Treatment of hypertensive patients in Russian real-world practice based on the data from 2025 blood pressure measurement campaign

Aim. To evaluate the features of antihypertensive therapy (AHT), adherence to therapy and achievement of target blood pressure (BP) in patients with hypertension (HTN) in Russian real-world practice after the implementation of 2024 Russian clinical guidelines on hypertension in adults. Material and methods. During May 2025, 7990 patients with HTN from 19 Russian cities and Tiraspol (Pridnestrovian Moldavian Republic) took part in the BP measurement campaign. Outpatients with HTN over the age of 18 voluntarily participated in the campaign. During the screening, BP and pulse were measured three times using an automatic or mechanical BP monitor. In addition, a questionnaire was filled out on behavioral risk factors, BP self-monitoring skills, medication adherence, AHT, comorbidities and related therapy. The effectiveness of AHT was understood as achieving the target BP level <140/90 mm Hg in patients with HTN and taking AHT, and BP control — in all hypertensive patients, regardless of taking AHT. Results. The analysis included 7972 respondents aged 18 to 96 years (median age 62 years [51;71]), including 3372 men (42,3%). Among the participants, 74,4% took AHT, while 62,6% achieved target BP <140/90 mm Hg and 25,8% — target BP <130/80 mm Hg. On-demand therapy remains the leading reason for not taking AHT among patients with HTN. Approximately half of the participants (57,7%) answered that they do not use medication reminder systems. Most often, hypertensive patients use BP self-monitoring diaries and pill boxes. Every fifth patient with HTN was registered as taking antihypertensive monotherapy, every third as dual AHT, and every fourth as triple AHT. Single-pill combinations were taken by 34,5% of patients. In outpatient practice, following sex differences were revealed: significantly higher prevalence of taking AHT, using AHT reminder systems, discussions with a doctor, and the effectiveness of treatment and control of HTN were characteristic of female patients. Discussion with a doctor about the importance of following recommendations was associated with a significantly higher achievement of target BP level (odds ratio (OR) 1,43), the use of a single-pill AHT combination (OR 1,3) and statin therapy (OR 1,39), p<0,0001. Conclusion. In outpatient practice after the implementation of 2024 Russian clinical guidelines for HTN, an increase in the coverage and efficacy of AHT, and the HTN control is observed compared to the population data of 2020-2022. AHT prescription profile indicates a decrease in the share of monotherapy and an increase in the share of triple combination. The use of single-pill antihypertensive combinations is growing, but remains insufficient. The results obtained demonstrate the importance of discussing with a physician the need to comply with recommendations in hypertensive patients to improve adherence and treatment effectiveness.