Role of mental disorders in achieving blood pressure control in patients with resistant hypertension

Abstract

Aim . To evaluate the relationship between the severity of anxiety and depressive symptoms and the achievement of target blood pressure (BP) in patients with resistant hypertension (RH). Material and methods . This open, prospective, single-center, 13-week study was conducted in 100 patients with RH. Anxiety and depressive symptoms were screened using the Hospital Anxiety and Depression Scale (HADS) and quality of life was assessed using the Short Form Health Survey (SF-36). Patients with clinically significant anxiety and depressive symptoms (n=50) comprised the study group and additionally received psychopharmacotherapy as prescribed by a psychiatrist. In the comparison group (n=50), patients continued standard antihypertensive therapy. Efficacy was assessed by achieving target BP, changes in office and home blood pressure, and the Clinical Global Impression (CGI) scale score. Results . Treatment of anxiety and depressive symptoms was a factor associated with achieving target BP (odds ratio, OR=18,75; 95% confidence interval: 1,51-232,30; p=0,022). To achieve target BP, patients in the study group required a smaller increase in the number of antihypertensive medications compared to the control group (p<0,001). A positive correlation was found between anxiety levels and baseline systolic BP (ρ=0,208, p=0,038). Assessment using the CGI demonstrated satisfactory tolerability of psychopharmacotherapy and a favorable benefit-risk ratio. Conclusion . Screening and treatment of anxiety and depressive symptoms in patients with RH can improve the effectiveness of antihypertensive therapy and optimize BP control.