Hypercholesterolemia is a proven risk factor for atherosclerotic cardiovascular diseases and for their complications. Aim. To assess the quality of diagnosis and treatment of patients with severe hypercholesterolemia (total cholesterol >6.2 mmol/L) in the real outpatient practice. Material and methods. All patients with a diagnosis of arterial hypertension, ischemic heart disease, chronic heart failure, atrial fibrillation applied to primary care physicians or cardiologists in one of the randomly selected out-patient clinic of Ryazan in March-May 2012 and included into the RECVASA registry were enrolled into the study group (n=1642). Results. The group of patients with severe hypercholesterolemia consisted of 561 (44%) patients at the age of 67 (59-75) years [Me (25% -75%)]. At that, diagnosis of hyperlipidemia was indicated only in 9% of outpatient cards. Data of one or more blood chemistries including low density cholesterol (LDC) levels were presented only in 7% of outpatient cards. 83.7% of patients with severe hypercholesterolemia were classified as patients at high or very high cardiovascular risk, but statins were recommended only to 17.8% of them. Statins were mainly recommended in moderate doses; only one patient took atorvastatin 40 mg per day. Blood LDC levels were examined only in 5% of patients during statins therapy; nobody of them reached target LDC levels. Conclusion. The study data revealed the presence of a high prevalence of severe hypercholesterolemia in patients with cardiovascular diseases and poor quality of diagnosis and treatment in these patients in the real outpatient practice.

Aim. To assess the quality of arterial hypertension (HT) pharmacotherapy within the outpatient register RECVASA, emphasizing whether the choice of antihypertensive drugs (AHD) is in line with current clinical guidelines. Material and methods. Patients with HT without ischemic heart disease, chronic heart failure and atrial fibrillation (n=741) were selected from all patients (n=3690) included into the register. Among concomitant diseases were revealed the following: bronchial asthma and/or chronic obstructive pulmonary disease (COPD) – in 42 (5.7%) patients; obesity – in 93 patients, impaired glucose tolerance – in 9 patients, and diabetes mellitus – 84 patients. Prescription of AHD, their number and class were recorded at every next visit to doctor. Accuracy of AHD choice, compliance with current clinical guidelines, and other considerations were assessed through the example of beta-blockers (BBs). Results. AHD were prescribed to 641 patients, and in 13.5% of patients did not receive any AHD. 49.7% of patients received ACE inhibitors, 38.5% – diuretics, 32.5% – BBs. BBs were prescribed to the third part of patients with diabetes and obesity. Furthermore a quarter patients with COPD and the third part of patients with bronchial asthma received BBs. BBs in combination with thiazide diuretics were prescribed to 12 (41.4%) patients with diabetes mellitus and to 13 (40.6%) patients with obesity. Conclusion. Doctors do not always make AHD choice according to current clinical guidelines. Compliance of AHD choice with current clinical guidelines should be an element of treatment quality assessment.