Factors associated with successful hypertension control: analysis of ESSE-RF study data

Objective . To analyze associations between demographic, behavioral, psycho-emotional, and clinical characteristics and the likelihood of receiving treatment, achieving control, and treatment effectiveness for hypertension among participants of the ESSE-RF study. Design and methods . A multivariable logistic regression analysis was performed using data from 9,966 participants (3,846 men; 6,120 women) aged 25–64 years with a confirmed diagnosis of hypertension from the ESSE-RF study. Three binary outcomes were assessed: antihypertensive therapy (AHT), hypertension control (achieving target blood pressure among all individuals with hypertension), and treatment effectiveness (achieving target blood pressure among those receiving AHT). Fortyseven potential predictors were included in the regression model. Results . Among ESSE-RF participants with hypertension, 62,5% received AHT and only 23 % of all patients achieved target blood pressure levels; and 35,4 % were effectively treated (targets achieved among those receiving AHT). The likelihood of receiving AHT was positively associated with female sex (OR 1,86), history of stroke (OR 4,70), cardiac arrhythmias (OR 2,19), ischemic heart disease (OR 1,99), diabetes mellitus (OR 1,89), and high physical activity (OR 4,3). Sleep apnea complaints, older age, higher BMI, and higher anxiety level were associated with a lower likelihood of receiving AHT. Hypertension control was more frequent in women (OR 2,08), in individuals with educational attainment, and with higher physical activity (OR 2,55 for high activity). The presence of certain comorbidities and a high level of anxiety (OR 0,95) reduced the odds of hypertension control. Treatment effectiveness was higher in women (OR 1,83), in older individuals, in those with higher BMI, with kidney disease (OR 1,31), and with higher education. Chronic bronchitis (OR 0,70) and high anxiety level (OR 0,95) predicted lower treatment effectiveness. Conclusions . Both treatment coverage and effectiveness for hypertension in the Russian population remain insufficient. Female sex, higher education, moderate/high physical activity are universal predictors of better hypertension management. High anxiety is an important barrier at all stages of hypertension care. The observed associations with sleep related complaints and comorbidities warrant further investigation and may indicate specific psychosocial barriers.