Features of the psychological status of patients with isolated and comorbid hypertensive disease and its impact on the quality of life of rural and urban residents

Abstract

Introduction. This article presents the results of our own research on the manifestations
of anxiety and depression in patients with isolated and comorbid hypertension, as well as
their impact on the quality of life of rural and urban residents.
Purpose. To examine the prevalence of anxiety and depression as psychosocial factors in
isolated and comorbid hypertension, and to evaluate their impact on the quality of life of
rural and urban residents.
Materials and Methods. A survey was made among 152 patients, who were divided into
three groups. The first group included patients with isolated hypertension (n = 45), of whom
26 (57.8%) were urban residents and 19 (42.2%) were rural residents. The second group
(n = 68) consisted of patients with hypertension complicated by ischemic heart disease, with an
equal distribution of rural and urban residents 34 (50.0%) ans 34 (50.0%). The third group (n =
39) comprised patients with comorbid hypertension, ischemic heart disease, and type 2 diabetes,
among whom 24 (61.5%) lived in urban areas and 15 (38.5%) in rural areas.
The levels of anxiety and depression were assessed using the Hospital Anxiety and Depression
Scale (HADS), while quality of life was evaluated through self-administered questionnaires followed
by the official version of the “Short Health Status Assessment Questionnaire” MOS SF-36 (2011).
The obtained results were analyzed separately in rural and urban patients with comorbid
hypertension at the beginning of treatment and three months after hospital discharge.
Results. In our study, among patients with isolated hypertension, clinical manifestations
of anxiety and depression were observed in 45.4% of cases, while 55.6% showed no such
symptoms. In group II, the absence of anxiety and depression was noted in a relatively
smaller proportion of patients (44.1%) compared with those who had isolated hypertension.
Anxiety manifestations were detected more frequently, whereas depressive disorders were
present in 5.8% of patients. In group III, a marked reduction in the proportion of patients
without signs of anxiety and depression was observed—only 13.3% among rural residents
and 8.3% among urban residents. Depressive manifestations were clinically pronounced
but did not differ significantly between rural and urban patients. Overall, the presence of
anxiety and depression significantly worsened the quality of life.
Conclusions. The presence of anxiety and depression, which is noted in almost half of rural
and urban residents, negatively affects the clinical course, and the comorbid course of arterial
hypertension causes an increase in the number of patients with severe arterial hypertension.