Pills don't help: anxiety and depression can cause uncontrolled hypertension
Anxiety and depression can cause uncontrolled hypertension, in which conventional blood pressure medications do not work. This is evidenced by the results of a recent study conducted at Sechenov University. Izvestia found out how to help such patients and why it is important to treat mental illnesses on time.
Why Anxiety and Depression increase blood Pressure
Anxiety and depression can cause resistant hypertension, in which medications to reduce blood pressure do not work. This is stated in the results of a study by Sechenov University, transmitted to Izvestia.
According to scientists, 36.8% of hypertensive patients suffer from anxiety and depressive disorders. These conditions trigger dangerous processes in the body: the blood becomes thicker, increasing the risk of thrombosis, and the glucose level increases. The release of stress hormones and cortisol causes systemic inflammation, making it difficult for the heart to function. As a result, older people are 3.6 times more likely to have hypertension in men and 6.8 times more likely to have hypertension in women, and 1.8 times more likely to have hypertension in middle—aged people.
Research led by Professor Beatrice Volel has revealed that half of hypertensive patients with anxiety develop phobias: obsessive fear of heart attack or stroke, the habit of constantly measuring blood pressure and hypersensitivity to any sensations in the chest. Panic provokes new pressure surges, creating a vicious circle. At the same time, 40% of patients outwardly seem indifferent, denying their illness, but internally they also experience fears.
The combination of hypertension and depression is also dangerous.: it increases the risk of stroke by 2.5 times.
— The main problem with depression is low adherence to treatment. Patients ignore doctors' prescriptions, trusting questionable sources, advice from friends or folk methods, which leads to complications," said Beatrice Volel, director of the N.V. Sklifosovsky Institute of Clinical Medicine, professor at the Department of Psychiatry and Psychosomatics at Sechenov University.
How to treat hypertension with anxiety and depression
Arterial hypertension, or persistent high blood pressure, increases the risk of heart attack, stroke and other cardiovascular diseases that claim millions of lives every year. At the same time, 10-20% of these patients develop drug resistance over time, and they lose their effectiveness. Depression, anxiety and PTSD create the basis for this, according to Sechenov University.
Also, the development of pathology can be influenced by the nature of the patient. More than a third (34%) of the study participants with resistant hypertension were prone to dramatization and mood swings, and one in four (24%) were withdrawn and avoided close contact.
To reduce the risks to the patient's life and improve the quality of treatment, the scientists advised that screening for anxiety and depression should be included in the mandatory part of the diagnosis of cardiovascular diseases. This is especially true for those who have already started resistant hypertension, that is, when three courses of treatment have not helped the patient.
–– A cardiologist can give such a patient questionnaires that will help identify anxiety and depression. Either you can immediately refer them to a psychiatrist or a psychotherapist, who will diagnose them and choose the right treatment. Then the situation with hypertension can stabilize," said Beatrice Volel.
In a conversation with Izvestia, the professor added that it is important to treat anxiety and depression at any age because they reduce the quality of life and can contribute to the appearance of somatic diseases. But disorders are especially dangerous for the elderly, as they can lead to the development of cardiovascular pathology with life-threatening consequences.
Can anxiety and depression cause hypertension
Depression and anxiety disorders have a significant impact on the autonomic nervous system, hormonal balance, and inflammatory processes in the body — all of which directly affect blood pressure regulation, explains Evgeny Kokon, cardiologist at Medicine JSC (Academician Roitberg Clinic).
–– Anxiety disorder activates the sympathetic nervous system, causing the release of adrenaline and norepinephrine. This leads to a rapid heartbeat, vasoconstriction and, as a result, an increase in blood pressure," says the doctor. –– Depression, especially chronic depression, is associated with dysregulation of the hypothalamic-pituitary-adrenal axis (HPA), which leads to increased levels of cortisol, the "stress hormone." Increased cortisol contributes to sodium and water retention, increased vascular tone, and eventually persistent hypertension.
In addition, both conditions are accompanied by a decrease in the sensitivity of baroreceptors, mechanisms that regulate blood pressure, which impairs the body's ability to respond adequately to fluctuations in blood pressure. This mainly concerns young patients and middle-aged people.
–– And finally, the patients' lifestyle itself plays a role. People with depression are more likely to lead a sedentary lifestyle, abuse alcohol, and are overweight. All this additionally increases the likelihood of hypertension. It is important to take into account that depression reduces adherence to therapy — it is more difficult for a person to take medications regularly, follow a diet and physical activity regime, adds Vladislav Zhukovsky, cardiologist at the FNCC FMBA.
Treatment and prevention of diseases
Treatment of patients with hypertension who have anxiety or depressive disorders should be comprehensive, says cardiologist Zhukovsky. Arterial hypertension is treated according to general standards — using drugs from the main groups aimed at controlling blood pressure and reducing cardiovascular risk. However, in parallel, work with the mental state is required: taking antidepressants, psychotherapy.
At the same time, Evgeny Kokon adds, it is important to monitor a person's condition: conduct daily monitoring of blood pressure (BPAD) to identify latent stress—related hypertension and assess the psycho-emotional state according to specially developed scales.
According to doctors, the prevention of depression and hypertension overlap in many ways. Such patients need to closely monitor their lifestyle.:
— add physical activity (walking, swimming, yoga) — it reduces both anxiety and pressure;
— sleep at least 7-8 hours, go to bed at the same time;
— give up smoking and alcohol;
— avoid fatty foods;
— try to follow a Mediterranean diet rich in omega-3, magnesium, and potassium;
— practice meditation and relaxation techniques.
All these measures will reduce the likelihood of developing both diseases, concludes cardiologist Vladislav Zhukovsky.
"But it is equally important to identify symptoms of depression and anxiety in a timely manner, because early help helps prevent not only mental but also somatic complications," the specialist warns.
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