Psychosocial approach: quality of life in young people with elevated blood pressure

Abstract

Aim. To study quality of life (QoL), as an instrument for standardized assessment and monitoring of patients’ psychosocial status. Psychosocial approach is particularly important in diseases with psychosomatic component, such as essential arterial hypertension (EAH). Material and methods. QoL was assessed in 101 adolescents (62 boys, 39 girls; age 14-17 years) with various EAH forms, as well as in 38 healthy adolescents (comparison group, CG). Based on the results of 24-hour blood pressure monitoring (BPM), all patients were divided into 3 groups: with white-coat hypertension (n=32); with labile AH (n=33); and with stable AH (n=36). QoL was assessed with the MOS SF-36 scale, measuring not only absolute QoL values, but also the “proxy-problem” phenomenon (the discrepancy between QoL reported by the patients themselves and their proxies – parents). Results. Compared to the CG, adolescents with various BP levels demonstrated reduced QoL. QoL reduction was minimal in adolescents with white-coat hypertension, and maximal in patients with labile AH. In the latter group, both physical and psychological functioning parameters were reduced. The parents of EAH adolescents typically overestimated the severity of physical dysfunction of their children, while underestimating the magnitude of psychological dysfunction. Conclusion. The results obtained confirm the important role of psychosomatic mechanisms in AH pathogenesis, and emphasize the need for psychiatrist or clinical psychologist’ participation in the treatment of hypertensive adolescents. In adolescents with stable AH, physical dysfunction was predominant.