Preview

Rational Pharmacotherapy in Cardiology

Advanced search

THE EVALUATION OF COMPLIANCE TO ANTIHYPERTENSIVE THERAPY IN PATIENTS AFTER STROKE AND POSTSTROKE DEPRESSION DURING ANTIDEPRESSANT THERAPY

https://doi.org/10.20996/1819-6446-2010-6-6-828-831

Full Text:

Abstract

Aim. To study the effect of the antidepressant paroxetine on the compliance to antihypertensive therapy in patients with arterial hypertension (HT) and post-stroke depression.

Material and methods. Patients (n=24) aged 55-73 with controlled HT (blood pressure, BP<140/90 mm Hg) and with subclinical poststroke depression after rehabilitation course were included into the study. Patients were split into two groups. Patients of group 1 (n=12) received adequate antihypertensive therapy and selective serotonin reuptake inhibitor paroxetine. Patients of group 2 (n=12) received antihypertensive therapy only. The study duration was 16 weeks. Patient compliance to antihypertensive therapy, BP and severity of depressive disorders, motor and intellectual functions was evaluated initially and after 16 weeks.

Results. BP>140/80 mmHg after 16 weeks was found in 10 (41.6%) patients. Clinical post-stroke depression was found in 7 (30.4%) patients, 5 (41.6%) of them were from group 2 (OR=0.35, 95% CI 0.12-0.78). High treatment compliance was in 15 (65.2%) patients, and 9 (81.8%) of them were from group 1. Nine (39.1%) patients did not receive an adequate antihypertensive therapy, 5 (41.6%) of them were from group 2 and could not explain their refusal from medication. General index of intellectual function was higher in patients of group 1 (p=0.034) than this in group 2; index of motor function did not change significantly (p>0.05).

Conclusion. Reduction of compliance to antihypertensive therapy and rehabilitation in hypertensive patients after stroke is associated with unmotivated refusal from treatment because of clinical post-stroke depression.

About the Authors

B. B. Fishman
Yaroslav Mudryy Novgorod State University
Russian Federation
Bol'shaya Sankt-Peterburgskaya ul. 4, Veliky Novgorod, 173003


A. I. Khoroshevskaya
Novgorod Regional Hospital
Russian Federation
Pavla Levitta ul. 14, Veliky Novgorod, 173008


A. A. Abdulin
Yaroslav Mudryy Novgorod State University
Russian Federation
Bol'shaya Sankt-Peterburgskaya ul. 4, Veliky Novgorod, 173003


G. G. Semenova
Yaroslav Mudryy Novgorod State University
Russian Federation
Bol'shaya Sankt-Peterburgskaya ul. 4, Veliky Novgorod, 173003


P. V. Starikov
City Clinical Hospital № 1
Russian Federation
Zelinsky ul. 11, Veliky Novgorod, 173016


O. V. Pavlova
Novgorod Regional Hospital
Russian Federation
Pavla Levitta ul. 14, Veliky Novgorod, 173008


References

1. Oganov R.G., Ol'binskaya L.I., Smulevich A.B. et al. Depression and depressive disorders in the spectrum of general medical practice. The results ofthe KOMPAS program. Kardiologiia 2004;1:48-54. Russian. (Оганов Р.Г., Ольбинская Л.И., Смулевич А.Б. и др. Депрессии и расстройства депрессивного спектра в общемедицинской практике. Результаты программы КОМПАС. Кардиология 2004;1:48-54).

2. Artyukhova M.G. New approaches to the treatment of depressive disorders in patients with cardiac hospital. Russkiy meditsinskiy zhurnal 2009; 17(11):822-824. Russian. (Артюхова М.Г. Новые подходы к лечению депрессивных расстройств у больных кардиологического стационара. РМЖ 2009; 17(11):822-824).

3. Dovzhenko T.V, Maychuk E.Yu. Cardiological syndrome with cardio-vascular diseases of various origins. Clinical, psychopathological and therapeutic aspects. Russkiy meditsinskiy zhurnal 2001;9(25):1192- 1197. Russian. (Довженко Т.В, Майчук Е.Ю. Кардиологический синдром при сердечно-сосудистых заболеваниях различного генеза. Клинические, психопатологические, терапевтические аспекты. РМЖ 2001;9(25):1192-1197).

4. Smulevich A.B.,Dubnitskaya E.B., Tkhostov A.Sh. ey al. Psychopathology of depression (the construction of the typological model). In: Smulevich A.B., eds. Depression and comorbid disorders. Moscow; 1997. S.28-53. Russian. (Смулевич А.Б., Дубницкая Э.Б., Тхостов А.Ш. и др. Психопатология депрессий (к построению типологической модели). В: Смулевич А.Б., редактор. Депрессии и коморбидные расстройства. М.; 1997. С.28-53).

5. Watkins L.L., Grossman P. Association of depressive symptoms with reduced baroreflex cardiac control in coronary artery disease. Am Heart J 1999; 137(3): 453-457.

6. Polishchuk Yu.I. On the failure of the clinical method in psychiatry. Obozrenie psikhiatrii i meditsinskoy psikhologii im. V.M. Bekhtereva 1991; 4:90-92. Russian. (Полищук Ю.И. О недостаточности клинического метода в психиатрии. Обозрение психиатрии и медицинской психологии им. В.М. Бехтерева 1991; 4:90-92).

7. VeynA.M.,Voznesenskaya T.G., GolubevV.L.,Dyukova G.M.Depression in neurological practice. Moscow: MIA; 2007. Russian. (Вейн А.М., Вознесенская Т.Г., Голубев В.Л., Дюкова Г.М. Депрессия в неврологической практике. М.: МИА; 2007).

8. Penninx В.W., Beekman А.Т., Honig A. et al. Depression and cardiac mortality: results from a community-based longitudinal study. Arch Gen Psychiatry 2001;58(3):221-227.

9. Berg A., Palomäki H., Lehtihalmes M. Poststroke depression: an 18-month follow-up. Stroke 2003;34(1):138-43.

10. Hackett M.L., Yapa C., Parag V., Anderson C.S. Frequency of depression after stroke: a systematic review of observational studies. Stroke 2005;36(6):1330-40.

11. Montgomery S.A., Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979; 134: 382-389.

12. Pogosova G.V., Koltunov I. E., Melik-Ogandzhanyan G. Yu., Sokolova O. Yu. Compliance to cardiovascular treatment: clinicians and patients’ problem. Cardiovascular therapy and prophylaxis 2009;4:98-102. Russian. (Погосова Г.В., Колтунов И.Е., Мелик-Оганджанян Г.Ю., Соколова О.Ю. Приверженность к лечению сердечно-сосудистых заболеваний: проблема врачей и пациентов. Кардиоваскулярная терапия и профилактика 2009;4:98-102).

13. BelovaA.N., Shchepetova O.N., editors. Scale tests and questionnaires in medicalrehabilitation. Moscow: Antidor; 2002. Russian. (Белова А.Н., Щепетова О.Н., редакторы. Шкалы, тесты и опросники в медицинской реабилитации. М.: Антидор; 2002).


For citation:


Fishman B.B., Khoroshevskaya A.I., Abdulin A.A., Semenova G.G., Starikov P.V., Pavlova O.V. THE EVALUATION OF COMPLIANCE TO ANTIHYPERTENSIVE THERAPY IN PATIENTS AFTER STROKE AND POSTSTROKE DEPRESSION DURING ANTIDEPRESSANT THERAPY. Rational Pharmacotherapy in Cardiology. 2010;6(6):828-831. (In Russ.) https://doi.org/10.20996/1819-6446-2010-6-6-828-831

Views: 240


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)