Life expectancy of patients of different ages with arterial hypertension and measures for its secondary prevention

BACKGROUND.  Arterial hypertension is, on the one hand, a disease requiring lifestyle changes, constant drug therapy, which worsens the quality of life of patients, and, on the other, an independent risk factor for the development of chronic non–communicable diseases. The greatest importance in determining the life expectancy of patients with hypertension is the complex effect of age-mediated rearrangements of organs and systems and the long-term damaging effects of blood pressure.

The importance of arterial hypertension as a factor determining the duration and quality of life is undeniable, but insufficient attention remains to the individual components of the external and internal environment that determine the course of hypertension.

OBJECTIVE. Analysis of the impact of certain medical and social factors on the average life expectancy of older patients with arterial hypertension in the Kursk region.

MATERIALS AND METHODS. The study material includes outpatient cards (form 025/y) of 449 deceased patients with hypertension (2014–2024). Of these, 117 from Kursk and 73 from the Kursk region in 2014–2019, 158 from Kursk and 101 from the Kursk region in 2020–2024. Analysis of the results ― MicrosoftExcel 2010.

RESULTS. The main indicator is the life expectancy of patients with hypertension served in multidisciplinary urban polyclinics for the period 2020–2024 reached (69.74 ± 0.97) year, that is, lower than in 2014–2019, when it was (72.12 ± 1.07) year. Similar changes in life expectancy can be traced in rural areas, where the observed patients received medical care mainly in outpatient clinics. So for the period 2020–2024. It was (68.42 ± 1.29) year, and in 2014–2019 it was (71.64 ± 1.26) year. Such unfavorable trends are determined by the complicated course of COVID-19 in older people and the antiepidemic limitations of preventive measures.

The influence of coronavirus infection can also be traced in the assessment of life expectancy with hypertension. So in 2020–2024 in Kursk it was (11.07 ± 0.52) year and in the Kursk region ― (9.13 ± 0.79) year. Which is lower than the values of the previous calendar period ― (14.38 ± 0.61) year and (13.82 ± 0.73) year, respectively.

Effective follow–up in 2020–2024 was only 47.24 % for the city of Kursk, 43.75 % for the Kursk region, that is, significantly lower than the values of the pre-epidemic period ― 84.06 % and 73.56 %, respectively.

The extremely negative aspects were the lack of recommendations on lifestyle changes in 2020–2024 in 46.18 % of cases in Kursk and 25.3 % in the Kursk region.

There is a similar trend in assessing involvement in regular health school attendance: in the period 2014–2019, the figure reached 22.45 % for urban residents and even higher ― 30.28 % ― among residents of the Kursk region. In 2020–2024 ― 10.8 % and 9.73 % in the city of Kursk and the Kursk region.

A positive trend has been noted over the past two years in the Kursk region as a whole ― the intensification of dispensary monitoring and patient involvement in health schools, but it is too early to assess the effectiveness of these trends.

CONCLUSION. Thus, the unsatisfactory restructuring of indicators characterizing life expectancy in the region was largely determined by the anti-epidemic limitations of COVID-19, when the quality and volume of preventive measures were significantly reduced due to the reorientation from prevention to treatment of urgent conditions.