Эффективность комбинированной с психотропными препаратами антигипертензивной фармакотерапии у больных с артериальной гипертонией и аффективными расстройствами

Aim. To compare effects of isolated antihypertensive therapy (AHT) and AHT combined with anxiolytic and antidepressant on parameters of 24-hour blood pressure (BP) profile, severity of affective disorders, and quality of life (QL) in patients with uncontrolled arterial hypertension (AH) and anxiety or depressive disorders. Material and methods. We randomized 140 patients (age 48.6±5.9 year, 72 women) into 2 groups. During 1 year patients of each group received 2 variants of pharmacotherapy: isolated AHT and AHT combined with psychotropic medication (PM) - anxiolytic for persons with anxiety disorder and antidepressant for persons with depressive disorder (AHT+PM). Patients of group I received AHT for first 6 months and AHT+PM for remaining 6 months. Group II patients started with AHT+PM and after 6 months switched to AHT. In each group we selected subgroups of patients with prevailing anxiety (I-A, II-A) and prevailing depression (I-D, II-D). In the end of each 6 months period we compared parameters of 24-hour BP monitoring, severity of affective disorders, and QL in subgroups IA vs. II-A and ID vs. IID. Same comparisons were done for each sub-group in the end of the first and second stages of treatment. Results. Starting with combination AHT provided more rapid achievement of low values of average diurnal and nocturnal systolic (S) and diastolic (D) BP, lower parameters of BP variability. In patients with comorbid depression it led to lowering of magnitude and velocity of morning increment of SBP and DBP. Only combination AHT demonstrated adequate reduction of affective disorders. Both combination and isolated AHT in 6 months resulted in significant improvement of QL, however combination AHT provided significantly better estimates of QL. Conclusion. In patients with AH and anxiety or depressive disorders effectiveness of AHT combined with anxiolytic or antidepressant was higher compared with isolated AHT.