THE IMPACT OF ANXIETY AND DEPRESSION ON THE MENTAL WELL-BEING OF PATIENTS WITH HYPERTENSIVE DISEASE

Abstract

Introduction: at present, hypertension is the most common non-infectious disease worldwide, with a progressively growing number of patients each year. This escalating prevalence results in increased disability and early mortality in both rural and urban populations. Currently, it is believed that psychosomatic disorders contribute to the progression of hypertension. Consequently, a comprehensive examination of this relationship is highly relevant. The aim of the research is to analyze the presence of anxiety and depression in patients with isolated and comorbid hypertensive disease and to determine their influence on mental well-being, depending on the territorial affiliation of the patients. Materials and methods: we analyzed the results of treatment of 152 patients with isolated and comorbid (ischemic heart disease, type 2 diabetes) course of hypertensive disease. These patients received medical care at the Municipal Enterprise “Poltava Regional Clinical Medical Cardiovascular Center of the Poltava Regional Council” between 2018 and 2022. We categorized these patients into three groups based on the course of hypertension. Group 1 consisted of 45 patients with an isolated presentation (26 (57.8%) residing in urban areas and 19 (42.2%) in rural settings). Group 2 comprised 68 patients with a combined presentation of hypertension and coronary heart disease, with an even distribution between urban (34 (50.0%)) and rural (34 (50.0%)) backgrounds. Group 3 encompassed 39 patients with a combined presentation of hypertension, coronary heart disease, and type 2 diabetes, with 24 patients (61.5%) from urban areas and 15 (48.5%) from rural areas. Patients in all groups were comparable in terms of age (ranging from 22 to 85 years), gender, and disease duration. Anxiety and depression levels were assessed using the HADS scale, and quality of life was evaluated using the SF-36 scale through self-questionnaires. Results: the study revealed a notable decline in the mental component of quality of life as comorbidity increased, affecting both rural and urban residents. At the same time, a corresponding increase in the levels of anxiety and depression was observed with escalating comorbidity. A strong inverse correlation was established between the levels of anxiety and depression and all indicators of the mental component of quality of life (r from -0.94 to -0.91). Furthermore, the research highlighted that in patients with an isolated presentation of hypertension, psychosomatic factors exerted the most substantial influence on the mental health index (MH). In contrast, for patients with comorbid conditions, the presence of psychosomatic factors more frequently impacted the levels of social functioning (SF) and vitality (VT). Conclusions: Patients residing in rural areas who have comorbid conditions such as hypertensive disease, coronary heart disease, and type 2 diabetes are particularly susceptible to experiencing anxiety and depression.