The dissertation is devoted to the development of ways to optimize treatment of patients with arterial hypertension on the ambulatory-polуclinic level using evaluation of various factors that may influence blood pressure control in various unorganized cohorts in Ukraine. This study included 9870 patients from 62 cities in Ukraine. Treatment was prescribed by general practitioners in accordance with current national standards and protocols. In general, the patient included in the study had 4 visits. The following procedures were performed: anamnesis collection, anthropometric measurements, determination of office systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), electrocardiography, cardiovascular risk assessment, patient questionnaire on adherence to treatment and lifestyle, registration of side effects. In choosing the treatment the preference was given to relatively available antihypertensive drugs of domestic production. It was confirmed that the initial questionnaire of patients about adherence to treatment, as well as lifestyle questionnaire, can help to identify patients with a higher risk of non-effective of antihypertensive therapy, which would allow us to adjust the program for the management of such patients. In patients with initially high adherence to treatment modification of lifestyle can be an additional way to improve blood pressure control, and in patients with initially low and moderate adherence rationalization of antihypertensive therapy (using fixed combinations, minimization of adverse reactions), treatment of concomitant diseases and explanation to the patient the problem of AH along with the providing of written recommendations or notifications, involvement the family or the environment can help to improve BP control. Based on the factors found that were associated with poor blood pressure control and that also are characteristic of individual cohorts of patients with arterial hypertension, we have described facilities that are recommended to improve the effectiveness of antihypertensive treatment in these groups. In patients with diabetes we proposed a method for predicting the efficacy of therapy, which proposes to determine such factors such as SBP/DBP >160/100 mmHg, BMI >25 kg/m2, duration of physical activity less than 2.5 hours per week, adherence to treatment (defined by questionnaire) less than 75 %, age >60 years, which allows to predict the probability of insufficient control of blood pressure after 3 months. In the presence of at least one of the listed risk factors the probability to achieve target BP level decreased by 27 %, with two factors and more factors - by 35 %, three factors and more - by 47 %, four or more - by 75 %. Considering a slightly different distribution of factors associated with not achieving of target BP level it is recommended in various regions of Ukraine to develop methods aimed to optimize antihypertensive treatment, which should take into account these factors.
