Awareness of physicians about the management of elderly patients with arterial hypertension: results of an anonymous survey in the Russian Federation and the Kyrgyz Republic

Background. Frailty syndrome is a common condition among elderly patients. It is associated with increased risks of hospitalization, falls, and mortality. Despite its clinical significance, the syndrome remains underdiagnosed and underrecognized, particularly in the context of arterial hypertension (HTN) management in older adults. Objective. This study aimed to assess the awareness of practicing physicians in the Russian Federation (RF) and the Kyrgyz Republic (KR) regarding frailty syndrome and its role in managing elderly patients with HTN. Design and methods. An anonymous survey was conducted among 472 physicians (370 from RF and 102 from KR) using online forms in RF and paper questionnaires in KR. The survey included five questions evaluating knowledge of frailty syndrome, diagnostic practices, and treatment approaches to elderly patients with HTN. Statistical analysis involved chi-square tests and Fisher’s exact tests, where appropriate. Results. While 87,5 % of physicians were aware of frailty syndrome, only 37,5 % reported knowledge of its diagnostic criteria, and 23,1 % systematically evaluated it in clinical practice. Physicians from RF were more likely to consider glomerular filtration rate when prescribing antihypertensive drugs. Orthostatic hypotension was routinely assessed by 20 % of respondents, and half performed this evaluation only in symptomatic cases. Physicians expressed caution with beta-blockers, diuretics, and anticoagulants when treating elderly patients. Conclusion. The results underscore the insufficient implementation of frailty syndrome screening in routine care of elderly hypertensive patients. Despite its presence in clinical guidelines, actual use remains low. Educational interventions and the inclusion of frailty assessment in quality indicators are needed to improve elderly care practices.

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