EFFECTS OF AMLODIPIN AND METOPROLOL ON AUTONOMIC SYSTEM IN EMOTIONAL AND COLD TESTS IN HYPERTENSIVE PATIENTS WITH DIFFERENT PSYCHOLOGICAL PROFILE

Abstract

Aim. To asses effects of amlodipin and metoprolol on autonomic system in emotional and cold tests in hypertensive patients with different psychological profile (PP) Material and methods. 61 patients with arterial hypertension of II grade were observed. Therapy with amlodipin or metoprolol was prescribed and allowed to reach target blood pressure (BP) level in all the patients. Patients were divided into 2 groups: 1-st one – patients with normal PP, 2-nd group – patients with subclinical depression. Patients were examined before and 30 days after therapy. Examination included ambulatory BP monitoring, assessment of autonomic status by variational intervalometry and spectral analysis of heart rate variability (HRV) in cold and emotional tests. Depression and anxiety levels were determined with Bek’s and HADS scales. Results. Treatment with amlodipin and metoprolol can result in improvement, worsening or unchanging of PP. In hypertensive patients with subclinical depression improving their PP resulted in autonomic reaction change: sympathetic activity increases and reaction on stress becomes more adequate. If subclinical depression occurred in hypertensive patients because of amlodipin and metoprolol therapy, sympathetic system stress-reaction decreased and parasympathetic influence increased. Conclusion. The study results show necessity of psychometric examination of hypertensive patients in order to reveal subclinical depression and anxiety.

Keywords

• arterial hypertension
• subclinical depression
• psychological profile
• amlodipine
• metoprolol