Possibilities of interdisciplinary approach to early detection of asymptomatic arterial hypertension

• Published in: CardioSomatika Vol. 9; no. 4; pp. 26 - 30
• Main Authors: Leshchuk, T. Yu, Gelberg, I. S, Kopuckij, A. V
• Format: Journal Article
• Language: English
• Published: Concilium Medicum 15.12.2018
• Subjects: asymptomatic arterial hypertension; digital fluorography; left ventricular enlargement; logit model
• ISSN: 2221-7185; 2658-5707
• DOI: 10.26442/22217185.2018.4.000015

The latent form - asymptomatic form of arterial hypertension occurs in the general population in 15% to 24% of individuals, is more often associated with men, increased body mass index, smoking, stress, increased systolic blood pressure (BP), hypertrophy and diastolic dysfunction of the left ventricle and is considered the most dangerous a form of the disease that can result in sudden cardiac arrest. Early detection of risk factors for hypertension is of great preventive and economic importance. Objective - to develop a method for early detection of a high risk of developing asymptomatic hypertension with preventive digital X-ray fluorography studies and an interdisciplinary approach. Based on the screening survey conducted in 1411 workers, a method for early detection of high risk factors for asymptomatic hypertension was developed based on statistical significant risk factors. Research was conducted among workers at the workplace of 6 urban enterprises, with the detection of an enlarged left ventricle (ELV) in screening of the subject contingent and measuring BP levels. With elevated BP, 604 (42.8%) workers were identified, and with ELV - 236 (16.7%) cases. The combination of elevated BP and ELV was significantly more frequent (160, 67.8%) than with normal BP (76, 32.2%). Based on the statistical analysis, a logistic regression model with a high residual deviance (about 84%) is constructed, which gives satisfactory forecasts. The diagnostic test of the model, with cutoff threshold equal to pо=0.397, corresponds to: sensitivity - 75.5%, specificity - 64.4%, accuracy - 69.2%. Thus, the use of the screening diagnostic method in the detection of ELV in combination with age in men of 28 years or in women from 39 years of age reveals a high risk of developing asymptomatic forms of hypertension. These patients are taken to the control and sent to the physician by the therapist to perform the pre-examination.