Anxiety-depressive syndrome in patients with arterial hypertension and chronic obstructive pulmonary disease with frequent exaccations

Background. In patients with frequent exacerbations of chronic obstructive pulmonary disease occurring against the background of hypertension, there is a high level of personal neuroticism, the presence of signs characteristic of a depressive response in the emotional state and behavior, as well as a decrease in the need for communication and significant changes in the emotional state. Objective. To reveal psychosomatic features of the course of arterial hypertension in chronic obstructive pulmonary disease with frequent exacerbations.

Materials and methods. The observational analytical cohort study included 183 patients with AH and chronic obstructive pulmonary disease aged 45-60 years, from Novosibirsk City Clinical Hospital No. 2, which were divided into 2 groups I – arterial hypertension and chronic obstructive pulmonary disease without frequent exacerbations and II – Hypertension with frequent exacerbations of chronic obstructive pulmonary disease (more than 2 times a year. Data from home and "office" blood pressure monitoring and psychodiagnostic tools were evaluated. Anxiety and depression status was assessed using validated diagnostic methods: the Hospital Anxiety and Depression Scale and the Hamilton Rating Scale for Depression.In addition to the formalized automated evaluation of the above criteria, an expert evaluation of psychological testing data was carried out. Computer analysis of the results of this study was carried out using the SAS, USA statistical software package using standard variational algorithms. statistics. When analyzing intergroup differences in indicators measured on an interval scale, the values of Student's t-test were calculated using the corresponding formulas.

Results. The presence of a statistically significant frequency of anxiety-depressive syndrome was revealed in persons with frequent exacerbations of chronic obstructive pulmonary disease in arterial hypertension, so, according to the results of the Hospital Anxiety and Depression Scale "Mixed anxiety and depressive disorder", it was noted in 68%, significantly (p < 0.05) more often in compared with patients with hypertension and chronic obstructive pulmonary disease without frequent exacerbations. Of these, 72% of patients had an anxiety syndrome and 32% – a depressive syndrome, p < 0.001 and p = 0.001, respectively. It was found that in persons with frequent exacerbations of chronic obstructive pulmonary disease and anxiety-depressive syndrome, uncontrolled hypertension was detected significantly more often than in those examined without TDS (p < 0.0001). It has been proven that persons with signs of TDS had higher levels of SBP (p < 0.003) compared to persons without TDS (p = 0.001). To clarify the nature of depressive disorders, the Hamilton Rating Scale for Depression was used, according to which depressive disorders of 77% were found in most patients of the 2nd group (p = 0.003). An expert evaluation of psychological testing data showed that subclinical depression was observed in 24%, clinically significant depression was observed in 46%, and major depression in 8% of hypertensive patients with frequent exacerbations of chronic obstructive pulmonary disease.

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