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Obsessive-Compulsive and Post Traumatic Avoidance Symptoms Influence the Response to Antihypertensive Therapy:
Anna Realdi1, Angela Favaro2, Paolo Santonastaso3
1Clinica Medica 4, Department of Clinical and Experimental Medicine, Policlinico Universitario, Via Giustiniani 2 35128 Padova, Italy. anna.realdi@gmail.com.
Insights
Uncontrolled hypertension is linked to low obsessionality and post-traumatic avoidance symptoms, potentially reducing treatment compliance. Type D personality, however, did not correlate with uncontrolled hypertension in this study.
Area of Science:
- Cardiology
- Psychology
- Internal Medicine
Background:
- Uncontrolled hypertension contributes significantly to cardiovascular morbidity and mortality.
- Psychological factors are increasingly recognized as potential contributors to hypertension management.
- Understanding these associations is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the relationship between uncontrolled hypertension and psychological factors.
- To examine the roles of Type D personality, depression, and post-traumatic stress symptoms.
- To identify psychological predictors of uncontrolled hypertension.
Main Methods:
- 205 hypertensive outpatients completed questionnaires assessing Type D personality, post-traumatic symptoms, and psychological traits.
- Uncontrolled hypertension was defined as clinic blood pressure >140/90 mmHg (or >130/80 mmHg with diabetes/nephropathy) despite adherence to multiple medications.
- Statistical analyses were used to identify predictors of uncontrolled hypertension.
Main Results:
- 39% of patients had uncontrolled hypertension.
- Lower obsessive-compulsive traits and higher post-traumatic avoidance symptoms predicted uncontrolled hypertension.
- Type D personality correlated with depression, hostility, and anxiety, but not with uncontrolled hypertension.
Conclusions:
- Uncontrolled hypertension is associated with low obsessionality and avoidance symptoms, potentially impacting treatment compliance.
- Type D personality, characterized by compulsiveness, was not found to be correlated with uncontrolled hypertension.
- A multidisciplinary approach is recommended to assess the impact of psychological profiles on hypertension compliance.
Aim:
To investigate the association of uncontrolled hypertension with psychological factors associated with high cardiovascular morbidity and mortality (type D personality, depression, posttraumatic stress-related symptoms).
Methods:
205 consecutive outpatient hypertensives completed three questionnaires evaluating Type D personality (DS 16), post traumatic symptoms (revised Impact of Events Scale), symptoms of anxiety, hostility, depression and obsessive-compulsive traits (subscales of the Symptom Checklist). Uncontrolled hypertension was diagnosed when clinic sitting blood pressure was above 140/90 mmHg (130/80 in the presence of diabetes or nephropathy), despite reported adherence to treatment with at least three antihypertensive medications, including a diuretic.
Results:
Uncontrolled hypertension (39%), was predicted by lower scores at Symptom Checklist obsessive-compulsive subscale and higher number of post traumatic avoidance symptoms, older age, diabetes, higher systolic pressure at first visit and longstanding hypertension. Type D personality correlated with depression, hostility, anxiety, compulsiveness, history of malignancy, and older age, but not with uncontrolled hypertension.
Conclusions:
Uncontrolled hypertension is associated with low obsessionality and avoidance symptoms, which reduce compliance to treatment. On the contrary, type D personality is not correlated with uncontrolled hypertension, as it includes compulsiveness, which improves compliance. A multidisciplinary approach to the hypertensive patient is mandatory to establish if the psychological profile affects compliance.
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