Via practica 5/2025
Charter 70/2023 – final summary of challenges aimed at implementing and optimizing blood pressure control in patients with arterial hypertension in Slovakia
Introduction: Untreated or suboptimally managed arterial hypertension (AH) is one of the main triggers of the negative path of the cardiovascular (CV) continuum of the at-risk patient. Several factors are responsible for the manifestation of serious cardiovascular diseases (CVD). One of them is the important role of the patient in taking care of their blood pressure (BP). Healthcare professionals contribute complementary to the care of the patient with AH with their expertise within the scope of competence and treatment according to the latest recommendations, respecting a personalized approach. The sample consisted of 3018 patients with diagnosed and treated arterial hypertension (AH) (60.9 % without CVD, 39.1 % with CVD) with a mean age of 61,49 (± 11,64) (60, 42 years without CVD vs 69.7 years with CVD, p < 0.0001). Data were provided by 103 general practitioners (GPs).
Methodology: Standardized questionnaire with patient data (weight, height, age, education, duration of AH treatment, abuse), presence of dyslipidemia (DLP), CVD, concomitant treatment (AH, DLP), change in AH treatment in the last 3 months before inclusion and at the first visit, laboratory parameters (lipid profile, glycemia). Blood pressure was measured 3 times in a row at the first visit (V1) and the second visit (V2), the values from the second and third measurements were averaged. A template for measuring BP at home after education was given to the patient.
Objective: To determine the effect of education and strengthening the patient’s role through home monitoring on the resulting BP values, the percentage of patients achieving the first step of treatment (BP ≤ 140/90 mmHg), the second step of treatment (BP ≤ 140/80 mmHg in patients > 65 years, BP ≤ 130/80 mmHg in patients ≤ 65 years) and to map the structure of antihypertensive treatment. Results: Finally, 74 % of patients in 2023 reached the first step of treatment, the proportion globally increased by 28 % over time – 46 % in 2019 (1), 67 % in 2022 (2). The second step of treatment was reached by 38 % of patients. DLP and AH occurred simultaneously in 67 % of patients with AH. Another challenge is age-based BP control and rationalization of pharmacotherapy (fixed combination of antihypertensive tablets or polypill were absent in almost 35 % of patients).
Keywords: arterial hypertension, blood pressure target values, Charter 70/2023, home blood pressure monitoring, dyslipidemia, fixed combinations, polypill
