METABOLIC, PSYCHIC-VEGETATIVE DISORDERS AND QUALITY OF LIFE IN PATIENTS WITH ISCHEMIC HEART DISEASE AND ARTERIAL HYPERTENSION
DOI:
https://doi.org/10.11603/1811-2471.2019.v.i3.10439Keywords:
coronary heart disease, hypertension, metabolic and psycho-autonomic disorders, quality of lifeAbstract
SUMMARY. Nowadays, the presence of concomitant metabolic and psycho-autonomic disorders is a proven risk factor for worsening of the somatic status of patients with coronary heart disease (CHD) and arterial hypertension (AH), as well as a predictor of quality of life decline in this category of patients.
The aim − to study the peculiarities of metabolic, psycho-autonomic disorders and their influence on the quality of life of patients with coronary artery disease with hypertension.
Materials and Methods. A prospective monocenter, double-open, randomized study in parallel groups involved 56 coronary heart disease patients: stable exertional angina II – III functional class, comorbid with hypertension (median age 59.0 (54.0; 65.0)). Patients were divided into two groups: group 1 – 34 patients in combination with anxiety-depressive disorders (ADD) and group 2 – 22 patients without ADD. The quality of life study in CHD patients was conducted using the Seattle Questionnaire (SAQ) and the SF-36 questionnaire; detection of ADD – using the HADS Hospital Anxiety and Depression Scale; assessment of autonomic dysfunction – by determining the temporal and spectral parameters of heart rate variability (HRV).
Results. In patients with coronary artery disease and hypertension with ADD, more pronounced manifestations of metabolic syndrome (degree of obesity, atherogenic dyslipidemia, hyperglycemia) were observed, which had a direct correlation with the total level of anxiety and depression. Ventricular extrasystoles, significantly longer overall ST segment depression duration by 22.5 % (p<0.05), and deeper ST segment depression by 2.14 times (p<0, were more frequently reported in patients with coronary artery disease and hypertension). 05) compared with patients without ADD, autonomic imbalance with a decrease in overall heart rate variability, predominance of sympathetic link activity against the background of parasympathetic effects suppression. Patients with coronary artery disease with hypertension with ADD revealed a deterioration in the quality of life of patients according to the Seattle Questionnaire and the SF-36 general health questionnaire.
Conclusions. The presence of anxiety-depressive disorders in patients with coronary artery disease with hypertension is accompanied by more pronounced metabolic, ischemic disorders, autonomic imbalance and decreased quality of life of patients.
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