scholarly journals HYPERTENSION CONTROL AND DEPRESSION A STUDY IN SSPM MEDICAL COLLEGE & LIFETIME HOSPITAL PADAVE SINDHUDURG

Author(s):  
Sheetal Ratankumar Gatagat

Introduction:  Hypertension is a major public health issue worldwide, affecting millions of patients. Although control rates have improved during the past few years, the actual rate is still unacceptably low, and control rates in more vulnerable populations, like people living with diabetes mellitus, are even lower. Optimal BP control could prevent a high percentage of coronary heart disease events, and early BP control significantly reduces the risk of stroke and cardiovascular events Depression is usually not detected at primary levels, and patients do not typically receive adequate treatment, which may not only affect their quality of life, but may also interfere with the treatment and prognosis of other chronic diseases such as ischemic heart disease and stroke.  Material and Methods: 46 hypertensive patients undergoing antihypertensive therapy for longer than six months were included in the study. After a 5 min of rest period, measurement of BP was recorded in triplicate at 3 min intervals between measurements. Adherence to antihypertensive therapy was monitored. All patients completed the Zung Self-rating Depression Scale survey; depression was diagnosed if the patient scored >50 points (the maximum possible score using this scale was 80). The Zung Self-rating Depression Scale is said to be a sensitive measure of clinical severity in depressed patients. Results: Out of 46 patients there were 22 (47.8%) female and 24(52.2%) male. Patients who were depressed were 20 (43.5%) of which 8(40%) were male and 12 (60%) were female. Of the total 20 depressed patients 1 male having controlled hypertension while 19 (80%) were in the group of uncontrolled diabetes. In controlled hypertension group only 1 mild depression patient was observed while in uncontrolled group of the 19 patients 10 (50%) were having mild, 8 (40%) were having moderate and 1 (20%) were having severe depression according the Zung Self-rating Depression Scale. Mean blood pressure in depressed controlled BP group was 128/73 mmHg while in depressed uncontrolled group was 149/90 mmHg. Mean blood pressure in normal controlled BP group was 121/75mmHg while in depressed uncontrolled group was 146/95 mmHg. There was a significant correlation observed between depression and systolic and diastolic blood pressure value (P<0.001). Conclusion: Depression is common in patients having uncontrolled hypertension and screening of depression in hypertensive patients is simple and effective tool to control the hypertension. Keywords: Hypertension, Depression, controlled, uncontrolled.

Author(s):  
Mahendra Sawarkar ◽  
Mukund Ganeriwal ◽  
Shriram Kane

Introduction:  Hypertension is a major public health issue worldwide, affecting millions of patients. Although control rates have improved during the past few years, the actual rate is still unacceptably low, and control rates in more vulnerable populations, like people living with diabetes mellitus, are even lower. Optimal BP control could prevent a high percentage of coronary heart disease events, and early BP control significantly reduces the risk of stroke and cardiovascular events Depression is usually not detected at primary levels, and patients do not typically receive adequate treatment, which may not only affect their quality of life, but may also interfere with the treatment and prognosis of other chronic diseases such as ischemic heart disease and stroke.  Material and Methods: 46 hypertensive patients undergoing antihypertensive therapy for longer than six months were included in the study. After a 5 min of rest period, measurement of BP was recorded in triplicate at 3 min intervals between measurements. Adherence to antihypertensive therapy was monitored. All patients completed the Zung Self-rating Depression Scale survey; depression was diagnosed if the patient scored >50 points (the maximum possible score using this scale was 80). The Zung Self-rating Depression Scale is said to be a sensitive measure of clinical severity in depressed patients. Results: Out of 46 patients there were 22 (47.8%) female and 24(52.2%) male. Patients who were depressed were 20 (43.5%) of which 8(40%) were male and 12 (60%) were female. Of the total 20 depressed patients 1 male having controlled hypertension while 19 (80%) were in the group of uncontrolled diabetes. In controlled hypertension group only 1 mild depression patient was observed while in uncontrolled group of the 19 patients 10 (50%) were having mild, 8 (40%) were having moderate and 1 (20%) were having severe depression according the Zung Self-rating Depression Scale. Mean blood pressure in depressed controlled BP group was 128/73 mmHg while in depressed uncontrolled group was 149/90 mmHg. Mean blood pressure in normal controlled BP group was 121/75mmHg while in depressed uncontrolled group was 146/95 mmHg. There was a significant correlation observed between depression and systolic and diastolic blood pressure value (P<0.001). Conclusion: Depression is common in patients having uncontrolled hypertension and screening of depression in hypertensive patients is simple and effective tool to control the hypertension. Keywords: Hypertension, depression, controlled, uncontrolled.


1978 ◽  
Vol 42 (1) ◽  
pp. 309-310 ◽  
Author(s):  
Robert J. Rhodes

A factor analysis of the Index of Depression and MMPI data from 20 male and 20 female depressed patients suggests that the Index is a useful self-rating measure of depression and that its Covert Depression scale makes a necessary contribution.


2018 ◽  
Vol 3 (5) ◽  
pp. 27-32
Author(s):  
O. V. Fedorishina ◽  
K. V. Protasov ◽  
A. M. Torunova

Background.Little is known about the effect of statins addition to standard antihypertensive therapy on blood pressure level and vascular stiffness in high-risk hypertensive patients.The aimof the study was to assess the dynamics of vascular stiffness in hypertensive patients of high or very high cardiovascular risk under the influence of rosuvastatin addition to combined two-component amlodipine and lisinopril antihypertensive therapy.Materials and methods.We investigated 60 hypertensive patients who were randomized into two groups: the 1st group received a fixed amlodipine/lisinopril combination, the 2nd one followed the same regimen of therapy with addition of 20 mg rosuvastatin. Mean office and ambulatory blood pressure as well as central aortic blood pressure and pulse wave velocity were evaluated in both groups before and after 24-week follow-up period.Results.At end of follow-up period the office and average daily blood pressure significantly decreased in both groups, with more prominent office diastolic blood pressure decline in the 2nd one. The central aortic blood pressure equally decreased in both groups. The augmentation index significantly reduced in both groups, mostly in the 2nd one. The carotid-femoral pulse wave velocity declined in both groups to the same extent. The carotid-radial pulse wave velocity decreased statistically only in the second group.Conclusions.Addition of rosuvastatin to a fixed amlodipine/lisinopril combination in high/very high cardiovascular risk hypertensive patients was accompanied by more pronounced decline of diastolic blood pressure and augmentation index, as well as significantly reduction of pulse wave velocity.


2012 ◽  
Vol 18 (5) ◽  
pp. 412-420
Author(s):  
S. S. Davydova ◽  
I. A. Komissarenko

Objective. To analyze the dynamics of blood pressure in the early postoperative period in hypertensive patients with kidney tumor after nephrectomy. Design and methods. We examined 96 patients with cardiovascular diseases and kidney tumors, at the age from 41 up to 75 years (mean age — 57 ± 6,3 years), who were planned for nephrectomy (I group). Group II included 53 patients aged 37-65 years (mean age — 49 ± of 7,2 years) who underwent laparoscopic nephrectomy. Daily monitoring of blood pressure MECG-DS-HC-01 («LCA Advanced technologies», Russia) was performed in all subjects. Results. Young hypertensive patients (from 40 to 48 years, mean age — 43,7 ± 4,6 years) demonstrated blood pressure elevation in the early postoperative period after nephrectomy even when antihypertensive medication was taken. At the same time elderly patients (from 56 to 85 years of age, mean age — 65,3 ± 7,5 years) develop hypotension episodes. Calcium channel blockers appeared to be highly effective in young patients who also demonstrated higher blood pressure levels in the postoperative period after laparoscopic nephrectomy, as compared with patients after open surgery. On the second day after the open nephrectomy 22,9 % (22 of 96) patients required antihypertensive treatment correction, and on the tenth only 1 % (1 patient out of 96) required treatment enhancement, whereas in group II on the second day after the intervention 100 % patients required therapy enhancement, and on the tenth day 60,4 % (32 out of 53) patients needed some correction of the treatment. Conclusions. Hypertensive patients with kidney tumors require precise control of blood pressure before the operation and correction of antihypertensive therapy, as almost one third of the patients develop increase of blood pressure in postoperative period. Calcium channel antagonists should be considered as a drug of choice in the young patietnts (mean age — 44 years) as they allow to achieve target blood pressure, that is necessary to improve renal blood flow and protects the kidney. At the same time 20 % of elderly patients (age 66) develop hypotension episodes requiring lower doses of antihypertensive drugs.


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