THE CORRECTION OF PSYCHOLOGICAL STYLE OF BEHAVIOR MAY IMPROVE THE EFFECTIVENESS OF ANTIHYPERTENSIVE THERAPY IN THE WORKPLACE IN PATIENTS WITH HYPERTENSION

Abstract

Objective: The aim of study was to define if the emotional intelligence (EI) of patients with arterial hypertension (AH) may influence the effectiveness of antihypertensive therapy in the workplace.Design and method: We assessed 70 ambulatory blood pressure monitoring (ABPM) data of AH patients without serious concomitant diseases. ABPM monitor (Spacelabs 90207) was applied after the washout period. We defined daytime period as 8.00–22.00, nighttime – 0.00–6.00, and work period as 11.00–19.00. After ABPM session patients completed the emotional intelligence questionnaire (EmIn) by Lyusin D. We analyzed following EmIn scale scores: I - emotion self-awareness; II - management of one's own emotions; III - control of emotional expression; IV - understanding others’ emotions; V- management of others’ emotions. The patients were randomized to treatment antihypertensive drugs. Then the patients were randomized to the control and intervention groups. In the control group were used standard recommendations for cardiovascular disease patients. In the intervention group, physicians advised to follow both standard recommendations for cardiovascular patients and additional recommendations according to the results of the EmIn questionnaire. The patients were treated with antihypertensive drugs in average therapeutic doses for 3 weeks (amlodipine, metoprolol, enalapril, telmisartan). If the therapy was ineffective, the patient dropped out of the study and began to treatment with the combined therapy. At the end of the three-week therapy was performed EmIn test and ABPM. Results: The mean daytime BP was (M ± SD): systolic (SBP) - 142.1 ± 14.5; diastolic (DBP) - 90.1 ± 10.9 mm Hg. The groups were comparable in baseline BP, sex, age, EmIn characteristics, body mass index and drugs doses. We found that treatment with average therapeutic doses of antihypertensive drugs is not effective (table 1) in the control group. However, in the intervention group, the same doses of the drug leads to the significant BP reduction of workplace and daytime BP levels. Night BP indices in this patients did not decrease significantly (table 2). Conclusions: Thus, lifestyle changes based on both conventional and additional recommendations with regard of the results of the EmIn psychological questionnaire may improve the effectiveness of the antihypertensive therapy in the workplace.