Рациональная фармакотерапия в кардиологии (Jan 2016)

INFLUENCE OF ANTIHYPERTENSIVE THERAPY ON PSYCHOLOGICAL STATUS OF CHERNOBYL NUCLEAR POWER PLANT ACCIDENT CONSEQUENCES LIQUIDATORS

  • E. M. Manoshkina,
  • I. I. Razdobreeva,
  • S. K. Kukushkin

DOI
https://doi.org/10.20996/1819-6446-2006-2-1-4-10
Journal volume & issue
Vol. 2, no. 1
pp. 4 – 10

Abstract

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Aim. To study psychological status and influence of antihypertensive therapy (AHT) on it in Chernobyl nuclear power plant (NPP) accident consequences liquidators, who suffer arterial hyper-tension (AH), with controlled treatment compared to the standard treatment in out-patient clinic. Material and methods. 81 liquidators with AH (all men) were included into open compara-tive randomized study. Study duration was 12 months. Patients were randomized into main group (MG) and control group (CG). Patients of MG received strictly regulated stepped AHT based on ACE inhibitor spirapril 6 mg daily (Quadropril®, Pliva-AVD), hypothiazide was added if necessary (12.5-25 mg daily) and afterwards – atenolol (12.5-100 mg daily). In CG AHT and its correction was set by physician in polyclinic. Brief multifactor questionnaire for personality analysis was used to study psychological status. Results. 57 patients completed the study, 28 in MG and 29 in CG. In MG target blood pres-sure (BP) levels were reached in 22 (78.6%) patients, in CG – in 11 (38%) patients (p<0.01). The main feature of psychological status of liquidators with AH was hypochondriac, depressive and anxious disorders. Controlled AHT made it possible to reach improvement in psychological status, i.e. growth of optimism and activity of patients, more often, than standard treatment in out-patient clinics. Increase in number of patients with pronounced anxious changes was observed in CG. Effi-ciency of AHT in liquidators with AH is connected with severity of depressive disturbances: in subgroups with inefficient treatment patients had the highest level of depression. In liquidators with AH, possessing neurotic disturbances, spirapril was efficient both as monotherapy, and in combina-tion with diuretic hydrochlorothiazide and beta-blocker atenolol. Conclusion. Controlled AHT in liquidators with AH has advantages over standard treatment in out-patient clinic and results in more frequent target BP level achievement as well as more fre-quent psychological status improvement.

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