Arterial hypertension or hypertension type of neurocirculatory asthenia in persons of military age

The authors raise the urgent problem of the discrepancy between the conceptual apparatus and strategies for the management of military age persons with high blood pressure, examined by military medical examination, and the current recommendations on arterial hypertension of the Russian Society of Cardiology. The reader's attention is focused on the preventive concept of the Russian Society of Cardiology: the desire for early diagnosis of hypertension and the initiation of treatment even with grade 1 hypertension in the absence of target organ damage. The authors propose consideration of a medical examination of males aged 18–27 years, registered or not registered in the military, as one of the effective tools for the early diagnosis of arterial hypertension. The urgency of the problem is due to the unfavorable phenotype of arterial hypertension at a young age, in which target organ damage is involved early in the pathological process. The above excerpts from the “Regulations on the military medical examination No. 565” draw the attention of readers to two articles of paragraph 9 of the disease schedule: 43–hypertension and 47–neurocirculatory asthenia, characterized by increased blood pressure, creating confusion in the diagnosis. Literature data are presented confirming the ambiguity of the interpretation of elevated blood pressure in the group of people aged 18–27 years, the complexity of the diagnosis, and differential diagnosis of hypertension and neurocirculatory asthenia. At the same time, the diagnosis of neurocirculatory asthenia, according to the literature, is established quite often in this age group and reaches 75% in the structure of cardiovascular disease. The results of studies by Russian scientists, indicating a subclinical lesion of target organ damage in young people with neurocirculatory asthenia with hypertensive reactions, call into question the appropriateness of this diagnosis and management strategy. With modern diagnostic capabilities, an unreasonable lengthening of the examination time for people of military age, examined by a military medical examination to confirm the diagnosis of hypertension and timely initiation of antihypertensive therapy, is emphasized. The question is raised about the correctness and expediency of using the term "neurocirculatory asthenia" in people of military age with high blood pressure.