J Epidemiol Community Health doi:10.1136/jech.2010.111377
  • Research report

Irregular treatment of hypertension in the former Soviet Union

  1. Martin McKee1
  1. 1European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK
  2. 2Stockholm Centre on Health of Societies in Transition (SCOHOST), Södertörn University, Huddinge, Sweden
  3. 3Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
  1. Correspondence to Bayard Roberts, European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, 15–17 Tavistock Place, London WC1H 9SH, UK; bayard.roberts{at}
  • Accepted 29 July 2010
  • Published Online First 4 November 2010


Background The USSR failed to establish a modern pharmaceutical industry and lacked the capacity for reliable distribution of drugs. Patients were required to pay for outpatient drugs and the successor states have inherited this legacy, so that those requiring long-term treatment face considerable barriers in receiving it. It was hypothesised that citizens of former Soviet republics requiring treatment for hypertension may not be receiving regular treatment.

Aims To describe the regularity of treatment among those diagnosed with hypertension and prescribed treatment in eight countries of the former Soviet Union, and explore which factors are associated with not taking medication regularly.

Methods Using data from over 18 000 respondents from eight former Soviet countries, individuals who had been told that they had hypertension by a health professional and prescribed treatment were identified. By means of multivariate logistic analysis the characteristics of those taking treatment daily and less than daily were compared.

Results Only 26% of those prescribed treatment took it daily. The probability of doing so varied among countries and was highest in Russia, Belarus and Georgia, and lowest in Armenia (although Georgia's apparent advantage may reflect low rates of diagnosis). Women, older people, those living in urban areas, and non-smokers and non-drinkers were more likely to take treatment daily.

Conclusions A high proportion of those who have been identified by health professionals as requiring hypertension treatment are not taking it daily. These findings suggest that irregular hypertension treatment is a major problem in this region and will require an urgent response.


  • Funding The LLH Project was funded by the European Community under the FP5 horizontal programme ‘Confirming the International Role of Community Research’ (INCO2-Copernicus; contract no: ICA2-2000–10031, project no: ICA2-1999–10074). However, the European Commission cannot accept any responsibility for any information provided or views expressed.

  • Competing interests None declared.

  • Ethics approval This study was conducted with the approval of the London School of Hygiene and Tropical Medicine.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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