-drug determinants, including non-modifiable and multiple modifiable factors. In a population sample (men/women, 55-84 years old, n=3,898, 2015-2018, HAPIEE project, Novosibirsk), a category of individuals with AH receiving antihypertensive therapy (AHT) (n=2,449) was selected and two groups with adequate and inadequate BP control (ABPC and IABPC, respectively) were identified. We evaluated associations of IABPC and a series of potentially related factors, including gender, age, AH duration, type 2 diabetes mellitus, cardiovascular diseases (CVD), anthropometric and biochemical parameters, behavioral (smoking, alcohol consumption, physical activity (PA)) and socioeconomic factors (education, marital status, economic activity, material deprivation).

Results    In a sample of 55-84-year-old individuals with AH taking AHT, ABPC was 30.7%. In the multivariate logistic model, IABPC was directly associated with male gender (odds ratio (OR) 1.72; 95% confidence interval (CI) 1.28-2.31), AH duration longer than 10 years (OR 2.55; 95% CI 2.07-3.14), alcohol consumption 1-3 times a month (OR 1.36; 95% CI 1.02-1.81) and 1-4 times a week (OR 1.91; 95% CI 1.26-2.89) and was inversely associated with moderate PA (OR 0.78; 95% CI 0.62-0.98). In men, IABPC was additionally inversely associated with history of CVD (OR 0.62; 95% CI 0.42-0.92). In women, IABPC was additionally associated with economically inactive status (OR 1.39; 95% CI 1.03-1.86) and inversely associated with smoking (OR 0.51; 95% CI 0.29-0.87).

Conclusion            In a Siberian population sample of 55-84-year-olds, one third of individuals with AH receiving AHT adequately controlled their BP. Inadequate BP control was directly associated with male gender, long history of AH, frequent alcohol consumption, and economically inactive status (in women), and was inversely associated with moderate PA, CVD (in men), and smoking (in women). Attention to non-pharmacological determinants may help optimize BP control.

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