Depression as a potential factor for the ineffectiveness of hypertension control in post-COVID-19 patients

Abstract

Objective: improving the effectiveness of hypertension control in patients after COVID-19 with manifestations of depression. Materials and methods: the study included 48 patients with hypertension who had suffered a coronavirus infection. The criterion for inclusion in the study was effective control of blood pressure when using two-component antihypertensive therapy before the development of coronavirus disease and its absence when using the same therapy at the time of inclusion in the study. To identify the symptoms of depression, a study was conducted using the Beck Depression questionnaire. Group A consisted of patients with arterial hypertension with manifestations of depression and group B-patients with arterial hypertension without symptoms of depression. In both groups, a combination of a renin-angiotensin-aldosterone system blocker, a diuretic and a calcium channel blocker were used. The observation was carried out for 4 weeks, the dynamics of blood pressure and its daily parameters, manifestations of depression were evaluated. Results: the presence of symptoms of depression was detected in 39.5% of patients. At the time of inclusion in the study, office blood pressure exceeded the target level in all patients, there was an insufficient decrease in systolic and diastolic blood pressure during the day and at night, an increase in most indicators of blood pressure variability. The use of three-component therapy made it possible to achieve the target blood pressure level in 93.1% of patients without symptoms of depression. In the group of patients with depression, only 21.0% of patients reached the target blood pressure level. The analysis of daily blood pressure indicators showed a decrease in the effectiveness of antihypertensive therapy in the group of patients with depression. All daily blood pressure indicators were statistically significantly higher than in group B. Conclusion: in patients who have suffered a coronavirus infection, it is necessary to identify depression as a possible factor of ineffective control of arterial hypertension and a decrease in adherence to the recommended therapy.