Psychological State and Quality of Life of Patients With Essential and Secondary (Nephrogenic) Arterial Hypertension

Objective: To evaluate the psychological state and quality of life of patients with different types of hypertension (essential and secondary, namely nephrogenic). Design and method: 98 patients with arterial hypertension (50 with essential and 48 with secondary due to chronic glomerulonephritis) were examined. The control group included 30 practically healthy individuals of appropriate age and sex. Psychological state was examined using the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). Quality of life was assessed using Medical Outcomes Study 36-Item Short-Form Health Survey (the SF-36 questionnaire). Results: According to Beck Depression Inventory patients with nephrogenic hypertension significantly more often had moderate and severe depression not only compared to the control group, but also patients with essential hypertension (p<0,05). According to State-Trait Anxiety Inventory patients with essential hypertension had a prevalence of moderate and high state anxiety (S-anxiety), while patients with secondary hypertension had a high one (for both p<0,05 compared to the control group) without a significant difference between these groups (p>0.05). Severe trait anxiety (T-anxiety) was significantly more common in patients with secondary hypertension compared to both the control group and patients with essential hypertension (p<0,05). There was no patient with mild T- and S-anxiety among patients with secondary hypertension (p<0,05 compared to both other groups). According to Medical Outcomes Study 36-Item Short-Form Health Survey the level of physical health in patients with essential hypertension was 19.6% lower, and in patients with secondary hypertension 21.4% lower than in the control group (p<0,05), without significant difference between these groups (p>0.05). The level of mental health was 5.6% and 12.1% lower than in the control group (p<0,05), respectively, with a tendency to significance depending on arterial hypertension etiology (0.05<p<0.1). Conclusions: Patients with arterial hypertension, regardless of its etiology, have worse quality of life and psychological status indicators. Patients with secondary hypertension were characterized by worse quality of life, a higher frequency of both severe depression and severe S- and T-anxiety.