Abstract
Background. The objective of this study was to analyze the influence of the living characteristics of large regions on the possible presence, awareness, management and control of hypertension at the individual level in the Russian population.Methods. Regional characteristics were obtained from the official website of the Federal State Statistics Service of Russia. Principal component analysis was used to reduce the dimensionality of data; it allowed defining 5 integral regional indices: Socio-Geographical, Demographic, Industrial, Mixed, Economic. Presence, awareness, management and control of hypertension were assessed according to the data of the cross-sectional stage of ESSE-RF study that was conducted in 2013-2014. The final sample included 19,791 patients from 12 regions of Russia. Generalized estimation equations were used to determine associations between regional indices and presence, awareness, management and control of hypertension at the individual level taking into consideration nested data structures (individuals in regions).Results. The Socio-Geographic Index demonstrated the positive impact on hypertension among male (OR = 1.18; 95% CI: 1.05-1.32), undereducated individuals (OR = 1.14; 95% CI: 1.02-1.27) and elderly people (OR = 1.16; 95% CI: 1.02-1.32). Awareness of hypertension is positively associated with Demographic (OR = 1.13; 95% CI: 1.02-1.25) and Industrial Indices (OR = 1.15; 95% CI: 1.01-1.33). Worsening of social environment (Socio-Geographic Index) reduces adherence to management (OR = 0.76; 95% CI: 0.64-0.90) and control of hypertension (OR = 0.79; 95% CI: 0.69-0.90). Impact of regional living conditions on the prevalence of hypertension is not high, compared to the individual predictors, but for the awareness, treatment and control of hypertension, this influence is important.Conclusions: The study performed allowed assessing the influence of living characteristics of the population in the large regions of Russia on the prevalence of hypertension and on the awareness, management and control of this disease. The data obtained provide new knowledge not only in terms of epidemiology of cardiovascular diseases in Russia but also in general, that is, in the context of studying the influence of living conditions on the health of population.