The psychological and social condition of hypertensives resistant to pharmacological treatment.
To characterize patients with therapy-resistant essential hypertension (TR) from a psychosocial point of view, 29 hypertensives, filling specified criteria for TR in a hypertension clinic were selected out of 800 patients screened. A control group of patients with established, but well controlled hypertension, pair-wise matching study patients for age and gender was also selected. TR patients were predominantly of working-class origin (68 vs 19% P less than 0.001). They tended to be more obese (BMI 28.7 +/- 5.5 vs 26.9 +/- 3.9 ns). TR tended to report fewer important life events, and reported significantly fewer positive events from the last 10 year period P less than 0.05. According to the EAI, their ability to channel emotions, especially anger, was impaired (P less than 0.01). So was their instrumental handling of emotions such as anger and sorrow (P less than 0.05). They experienced less of joy, and even had a more negative attitude towards that emotion (P less than 0.05). When adjusted for social class this latter difference was not statistically significant. Their degree of global emotional differentiation was lower (P less than 0.05). In the ISSI interview they had low scores for availability of emotional attachment (P less than 0.01), and friendship (P less than 0.05), but not for social integration. To conclude, when compared to well controlled hypertensives, TR exhibited the pattern, which has been shown to characterize young, asymptomatic, hypertensives in comparison to healthy subjects. These results must not be overinterpreted due to the limited sample.(ABSTRACT TRUNCATED AT 250 WORDS)
Isaksson
H
H
Department of Cardiology, Söder Hospital, Stockholm, Sweden.
Konarski
K
K
Theorell
T
T
D000342:Affective Symptoms / Q000523:psychology; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001143:Arousal; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000523:psychology*; D007406:Interview, Psychological; D008016:Life Change Events; D008297:Male; D010552:Personality Assessment; D012924:Social Conditions; D012931:Social Environment; D012944:Social Support
D000959:Antihypertensive Agents