MACROSOCIAL STRESSORS OF THE WAR PERIOD AS PREDICTORS OF MENTAL HEALTH DETERIORATION AND THE COURSE OF ARTERIAL HYPERTENSION IN PRIMARY CARE

Abstract

Purpose. To investigate the features of mental health of patients with hypertensive disease in conditions of mac- rosocial stress of martial law at the stage of primary medical care, to assess the relationship of psychoemotional disorders with the clinical condition of patients. Materials and Methods. 44 patients aged 49–64 years with confirmed stage II hypertension were examined. Psychoemotional state was assessed using the Hamilton Anxiety Scale (HAM-A), the HADS Depression and Anx- iety Scale, the Perceived Stress Scale (PSS-10) and the Hardiness Test (Muddy). Additionally, an analysis of the dynamics of somatic symptoms and blood pressure was performed. Statistical data processing was carried out using descriptive statistics, Student’s t-test and correlation analysis to determine the relationship between psy- cho-emotional and somatic indicators. Results. Most patients had an increased level of anxiety (75%), depressive manifestations (61.4%) and sub- jective stress (88.6%). The highest rates of psycho-emotional stress were found among women and middle-aged patients. Correlation analysis showed a close positive relationship between anxiety, depression and stress level (r = 0.47–0.54; p < 0.05), which confirms the integrated psychosomatic impact of stress on the course of hyperten- sion. Patients with a higher level of psycho-emotional stress had more frequent episodes of elevated blood pressure and worse hypertension control. Conclusions. Wartime macrosocial stress significantly affects the mental health of patients with hypertension, worsening blood pressure control and overall health. The results emphasize the need to integrate psychoemotional screening and brief interventions to reduce stress in primary care, which can increase treatment effectiveness and improve patients’ quality of life.