Получена: 11/04/2023/ Принята: 28/08/2023 / Опубликована online: 30/10/2023
УДК 616-01
DOI 10.53511/PHARMKAZ.2023.10.19.017
Д. М. МУХТАРХАНОВА1, С. Ф. БЕРКИНБАЕВ1, Г. А. ДЖУНУСБЕКОВА1, М. К. ТУНДЫБАЕВА1
1НАО «Казахский Национальный медицинский университет имени С. Д. Асфендиярова»
ПРИВЕРЖЕННОСТЬ К ТЕРАПИИ ПАЦИЕНТОВ С АРТЕРИАЛЬНОЙ ГИПЕРТОНИЕЙ
(ОБЗОРНАЯ СТАТЬЯ)
Резюме: Актуальность: Заболевания сердечно-сосудистой системы занимают ведущее место среди причин инвалидизации и смертности. По данным ВОЗ в 2016 году доля смертей от сердечно-сосудистых заболеваний составила 31% всех случаев [(1)]. Самым распространённым из них является артериальная гипертония.
Цель: Оценка уровня приверженности и причин её снижения или отсутствия, а также методов её
оценки.
Метод исследования: Анализ литературы с использованием баз данных Medline и PubMed с 2010
по 2022 год.
Выводы: Распространённость артериальной гипертонии в мире составляет около 34% [(2)]. А в
Казахстане, в частности, в городе Алматы и Алматинской области, по данным Научно-исследовательского института кардиологии и внутренних болезней – 35,8% [(3)]. Артериальная гипертония
ежегодно определяет 200 миллионов случаев инвалидизации, являясь сильнейшим фактором риска
развития осложнений: инсульт, инфаркт миокарда, сердечная недостаточность, хроническая болезнь почек [(4)]. Несмотря на доступность антигипертензивных препаратов, функционирование
Программ Управления Заболеваниями, школ здоровья достижение контроля артериального давления не превышает 50% в мире и 20% в Казахстане [(5)]. Основные причины: низкая комплаентность
пациентов к терапии и инерция врачей в отношении её назначения и коррекции. Понимание категорий факторов, способствующих несоблюдению режима лечения, полезно для управления и повышения контроля артериальной гипертонии.
Ключевые слова: артериальная гипертония, приверженность, комплаентность, сердечно-сосудистые заболевания, сердечно-сосудистая система, артериальное давление, целевое значение, контроль артериальной гипертонии.
СПИСОК ЛИТЕРАТУРЫ
1 Abbafati C, Abbas KM, Abbasi-Kangevari M, Abd-Allah F, Abdelalim A, Abdollahi M, et al. Global burden of 369 diseases and injuries in 204 countries and
territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020 Oct 17;396(10258):1204–22.
2 Beaney T, Schutte AE, Stergiou GS, Borghi C, Burger D, Charchar F, et al. May measurement month 2019: The global blood pressure screening campaign
of the international society of hypertension. Hypertension. 2020 Aug 1;76(2):333–41.
3 Isabekova Аk, Аkhyt B, Akpanova D, Aliyeva Berkinbayev GS, Djunusbekova G, Musagaliyeva А, et al. Prevalence of Major Cardiovascular Diseases among
Almaty Residents.
4 Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for themanagement of arterial hypertension. Vol. 39,
European Heart Journal. Oxford University Press; 2018. p. 3021–104.
5 Tulegenova L., Tlekenova D. Анализ комплаентности больных артериальной гипертензией. In: Marat Ospanov West Kazakhstan State Medical University
Confererence series. 2018. p. 32–6.
6 Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, Chen J, He J. Global disparities of hypertension prevalence and control: a systematic
analysis of population-based studies from 90 countries. Circulation. 2016;134:441–450. doi: 10.1161/CIRCULATIONAHA.115.018912
7 Tomaszewski M, White C, Patel P, Masca N, Damani R, Hepworth J, et al. High rates of non-adherence to antihypertensive treatment revealed by highperformance liquid chromatography-tandem mass spectrometry (HP LC-MS/MS) urine analysis. Available from: http://heart.bmj.com/
8 Sabaté Eduardo, World Health Organization. Adherence to long-term therapies : evidence for action. World Health Organization; 2003. 194 p.
9 Vrijens B, De Geest S, Hughes DA, Przemyslaw K, Demonceau J, Ruppar T, Dobbels F, Fargher E, Morrison V, Lewek P, Matyjaszczyk M, Mshelia C, Clyne
W, Aronson JK, Urquhart J; ABC Project Team. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol. 2012;73:691–
705. doi: 10.1111/j.1365-2125.2012.04167.x
10 Vrijens B, Vincze G, Kristanto P, Urquhart J, Burnier M. Adherence to prescribed antihypertensive drug treatments: longitudinal study of electronically
compiled dosing histories. BMJ. 2008;336:1114–1117. doi: 10.1136/bmj.39553.670231.25
11 Fischer MA, Choudhry NK, Brill G, Avorn J, Schneeweiss S, Hutchins D, Liberman JN, Brennan TA, Shrank WH. Trouble getting started: predictors of primary
medication nonadherence. Am J Med. 2011;124:1081. e9–1081.e22. doi: 10.1016/j.amjmed.2011.05.02820
12 Burnier M, Wuerzner G, Struijker-Boudier H, Urquhart J. Measuring, analyzing, and managing drug adherence in resistant hypertension. Hypertension.
2013;62:218–225. doi: 10.1161/HYPERTENSIONAHA.113.00687
13 Burnier M, Brede Y, Lowy A. Impact of prolonged antihypertensive duration of action on predicted clinical outcomes in imperfectly adherent patients:
comparison of aliskiren, irbesartan and ramipril. Int J Clin Pract. 2011;65:127–133. doi: 10.1111/j.1742-1241.2010.02616.x
14 Corrao G, Zambon A, Parodi A, Poluzzi E, Baldi I, Merlino L, Cesana G, Mancia G. Discontinuation of and changes in drug therapy for hypertension among
newly-treated patients: a population-based study in Italy. J Hypertens. 2008;26:819–824. doi: 10.1097/HJH.0b013e3282f4edd7
15 Caro JJ, Salas M, Speckman JL, Raggio G, Jackson JD. Persistence with treatment for hypertension in actual practice. CMAJ. 1999;160:31–37
16 Qvarnström M, Kahan T, Kieler H, Brandt L, Hasselström J, Bengtsson Boström K, Manhem K, Hjerpe P, Wettermark B. Persistence to antihypertensive
drug treatment in Swedish primary healthcare. Eur J Clin Pharmacol. 2013;69:1955–1964. doi: 10.1007/s00228-013-1555-z
17 Hasford J, Schröder-Bernhardi D, Rottenkolber M, Kostev K, Dietlein G. Persistence with antihypertensive treatments: results of a 3-year follow-up cohort
study. Eur J Clin Pharmacol. 2007;63:1055–1061. doi:10.1007/s00228-007-0340-2
18 Mancia G, Parodi A, Merlino L, Corrao G. Heterogeneity in antihypertensive treatment discontinuation between drugs belonging to the same class. J
Hypertens. 2011;29:1012–1018. doi: 10.1097/HJH.0b013e32834550d0
19 Moise N, Schwartz J, Bring R, Shimbo D, Kronish IM. Antihypertensive drug class and adherence: an electronic monitoring study. Am J
Hypertens.2015;28:717–721. doi: 10.1093/ajh/hpu199
20 Hasselström J, Zarrinkoub R, Holmquist C, Hjerpe P, Ljungman C, Qvarnström M, Wettermark B, Manhem K, Kahan T, Bengtsson Boström K.
The Swedish Primary Care Cardiovascular Database (SPCCD): 74 751 hypertensive primary care patients. Blood Press. 2014;23:116–125. doi:10.3109/08037051.2013.814829
21 Corrao G, Mancia G. Generating evidence from computerized healthcare utilization databases. Hypertension. 2015;65:490–498. doi: 10.1161/
HYPERTENSIONAHA.114.04858
22 Qvarnström M, Kahan T, Kieler H, Brandt L, Hasselström J, Bengtsson Boström K, Manhem K, Hjerpe P, Wettermark B. Persistence to antihypertensive
drug treatment in Swedish primary healthcare. Eur J Clin Pharmacol. 2013;69:1955–1964. doi: 10.1007/s00228-013-1555-z
23 Mazzaglia G, Mantovani LG, Sturkenboom MC, Filippi A, Trifirò G, Cricelli C, Brignoli O, Caputi AP. Patterns of persistence with antihypertensive medications
in newly diagnosed hypertensive patients in Italy: a retrospective cohort study in primary care. J Hypertens. 2005;23:2093–2100.
24 Halpern MT, Khan ZM, Schmier JK, Burnier M, Caro JJ, Cramer J, Daley WL, Gurwitz J, Hollenberg NK. Recommendations for evaluating compliance and
persistence with hypertension therapy using retrospective data. Hypertension. 2006;47:1039–1048. doi: 10.1161/01.HYP. 0000222373.59104.3d
25 Raebel MA, Schmittdiel J, Karter AJ, Konieczny JL, Steiner JF. Standardizing terminology and definitions of medication adherence and persistence in
research employing electronic databases. Med Care. 2013;51:S11–S21. doi: 10.1097/MLR.0b013e31829b1d2a
26 Fischer MA, Choudhry NK, Brill G, Avorn J, Schneeweiss S, Hutchins D, et al. Trouble getting started: Predictors of primary medication nonadherence.
American Journal of Medicine. 2011 Nov;124(11).
27 Burnier M. Drug adherence in hypertension. Pharmacol Res. 2017 Nov;125:142–9.
28 AlGhurair SA, Hughes CA, Simpson SH, Guirguis LM. A Systematic Review of Patient Self-Reported Barriers of Adherence to Antihypertensive Medications
Using the World Health Organization Multidimensional Adherence Model. The Journal of Clinical Hypertension. 2012 Dec;14(12):877–86.
29 Khatib R, Schwalm JD, Yusuf S, Haynes RB, McKee M, Khan M, et al. Patient and Healthcare Provider Barriers to Hypertension Awareness, Treatment
and Follow Up: A Systematic Review and Meta-Analysis of Qualitative and Quantitative Studies. PLoS One. 2014 Jan 15;9(1):e84238.
30 Nguyen TMU, Caze A la, Cottrell N. What are validated self-report adherence scales really measuring?: a systematic review. Br J Clin Pharmacol. 2014
Mar;77(3):427–45.
31 Burnier M, Egan BM. Adherence in Hypertension: A Review of Prevalence, Risk Factors, Impact, and Management. Circ Res. 2019 Mar 29;124(7):1124–40.
32 Moon SJ, Lee WY, Hwang JS, Hong YP, Morisky DE. Accuracy of a screening tool for medication adherence: A systematic review and meta-analysis of the
Morisky Medication Adherence Scale-8. PLoS One. 2017 Nov 2;12(11):e0187139.
33 Moon SJ, Lee WY, Hwang JS, Hong YP, Morisky DE. Correction: Accuracy of a screening tool for medication adherence: A systematic review and metaanalysis of the Morisky Medication Adherence Scale-8. PLoS One. 2018 Apr 17;13(4):e0196138.
34 Warren SR, Raisch DW, Campbell HM, Guarino PD, Kaufman JS, Petrokaitis E, et al. Medication adherence assessment in a clinical trial with centralized
follow-up and direct-to-patient drug shipments. Clinical Trials. 2013 Jun 3;10(3):441–8.
35 Hamilton GA. Measuring Adherence in a Hypertension Clinical Trial. European Journal of Cardiovascular Nursing. 2003 Sep 25;2(3):219–28.
36 Abegaz TM, Shehab A, Gebreyohannes EA, Bhagavathula AS, Elnour AA. Nonadherence to antihypertensive drugs: a systematic review and metaanalysis.
Medicine (Baltimore). 2017;96:e5641. doi: 10.1097/MD. 0000000000005641
37 Butler MJ, Tanner RM, Muntner P, Shimbo D, Bress AP, Shallcross AJ, Sims M, Ogedegbe G, Spruill TM. Adherence to antihypertensive medications and
associations with blood pressure among African Americans with hypertension in the Jackson Heart Study. J Am Soc Hypertens. 2017;11:581.e5–588.e5. doi:
10.1016/j.jash.2017.06.011
38 Breekveldt-Postma NS, Penning-van Beest FJ, Siiskonen SJ, Koerselman J, Klungel OH, Falvey H, Vincze G, Herings RM. Effect of persistent use of
antihypertensives on blood pressure goal attainment. Curr Med Res Opin. 2008;24:1025–1031. doi: 10.1185/030079908X280554
39 Veterans Administration Cooperative Study Group on Antihypertensive Agents. Effects of treatment on morbidity in hypertension. Results in patients with
diastolic blood pressures averaging 115 through 129 mm Hg. JAMA. 1967;202:1028–1034.
40 Veterans Administration Cooperative Study Group on Antihypertensive Agents. Effects of treatment on morbidity in hypertension. II. Results in patients with
diastolic blood pressure averaging 90 through 114 mm Hg. JAMA. 1970;213:1143–1152.
41 Saguner AM, Dür S, Perrig M, Schiemann U, Stuck AE, Bürgi U, Erne P, Schoenenberger AW. Risk factors promoting hypertensive crises: evidence from
a longitudinal study. Am J Hypertens. 2010;23:775–780. doi: 10.1038/ajh.2010.71
42 Mitchell GF, Hwang SJ, Vasan RS, Larson MG, Pencina MJ, Hamburg NM, Vita JA, Levy D, Benjamin EJ. Arterial stiffness and cardiovascular events: the
Framingham Heart Study. Circulation. 2010;121:505–511.doi: 10.1161/CIRCULATIONAHA.109.886655
43 Berni A, Ciani E, Cecioni I, Poggesi L, Abbate R, Boddi M. Adherence to antihypertensive therapy affects Ambulatory Arterial Stiffness Index. Eur J Intern
Med. 2011;22:93–98. doi: 10.1016/j.ejim.2010.07.015
44 Comberg HU, Knowles M, Tyroler HA, Heyden S, Hames CG, Sabo D. Status of patients seven years after completion of the hypertension detection and
follow-up program in Evans County, Georgia. J Natl Med Assoc. 1988;80:1285–1292.
45 Bruno A, Brooks DD, Abrams TA, Poorak MD, Gunio D, Kandhal PK, Lakhanpal A, Nagabandi AK, Akinwuntan AE, Looney S, Schafer PE. Left ventricular
hypertrophy in acute stroke patients with known hypertension. Clin Exp Hypertens. 2017;39:502–504. doi: 10.1080/10641963.2016.1259328
46 Johnson-Levonas AO, Oh BH. Prevalence of microalbuminuria and associated risk factors among adult Korean hypertensive patients in a primary care
setting. Hypertens Res. 2013;36:807–823. doi: 10.1038/hr.2013.44
47 Mazzaglia G, Ambrosioni E, Alacqua M, Filippi A, Sessa E, Immordino V, Borghi C, Brignoli O, Caputi AP, Cricelli C, Mantovani LG. Adherence to
antihypertensive medications and cardiovascular morbidity among newly diagnosed hypertensive patients. Circulation. 2009;120:1598–1605. doi: 10.1161/
CIRCULATIONAHA.108.830299
48 Corrao G, Parodi A, Nicotra F, Zambon A, Merlino L, Cesana G, Mancia G. Better compliance to antihypertensive medications reduces cardiovascular risk.
J Hypertens. 2011;29:610–618. doi: 10.1097/HJH. 0b013e328342ca97
49 Chowdhury R, Khan H, Heydon E, Shroufi A, Fahimi S, Moore C, Stricker B, Mendis S, Hofman A, Mant J, Franco OH. Adherence to cardiovascular therapy:
a meta-analysis of prevalence and clinical consequences. Eur Heart J. 2013;34:2940–2948. doi: 10.1093/eurheartj/eht295
50 Herttua K, Tabák AG, Martikainen P, Vahtera J, Kivimäki M. Adherence to antihypertensive therapy prior to the first presentation of stroke in hypertensive
adults: population-based study. Eur Heart J. 2013;34:2933–2939. doi: 10.1093/eurheartj/eht219
51 Yang Q, Chang A, Ritchey MD, Loustalot F. Antihypertensive medication adherence and risk of cardiovascular disease among older adults: a populationbased cohort study. J Am Heart Assoc. 2017;6:e006056.
52 Perreault S, Dragomir A, Roy L, White M, Blais L, Lalonde L, Bérard A. Adherence level of antihypertensive agents in coronary artery disease. Br J Clin
Pharmacol. 2010;69:74–84. doi: 10.1111/j.1365-2125.2009.03547.x
53 Perreault S, Dragomir A, White M, Lalonde L, Blais L, Bérard A. Better adherence to antihypertensive agents and risk reduction of chronic heartfailure. J
Intern Med. 2009;266:207–218.
54 Cedillo-Couvert EA, Ricardo AC, Chen J, et al; CRIC Study Investigators. Self-reported Medication Adherence and CKD Progression. Kidney Int Rep.
2018;3:64 Roy L, White-Guay B, Dorais M, Dragomir A, Lessard M, Perreault S.
55 Adherence to antihypertensive agents improves risk reduction of end-stage renal disease. Kidney Int. 2013;84:570–577. doi: 10.1038/ki.2013.1035–651.
doi: 10.1016/j.ekir.2018.01.007
56 Siegel D, Lopez J, Meier J. Antihypertensive medication adherence in the department of veterans affairs. Am J Med. 2007;120:26–32. doi: 10.1016/j.
amjmed.2006.06.028
57 Mulhem E, Lick D, Varughese J, Barton E, Ripley T, Haveman J. Adherence to medications after hospital discharge in the elderly. Int J Family Med.
2013;2013:901845. doi: 10.1155/2013/901845
58 Poon IO. Effects of antihypertensive drug treatment on the risk of dementia and cognitive impairment. Pharmacotherapy. 2008;28:366–375. doi: 10.1592/
phco.28.3.366
