Role of the psychosocial factors in blood pression balance

##plugins.themes.academic_pro.article.sidebar##

Published Apr 2, 2010
Download
pdf
Vol. 88 No. 4 (2010): Issue Apr 2010

##plugins.themes.academic_pro.article.main##

Jawher Masmoudi
Imene Trabelsi
Wassim Ketata
Leila Mnif
S Maalej
Samir Kammoun
Abdellaziz Jaoua

Abstract

Introduction: Hypertension is a real public health problem. His pathogenesis involves a combination of several factors including environmental and psychosocial factors.
Aim: We focus on the links between the blood pressure imbalance and some psychosocial factors in a population of ambulatory patients with hypertension.
Method: It was a cross-sectional study on 100 patients with hypertension followed up in Cardiology in Sfax (Tunisia). Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). Behavioral pattern was evaluated by a clinical interview, referring to the model of Friedman and Rosenman.
We also collected socio-environmental, clinical, therapeutic and prognostic data.
Results: The most predictive factors of an unbalanced blood pressure were independently: personality type "A" or unspecified (p = 0002), high fat diet (p = 0026), poor drug adherence (p = 0038) and depression (p = 0015).
Conclusions: Several sociodemographic and lifestyle factors are interrelated and implicated in the blood pressure imbalance, suggesting the need of a hygienic behavior joining the international recommendations. We insist on the treatment of the anxious and depressive disease and the psychotherapeutic approach of some
personality patterns in the management of hypertension.

Keywords:

Anxiety, Depression, Risk factors, Hypertension, Personality, Tunisia

##plugins.themes.academic_pro.article.details##

References

  1. Frérot L, Le fur P, Le Pape A, Sermet C. Hypertension artérielle: prévalence et prise en charge thérapeutique. Paris : CREDES, 2000.
  2. Hill C, Doyon F. Fréquence des cancers en France. Bulletin du cancer 2003; 90 : 207-13.
  3. Ketterer MW, Mahr G, Cao JJ, Hudson M, Smith S, Knysz W. What's "unstable" in unstable angina? Psychosomatics 2004; 45 : 185-96.
  4. ANAES. Texte de recommandations pour la prise en charge des patients adultes atteints d'hypertension artérielle. Paris: ANAES; Avril 2000.
  5. Kuper H, Marmot M, Hemingway H. Systematic review of prospective cohort heart disease. Semi Vasc Med 2002; 2: 267-314.
  6. Musselman DL, Evans DL, Nemeroff CB. The relationship of depression to cardiovascular disease: epidemiology, biology and treatment. Arch Gen Psychiatry 1998; 55 : 580-92.
  7. Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy Circulation. 1999; 99 : 2192-217.
  8. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983 ; 67 : 361-70.
  9. Kaplan H I, Sadok B J. Synopsis de psychiatrie, sciences du comportement, psychiatrie clinique. Paris: Pradel, 1998.
  10. Rigaud A, Bayle C, Latour F, Lenoir H, Seux ML, Hanon O, et al. Troubles psychiques des personnes âgées. EMC-Psychiatrie 2005; 2 259-81.
  11. Beaufils M. Hypertension in women : contraception and menopause. Arch Mal Coeur Vaiss 2000; 93 ):1404-10.
  12. Sereni C, Sereni D. On ne soigne pas les femmes comme les hommes. Paris : Odile Jacob, 2002.
  13. Halbert JA, Silagy CA, Finucane P, Withers RT, Hamdorf PA, Andrews GR. The effectiveness of exercise training in lowering blood pressure: a meta-analysis of randomised controlled trials of 4 weeks or longer. J Hum Hypertens 1997 ; 11 ): 641-9.
  14. Petrella RJ. How effective is exercise training for the treatment of hypertension? Clin J Sport Med. 1998; 8 : 224-31.
  15. Blair SN, Goodyear NN, Gibbons LW, Cooper KL. Physical fitness and incidence of hypertension in healthy normotensive men and women. JAMA 1984; 27: 487-90.
  16. Hagberg JM, Park JJ, Brown MD. The role of exercise training in the treatment of hypertension: an update. Sports Med. 2000; 30 : 193-206.
  17. Azoulaï G, Légeron P, Marboutin JP. Rapport du Comité Français de Lutte contre l'Hypertension Artérielle. Cognitions et comportements des patients hypertendus. Paris : Stimulus, 2000.
  18. Hickie I, Scott E, Naismth S, Ward PB, Turner K, Parker G, et al. Late-onset depression: genetic, vascular and clinical contributions. Psychol Med 2001; 31: 1403-12.
  19. Taylor WD, McQuoid DR, Krishnan KR. Medical comorbidity in late-life depression. Int J Geriatr Psychiatry 2004; 19: 935-43.
  20. Meyer CM, Armenian HK, Eaton WW, Ford DE. Incident hypertension associated with depression in the Baltimore Epidemiologic Catchment area follow-up study. J Affect Disord 2004; 83: 127-33.
  21. Jonas BS, Lando JF. Negative affect as a prospective risk factor for hypertension. Psychosom Med 2000; 62 : 188-96.
  22. Gorman JM, Sloan RP. Heart rate variability in depressive and anxiety disorders. Am Heart J 2000; 140: 77-83.
  23. Thayer JF, Smith M, Rossy LA. Heart period variability and depressive symptoms: gender differences. Biol Psychiatry 1998; 44: 304-6.
  24. Agelink MW, Boz C, Ullrich H. Relationship between major depression and heart rate variability. Clinical consequences and implications for antidepressive treatment. Psychiatry Res 2002; 113: 139-49.
  25. Krittayaphong R, Cascio WE, Light KC. Heart rate variability in patients with coronary artery disease: differences in patients with higher and lower depression scores. Psychosom Med 1997; 59: 231-5.
  26. Barth J, Schumacher M, Herrmann-Lingen C. Depression as a risk factor for mortality in patients with coronary heart disease: a metaanalysis. Psychosom Med 2004; 66: 802-13.
  27. Simonsick EM, Wallace RB, Blazer DG, Berkman LF. Depressive symptomatology and hypertension-associated morbidity and mortality in older adults. Psychosom Med 1995; 57: 427-35.
  28. Wang PS, Bohn RL, Knight E, Glynn RJ, Mogun H, Avorn J. Noncompliance with antihypertensive medications: The impact of depressive symptoms and psychosocial factors. J Gen Intern Med2002; 17: 504-11.
  29. Blumenthal JA, Williams RS, Wallace AG, Williams RB, Needles TL. Physiological and psychological variables predict compliance to prescribed exercise therapy in patients recovering from myocardial infarction. Psychosom Med 1982; 44: 519-27.
  30. Glazer KM, Emery CF, Frid DJ, Banyasz RE. Psychological predictors of adherence and outcomes among patients in cardiac rehabilitation. J Cardiopulm Rehabil 2002; 22: 40-6.
  31. Ades PA, Waldman ML, McCann WJ, Weaver SO. Predictors of cardiac rehabilitation participation in older coronary patients. Arch Intern Med 1992; 152: 1033-5.
  32. McDermott MM, Schmitt B, Wallner E. Impact of medication nonadherence on coronary heart disease outcomes. Acritical review. Arch Intern Med 1997; 157: 1921-9.
  33. Ziegelstein RC, Bush DE, Fauerbach JA. Depression, adherence behavior, and coronary disease outcomes. Arch Intern Med 1998; 158: 808-9.
  34. Gallacher JE, Yarnell JW, Butland BK. Type A behaviour and prevalent heart disease in the Caerphilly study: increase in risk of symptom reporting? J Epidemiol Commun Health 1988 ; 42: 226- 31.
  35. Irvine J, Garner DM, Craig H, Logan AG. Prevalence of Type A behavior in untreated hypertensive individuals. Hypertension 1991; 18 : 72-8.
  36. Zimmerman R, Frolich E. Stress and hypertension. J Hypertens 1990; 8 : 103-7.
  37. Shapiro D, Goldstem IB, Jamner LD. Effects of cymcal hostthty, anger out, anxiety, and defensiveness on ambulatory blood pressure m black and white college students. Psychosom Med 1996; 58: 354-64.
  38. Perini C, Muller FB, Buhler FR. Suppressed aggression accelerates early development of essential hypertension. J Hypertens 1991; 9: 499-503.
  39. Consoli S. Emotions, réaction, et action. Voies et impasses de l'HTA. Arch Mal Coeur1987; 80: 29-33.
  40. Markovitz JH, Matthews KA, Wing RR, Kuller LH, Meilahn EN. Psychological, biological, and health behavior predictors of blood pressure changes in middle-aged women. J Hypertens 1991; 9: 399-406. LA TUNISIE MEDICALE - 2010 ; Vol 88 (n°04) 229