Peculiarities of the Hypertension Course in Patients with high Level of Anxiety

Introduction. Arterial hypertension (AH) keeps the leading position in the list of the most common diseases of the cardiovascular system. AH often is accompanied by psycho-emotional disorders of different expression level. Aim. Determination of the psycho-emotional status of the patients with AH and the characteristics of AH course in patients with a high level of anxiety. Materials and methods. The study involved 70 patients with essential hypertension aged 33-81 years (mean age 61.1 ± 1.4 years), including 47 women (67.1%) and 23 men (32.9%). The average duration of AH was 9.6 ± 0.7 years. In addition to the standard questionnaire the survey for the self assessment was conducted using the Spielberger-Hanin scale to assess reactive (RA) and personal (PA) anxiety, which was assessed as low (less than 30 points), moderate (31-45 points) or high (46 points and more). The control group was composed of 18 healthy volunteers with an average age of 33.4 ± 3.3 years. Results. It was determined that the additional risk factors of cardiovascular complications in the patients with high levels of PA include: high blood pressure, abdominal obesity, elevated glucose levels, frequent hypo- or hypercholesterolemia, more frequent detection of diabetes mellitus. These include the more frequent concentric left ventricular hypertrophy, which is now recognized as the cause of an adverse prognosis and the least survival. Determining the level of PA, which is simple and informative, allows you to predict the nature of the course of the AH. Patients with AH with a high level of PA are more likely to experience AH crisis, higher systolic and diastolic blood pressure, complaints of high sweating and palpitations during the exercises, obesity of the III degree, in peripheral blood analysis – leukocytosis and anemia, higher glucose levels, very low and very high total cholesterol levels. In high PA ​​conditions, a larger Sokolow-Lyon index on ECG, a smaller diastolic diameter, but a larger relative thickness of the left ventricular wall on the echocardiography, is more likely to result in concentric remodeling and concentric left ventricular hypertrophy. Conclusions. It has been found out that 70,0 % of patients have a high level of anxiety and have significantly more risk factors for cardiovascular complications (higher levels of systolic and diastolic blood pressure, often detection of hyperglycemia, hypo- and hypercholesterolemia, more often deveopment of concentric left ventricular hypertrophy) than patients with moderate level of anxiety.