The Course of Comorbid Essential Hypertension and Type 2 Diabetes Mellitus under the Inﬂuence of Psychosomatic Factors

Cherkun, M.; Катеренчук, І. П.

doi:10.30702/card:sp.2019.10.038/0331727

Cited by 3 publications

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“…людей. Взаємний вплив стресу, тривоги та депресії̈ негативно позначається на перебігу ССЗ, що призводить до зниження працездатності та рівня якості життя пацієнта [6,7,8,9].…”

Section: вступunclassified

Influence of Anxiety and Depression on the Physical Component of the Quality of Life of Rural and Urban Population With Comorbid Hypertension

Cherkun

2023

Act. Probl. of the Modern Med.

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The aim of this study is to determine the presence of anxiety-depressive disorders in patients with hypertension and to determine their impact on the physical component of health, depending on the place of their residence of patients. Participants and methods. The study included 152 patients with hypertension and its comorbid conditions who received treated at the Poltava Regional Clinical Medical Cardiovascular Centre from 2018 to 2022. The patients were divided into three groups based on the progression of hypertension and were subsequently evaluated for anxiety and depression. Additionally, their physical component of quality of life was assessed using a questionnaire, with separate analyses conducted for residents in rural and urban settings. The study has found that the level of the physical component of quality of life significantly (p<0.05) decreases with increasing comorbidity. It has been also revealed that the level of anxiety and depression affects the indicators of the physical component of quality of life (r>0.90). A clinically significant difference (10 points or more) has been be noted in patients with comorbidities between hypertension, coronary heart disease, and type 2 diabetes mellitus living in urban and rural areas. Thus, the physical functioning (PF) score was higher in urban residents and amounted to 56.5±1.1 (95% CI 54.1-58.9) versus 44.8±1.8 (95% CI 41.0-48.6) (p<0.05) in rural residents; and the general health (GH) score was similarly higher in urban residents 48 (43.5-52.5) vs. 38 (35-48) in rural residents (Mann-Whitney U test - 61, p<0.001). Thus, manifestations of anxiety and depression were more often observed in patients from rural areas with comorbid hypertension.

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Influence of Anxiety and Depression on the Physical Component of the Quality of Life of Rural and Urban Population With Comorbid Hypertension

Cherkun

2023

Act. Probl. of the Modern Med.

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“…У хворих терапевтичного профілю найбільш несприятливим слід вважати поєднання та/або приєднання так званих «хвороб цивілізації» -АГ, ожиріння, ЦД 2-го типу до різноманітних реакцій на стрес або РА, що знаходить відображення у численних закордонних публікаціях [16][17][18][19][20][21][22]. Значну увагу цьому питанню при-діляли і відомі українські терапевти, ендокринологи та кардіологи [23][24][25]. При цьому зв'язки, первинність або вторинність внеску кожного з вищенаведених компонентів діагнозу у поширеність, захворюваність, інвалідність та смертність від коморбідної патології залишаються вивченими вкрай недостатньо.…”

Section: ) пролонгована депресивна реакція (F4321) змішана тривожна і...unclassified

Adjustment disorders, hypertension and type 2 diabetes: a cardiologist’s view (literature review)

Miloslavsky,

Koval

2023

Mìžnarodnij endokrinologìčnij žurnal

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The role of the stress factor and adjustment disorders among patients of a very high-risk group, namely with hypertension against the background of type 2 diabetes, was examined in the review of domestic and foreign sources of literature from the PubMed database. The authors provide data on the classification and terminology of adjustment disorders in this category of patients, and the contribution of the stress factor and activation of neurohumoral systems in their formation is considered in the historical aspect. The issue of the role of such adjustment disorders as anxiety, depression, sleep disorders, violent behavior in the family, at work is considered separately in terms of the negative course and progression of these dangerous diseases. Data are given on a number of non-modifiable and modifiable risk factors, namely genetic, haemodynamic, neurohumoral, hormonal and cardiometabolic characteristics of patients, prevalence, morbidity and mortality from complications of hypertension and type 2 diabetes in the presence of adjustment disorders; a brief description of diagnostic and preventive approaches to the correction of adjustment disorders among patients at a very high risk are described from a cardiologist’s standpoint.

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“…Станом на 2010 рік, кількість міського та сільського населення України, що хворіють на гіпертонічну хворобу, становило 29,6 % та 36,3 %, при цьому, досягнення цільових значень артеріального тиску (АТ) на фоні лікування вдалося лише у 15,0 % та 8,0 % відповідно. [3,4,5]. Дослідження вітчизняних та іноземних науковців доводять, що зниження АТ до цільового рівня супроводжується зменшенням частоти виникнення судинних ускладнень, зокрема, гострого інфаркту міокарда та цереброваскулярних подій [6,7,8,9].…”

Section: вступunclassified

“…Неабиякої актуальності це завдання набуває у хворих на хронічні неінфекційні захворювання з коморбідним перебігом, лікування яких є тривалим і в переважній більшості випадків триває все життя. [5]. Завдяки високій об'єктивності, простоті в застосуванні, для оцінки прихильності пацієнтів до призначеної терапії використовується удосконалена шкала оцінки прихильності пацієнтів до лікування 8-item Morisky Medication Adherence Scale (MMAS) (D.Е.…”

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Factors Influencing Treatment Noncompliance in Hypertension Management Among Rural and Urban Residents

Cherkun¹

2023

Act. Probl. of the Modern Med.

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Introduction: Hypertension is a prevalent health concern in both rural and urban populations, with varying rates of prevalence and treatment outcomes. This study aims to examine the factors contributing to decreased adherence to antihypertensive therapy among patients living in rural and urban areas. Essential arterial hypertension or hypertension is the most common cardiovascular cause of death in the population. It develops in more than half of the world's population over the age of 50, and affects 65% of men and 75% of women over the age of 70. The prevalence of hypertension is higher among rural residents (36.3%) compared to urban residents (29.6%). However, achieving target blood pressure values is a challenge for both groups, with only 8% of rural patients and 15% of urban patients reaching their treatment goals as reported in 2010. According to practicing doctors, the main reason for failing to reach target blood pressure levels is the low adherence of patients to their prescribed antihypertensive therapy. This noncompliance with treatment poses a significant obstacle to effective hypertension management. The article presents findings from an analysis of treatment adherence among 152 patients categorized into three groups: essential arterial hypertension (Group 1), hypertension and coronary heart disease (Group 2), and comorbidity between hypertension, coronary heart disease and type 2 diabetes (Group 3). The study included both urban and rural residents. Adherence to treatment was assessed using the 2008 8-item Morisky Medication Adherence Scale (MMAS-8) questionnaire. The analysis revealed distinct factors influencing adherence based on the patient's territorial affiliation. In the rural setting (Group 1), the primary reason for decreased adherence was patients independently discontinuing antihypertensive medication without notifying their doctor. In the urban setting (Group 1), patients tended to forget to take their medication as prescribed. In Group 2 (urban), challenges were observed in remembering the correct time for taking antihypertensive drugs, while rural patients in the same group tended to independently alter the dosage or discontinue medication. In Group 3 (urban), urban residents reported forgetting to take medication when away from home, whereas rural residents faced fewer difficulties in remembering their medication schedule. The research findings indicate that low adherence to antihypertensive therapy is not solely influenced by territorial affiliation or the specific course of hypertension. However, a notable factor affecting treatment adherence among both rural and urban residents is the more mobile lifestyle commonly observed in urban areas. Addressing the issue of low adherence to antihypertensive therapy requires tailored interventions that consider the unique challenges faced by rural and urban populations. Strategies should focus on improving patient education, enhancing medication reminders, and promoting better communication between patients and healthcare providers. By addressing these factors, it is possible to improve treatment adherence and subsequently enhance hypertension management outcomes for both rural and urban residents.

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The Course of Comorbid Essential Hypertension and Type 2 Diabetes Mellitus under the Inﬂuence of Psychosomatic Factors

Cited by 3 publications

References 0 publications

Influence of Anxiety and Depression on the Physical Component of the Quality of Life of Rural and Urban Population With Comorbid Hypertension

Influence of Anxiety and Depression on the Physical Component of the Quality of Life of Rural and Urban Population With Comorbid Hypertension

Adjustment disorders, hypertension and type 2 diabetes: a cardiologist’s view (literature review)

Factors Influencing Treatment Noncompliance in Hypertension Management Among Rural and Urban Residents

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