Introduction. The present research covers data and analysis on implementation of the "Algorithm of computer program for personalized dynamic observation of hypertensive patients in primary health care". In the health care system of Uzbekistan, as well as in the systems of other countries throughout the world, AH is a topical issue. Study objective: To increase the effectiveness of treatment and clinical observation of patients with hypertensive disease (HD) in primary health care settings. Material and methods: In the process of research data (for the past five years) of 222 randomly selected medical histories of patients with arterial hypertension, being under regular medical examination in family polyclinics (n=54) and in some rural health clinics of the Republic of Uzbekistan (n=168), was analyzed. Results of the analysis of the medical histories were compared with the results of examination of patients (questioning, medical examination, anthropometry, measurement of blood pressure, cholesterol test, etc.). Results and discussion: All the patients have been under the supervision for 2 years with subsequent repeated check-up and medical examination. In the core group (patients aged from 45 to 71 years, average age - 51.75 + 1.85 years; 29.5% males, 70.4% females), the patients were broken down by stages as follows: Stage I hypertensive disease - 45 (36, 8%) patients; Stage II hypertensive disease - 62 (50.8%) patients; Stage III hypertensive disease - 15 (12.2%) patients. Hypertensive crisis was observed in 40 (32.7%) patients. The experimental group consisted of 114 patients (80 (70.1%) females and 34 (29.8%) males, aged 44-75 years, average age - 52.6 ± 1.62 years), they were treated by the traditional method and did not participated in the training. In the core group, as opposed to the experimental group, there were positive changes in the lipid profile: the number of arterial hypertension patients with hypertriglyceridemia decreased from 19.6% to 11.4% (p <0.001); the number of arterial hypertension patients hypercholesterolemia decreased from 56.5% to 27.0% (p <0.001). Taking into account the peculiarities of the existing model of prophylactic medical observation and using the accumulated data of numerous evidence medicine-based scientific studies of recent years, we have improved (personalized) and implemented into the inpatient practice of PHC physicians the individual tactic to observe hypertensive patients. For this purpose, there was developed the algorithm of a computer program to identify and individual tactic for dynamic observation of hypertensive patients, adjusted to PHC settings. Conclusions: The organization of training at the "school for hypertensive patients" led to a significant increase in the number of hypertensive patients with constant self-monitoring of blood pressure. The algorithm of electronic program for personalized dynamic observation of hypertensive patients was created on the base of obtained results of anamnesis, anthropometry, and laboratory and instrumental tests. Implementation of the algorithm of electronic program creates the possibility of routine detection of abnormal changes in the health status of hypertensive patients in the early stages of their development and the reasons of inadequate disease control. This increases the effectiveness of HD prevention and treatment at the primary health care level.
1. Andreyev A.N. and others. "Health school" for patients with arterial hypertension: the results of work in the conditions of the district polyclinic // Cardiovascular therapy and prevention. – 2009. - №5 (3). - p.15-21. 2. Baksheyev V.I., Kolomoes N.M. Hypertension and coronary heart disease – a problem of a doctor and a patient – Moscow, BINOM Publishing House, 2015. – p.488. 3. Boysov S.A., Deyev A.D., Shalnova S.A. Mortality and risk factors for the development of non-infectious diseases in Russia: peculiarities, dynamics, prognosis. Scientific publication\\Therapeutic Archive\\- 2017. – Vol. 89, №1. - p. 5-13. 4. WHO. Report on the global situation of non-infectious diseases, 2010. Executive summary [electronic resource]. Access: http://www.who.int/nmh/publications/ncd_report 2010/r u/index.html (date of address 26.09.2017). 5. Gavrilyuk E.V., Konoplya A.I., Karaulov A.V. Role of immune disorders in the pathogenesis of arterial hypertension//Immunology. - 2016. - №1. - p. 29-35. 6. Drapkina O.M. Features of arterial hypertension course and treatment in elderly patients with metobolic syndrome//Farmatek. - 2010. - №8. - p. 39–44. 7. Yerina A.M. Prehypertension and cardiometabolic risk factors (from ESSE-RF study): scientific publication//Arterial hypertension. – SP, 2017. – Vol. 23,№3. - p. 243-252. 8. Zinatullina D., Sadreyeva S. Modified risk factors for arterial hypertension in rural residents. Scientific publication//Physician. – M., 2017. - №3. - p. 79-82. 9. Kalinina A.M. School of health for the patients as a factor in improving the effectiveness of arterial hypertension control//Difficult Patient. -2006.-№8. 10. Kurbanov R.D., Mamutov R.SH., Epidemiology of Cardiovascular Diseases // Textbook, Clinical Cardiology. Chapter 16. – Tashkent, 2007. - p. 438. 11. Kurbanov R.D., Mitropolskaya I.O., Mamutov R.SH., Yarmuxamedova G.X. Arterial hypertension prevalence, risk factors and their relationship to mortality (prospective study).//Improvement of prevention, diagnosis and treatment of major cardiovascular diseases. Optimization of cardioservice activity (May 23-24, 2003). - Tashkent, 2003. - 104 p. – S. 53-55. 12. Mamutov R.SH., Mamaradjapova D.A. Prognostic significance of risk factors and anamnestic data on mortality of patients with stable angina during 5-years of prospective observation (fragment of oks/oim register). Republican Specialized Centre of Cardiology, Tashkent, Uzbekistan//Eurasian Cardiology Journal. - 2017. – p.43-48. 13. Orlov A.V. Connection of food behavior principles and risk factors of cardiovascular diseases // A.V. Orlov, O.P. Rotar, Y. P. Kolesova [and others] // Russian National Congress of Cardiologists. Cardiology: from science to practice. Materials of the Congress. - 2013. - p.413. 14. Tulaboyeva G.M. Effectiveness of magnesium preparation in ischemic heart disease. Scientific publication//Tulaboyeva G.M., Nuralieva D.M.//Therapeutic Bulletin of Uzbekistan. – Tashkent, 2017. -№2. - p. 64-68. 15. Ushakov A.V., Ivanchenko V.S., Gagarina A.A. Features of arterial pressure daily profile and heart rate variability in patients with arterial hypertension depending on the level of physical activity and psychoemotional tension: scientific publication//Russian Cardiology Journal. - M., 2017. – Vol. 144, №4. - p. 23-28. 16. Chazova I. E., Jernakova Y.V., Oshepkova E.V. [i dr.]. Risk factors of cardiovascular diseases in patients with arterial hypertension of the Russian population.//Cardiology. – 2014. - Vol. 54, № 10. 17. Shilov A.M. Arterial hypertension in the primary health-care link: course for effective treatment with combined antihypertensive drugs//Farmatek. — 2013. - №13. — p. 54–60. 18. Bondanelly M. Pathogenesis and prevalence of hypertension in acromegaly / M.Bondanelly, M.R. Ambrosio, E.C. Degli-Uberti // Pituitary. – 2001. – Vol.4. –P.239-249. 19. Circulating vascular growth factors and central hemodynamic load in the community / J.P. Zachariah [et al.] // Hypertension. – 2012. – Vol.59. – P.773-779. 20. Effects of comprehensive lifestyle modification on diet, weight, physical fitness, and blood pressure control: 18-month results of a randomized trial / P.J. Elmer [et al.] //Ann. Intern. Med. – 2006. – Vol.144. – P.485-495. 21. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD – Summary. The Task Force on diabetes, prediabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD) //European Heart Journal. – 2013. – Suppl. –Р.1-32. 22. Five-year findings of the hypertension detection and follow-up program. III.Reduction in stroke incidence among persons with high blood pressure / Foster R.R. The importance of cellular VEGF bioactivity in the development of glomerular disease / R.R. Foster //Nephron Exp. Nephrol. – 2009. – Vol.113. - P.8-15.284. 23. Identification of polymorphisms within the vascular endothelial growth factor (VEGF) gene: correlation with variation in VEGF protein production / C.J. Watson, Identification of validated questionnaires to measure adherence to pharmacological antihypertensive treatments / В. Pérez-Escamilla [et al.] //Patient Prefer. Adherence. – 2015. – Vol. 9. – Р.569-578. 24. Mazóny P. Hypertension in Spanish women: analysis of data collected by the Spanish society of cardiology section of arterial hypertension / Р. Mazóny, V.Bertomeu //Rev. Esp. Cardiol. – 2010. – Vol.8. – Suppl.D. – P.30-37.
Gulyamova, Shakhzoda S.; Gadayev, Adigaffar G.; Zakirkhodjayev, Rustam A.; and Ruzieva, Zebo I.
"ALGORITHM OF COMPUTER PROGRAM FOR PERSONALIZED DYNAMIC OBSERVATION OF HYPERTENSIVE PATIENTS IN PRIMARY HEALTH CARE,"
Central Asian Journal of Medicine: Vol. 2020
, Article 1.
Available at: https://uzjournals.edu.uz/tma/vol2020/iss1/1