INFLUENCE OF PSYCHOSOMATIC FACTORS ON THE CLINICAL FEATURES OF COMORBID HYPERTENSION AND ADHERENCE TO ANTIHYPERTENSIVE THERAPY IN URBAN AND RURAL RESIDENTS
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i2.11342Keywords:
hypertension disease, anxiety, depression, psychosocial factorsAbstract
The aim – to determine the significance of the influence of psychosocial factors, namely anxiety and depression on the clinical course of hypertension in conditions of comorbidity and adherence to antihypertensive therapy in rural and urban residents.
Material and Methods. We examined and analyzed the treatment of 152 patients with hypertension who were on inpatient treatment at the Poltava Regional Medical Clinical Cardiovascular Center during 2018–2020. Patients were divided into groups depending on the isolated or combined course of hypertension, as well as on the place of residence, by age and gender. The presence of anxiety and depression was determined by using the hospital scale of anxiety and depression (HADS). Adherence to antihypertensive therapy were determined using the extended and modified the questionnaire Morisky-Green.
Results. A direct correlation was established (p>0.05) between the presence of anxiety and depression in one study group and the presence of comorbid pathology and does not depend on the territorial affiliation (p<0.001) of the studied patients. Based on gender characteristics, it was found that regardless of territorial affiliation, women are more likely than men to manifest anxiety or/and depression by almost 20.0 %. The decrease in the level of adherence had an inverse correlation with the growth of comorbid pathology and the presence and severity of anxiety and/or depression in the compared groups.
Conclusions. An isolated course of hypertension is less associated with psychosocial factors such as anxiety and/or depression, whereas with an increase in comorbidity during HD, there is a direct correlation between the growth of anxiety-depressive symptoms and concomitant CAD and type 2 diabetes. In all the studied groups, the tendency of urban residents to develop anxiety and depression in comparison with rural residents was revealed. Low adherence to treatment was associated with an increase in comorbid pathology and the presence of clinically expressed anxiety and depression.
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