Европейски конгрес по хипертония и сърдечно-съдова профилактика в Милано, Италия 2013 г.


St. Naydenov, Sv. Torbova, K. Ramshev, Sv. Tsonev, Sn. Tisheva,  Y.Yotov, V. Sirakova, N. Naydenova

Objective: Evaluation of arterial hypertension (AH) and concomitant risk factors (RF) in patients with and without previously diagnosed atrial fibrillation (AF) in Bulgarian urban population.

Design and method: A cross-sectional study, held on the 17th of May, 2012,  World Hypertension Day, organized by the Bulgarian Hypertension League with the joint support of the Association of the general practitioners in Bulgaria, Organization “Self-control” and the Association of the medical students in Bulgaria. Open-air stands were built up in the 4 largest Bulgarian cities.  Blood pressure (BP), waist circumference (WaC), height and weight were measured with body-mass index (BMI) calculated in 1185 volunteers, 536 (45.2%) males 649 (54.8%) females, mean age 56.7±18.5 years. The participants completed also a structured questionnaire.

Results: History of AH was present in 619 (52.2%) of all participants. Fifty-five (4.6%) of the hypertensives had concomitant AF, diagnosed previously in clinical conditions (p=N.S for males and females). The mean age of the hypertensives was 65.1±12.7 compared to 45.9±19.9 years of the participants without AH (p<0.05). Mean age of the hypertensives with AF was 70.1±10.1 years. The mean values of systolic and diastolic BP in the hypertensives without AF were 145.8±21.4/85.2±12.8 mmHg and 148.8±23.3/82.3±11.0 mmHg in the hypertensives with AF (p<0,05 for systolic BP). Heart failure had been diagnosed in 35 (6.2%) of the hypertensives without AF and in 12 (21.8%) of the hypertensives with AF. Diabetes mellitus type 2 was found in 90 (15.95%) of patients with AH without AF and in 22 (40.0%) of the patients with AH and AF. Mean values of BMI and WaC were 27.8±14.4 and 95.6±14.0 cm respectively in patients with AH without AF, and 28.0±3.8 and 98,6±13,7 cm in patients with AH and AF (p=N.S for BMI and WaC).

Conclusions: Patients with AH and AF in Bulgarian urban population are older, have higher BP, higher prevalence of concomitant cardiovascular RF and HF. Improvement of BP control is necessary for more effective prevention of AF in hypertensive patients.



Y. Yotov, Sv. Torbova, S. Naydenov, Sv. Tsonev, A. Postadjian,  V Sirakova, S Tisheva, F. Nikolov

Bulgaria is a country with constantly high total and cardiovascular (> 65%) mortality during the last decades. As a background for the aim of the study: to compare the  prevalence, awareness,  and control of arterial hypertension (AH) in Bulgarian urban population – 2007  and 2012 years. Participants and methods. The data from 2 cross-sectional epidemiologic studies, performed on the World Day of Hypertension – 17th May in the five largest Bulgarian cities, were compared. Structured questionnaire on AH, cardiovascular diseases, risk factors was filled in. Blood pressure (BP), waist circumference, height and weight were measured. Body mass index was calculated. Results. In 2007, 2514 citizens (1048 males and 1466 females), and in 2012, 1208 (450 males and 748 females) volunteered to participate. Mean age in 2007 was 55.06±16.65 years and 58.94±17.48 years in 2012 (p<0.0001). The mean systolic BP was 139.99±21.25 and 140.99±22.29 mmHg, respectively, for males; 132.13±22.09 and 136.93±93, for females (p<0.0001). Diastolic BP for males was 86.00±12.32 and 85.10±11.64 mm Hg, respectively; for females, it was 82.24±12.41 and 82.13±11.87 mm Hg (NS). Newly-diagnosed AH was detected in 15% (males 20% and females 11 %) in 2007, and in 2012 was 12%, for males – 17% and for females – 10% (NS). Known hypertension in 2007 was found in 42% in both sexes and in 2012 it was 57% (males 52% and females 60%), p<0.0001. AH (known and new) in 2007 was 72% and in 2012 was 69.5% (NS). Control of AH (BP<140/90 mm Hg) was achieved in 38% (35% males and 40% females) of the hypertensives in 2007 and in 34% (males 29%, females 40%) in 2012. In patients with AH and regular treatment in 2012, AH was controlled in 37% (males 30% and females 40%, NS). Conclusions. No difference in the overall prevalence, known and newly detected AH, is found in Bulgarian urban population between 2007 and 2012. Novel AH decreases slightly in 2012. The control of AH is consistently low, which corresponds to the steadily high cardiovascular mortality in the last 5 years. This requires complex interventions.


Healthy Life Style and Drug Treatment in Bulgarian Urban Population with Known Hypertension

Tsonev Sv, Sv. Torbova, S. Naydenov, Y. Yotov, A. Postadzyan, Sn. Tisheva

Objectives: To evaluate the life style and the drug treatment of the hypertensives subjects living in Bulgarian cities.

Design and methods: A cross-sectional study, performed  on  the 17th of May, 2012,  devoted to the World Hypertension Day, organized by the Bulgarian Hypertension League. Open-air stands were built up in the 4 of the largest Bulgarian cities. Voluntarily,1208 citzens  participated (450 males- 38% and 748 females- 62%), at mean age of 58.94 ±17.48 y. Blood pressure (BP) was measured   and a  structured questionnaire  completed.

Results: There were 678 subjects (56.9%) with known hypertension. From the hypertensives regular drug treatment declared by 610 (89%).  BP < 140/ 90 mmHg  or controlled hypertension was detected in 447 (37%) hypertensive patients. Data shows the following information for the healthy life style of the participants with known hypertension. Active smokers 102 (15.1%), exsmokers 101 (15%), passive smokers 5(0.7%). With sport activity were 117 (18.3%) hypertensives, walking- 376 (63%), home work- 178 (30.1%), gardening- 36 (6.1%). Fish eating once or twice weekly declared from 230 (34.2%) subjects, rarely-361 (53.6%), no fish- 80(11.9%). Fat consumption from  vegetable 190 (28.3%), from animal 42 (6.2%), mixed  439 (65.4%) hypertensive subjects. Number of  times eating each day : once- 19(2.8%), twice- 108 (16.1 %), tree- 428 (63.7%), four– 79 (11.8%), five times- 37 (5.6%).

Conclusions: Patients with AH in Bulgarian urban population have high prevalence of a regular drug treatment but with a very poor quality of healthy life style. Both approaches are with poor efficacy- only one of each three patients with known hypertension is controlled.