Professor Pershukov heads the Department of Hospital Therapy and also oversees radiological diagnostics and oncology at Jalal-Abad State University. He also serves as the Deputy Director for Research at the Southern Regional Scientific Center for Cardiovascular Surgery.
According to statistics from the World Health Organization and the World Heart Federation, arterial hypertension has become one of the most common non-communicable diseases of the 20th century, and its impact continues to grow in the 21st century. Adult men over 40 and women over 50 in various countries suffer from persistent high blood pressure, with every second person affected.
In 2017, experts from the American College of Cardiology and the American Heart Association revised the criteria for defining elevated blood pressure, lowering the norm from 140/90 to 130/80 mmHg. This change added 30 million new hypertension patients in the U.S., increasing the total number from 72 to 102 million.
However, according to current treatment guidelines for hypertension in the U.S. and Europe, about 20% of patients suffer from "resistant" hypertension, which does not respond to treatment even with three different classes of medications. This condition increases the risk of serious cardiovascular complications, such as heart attack and stroke.
Effective management of arterial hypertension symptoms requires modern antihypertensive medications, as indicated in medical guidelines worldwide, which educate students and professionals.
But how realistic is it to cope with hypertension, especially in its resistant forms? A study of pharmacy networks in two southern regions of Kyrgyzstan (Osh and Jalal-Abad) showed that out of more than ten surveyed pharmacists, only a limited number of medications are available on the market, primarily inexpensive and less effective options.
From the class of angiotensin-converting enzyme inhibitors, only four medications were found for sale (captopril, enalapril, perindopril, lisinopril), significantly limiting the choices for doctors. In the category of angiotensin II receptor blockers, only two out of eight possible medications (losartan and valsartan) were found, with more potent options absent.
In the group of calcium channel antagonists, only three medications from one subgroup (dihydropyridines: nifedipine, amlodipine, lerkanidipine) were available, with other subgroups not represented.
The selection of diuretics was also limited: only hydrochlorothiazide, indapamide, furosemide, and torsemide were on the market, and all of them are short-acting.
There were extremely few beta-blockers available: only bisoprolol and nebivolol, while metoprolol was found in only two pharmacies.
In such conditions, effective treatment of hypertension, especially its complicated forms and resistant cases, seems extremely challenging.
At the same time, official data shows that cardiovascular diseases remain the leading causes of mortality in the country. As long as the range of available medications is limited, the situation will not change.
Medications are vital for many people in modern society. To ensure a working population and sustainable regional development, the country needs accessible and effective medications, as well as constant quality control. New drugs must not only be widely available but also well-known to local specialists. While the current selection remains limited, it will be important to update doctors' approaches to therapy selection when innovations become available on the market.
