Comparative assessment of risk factors, cognitive and emotionalvolitional disorders in patients with stage III hypertension depending on the previous myocardial or cerebral infarction

Hypertension is a risk factor for myocardial and cerebral infarction. These conditions lead to cognitive impairment (CI) and emotional-volitional disorders (EVD), which subsequently can dramatically reduce the availability of industrial work activity and worsen health. Aim of the study was to conduct a comparative assessment of the frequency and relationship of cardiovascular risk factors, CI and EVD in patients with stage III hypertension, depending on the history of myocardial or cerebral infarction.

Material and methods. A total of 100 patients with verified hypertension stage III were examined, against the background of indicated hypotensive therapy. Patients, whose age was 62.7 ± 9.2 years (arithmetic mean ± error of the mean), were divided into two groups of 50 people. Group 1 included people with post-infarction cardiosclerosis, and group 2 included people with a history of acute cerebrovascular accident. The patients’ risk factors were analyzed, and their CI was assessed using the MMSE and MoCa scales. The Beck Depression Inventory was used to study the EVD.

Results and discussion. In patients with hypertension, the risk factors in the 2nd group were statistically significantly less likely to include alcohol and table salt abuse, and more often a sedentary lifestyle and COVID-19. In the 1st group, the frequency of individuals with increased level of glucose, high-density lipoproteins, triglycerides was significantly higher, and the frequency of individuals with elevated total cholesterol content and glomerular filtration rate less than 60 ml/min/1.73 m² was lower. Patients of the 2nd group were statistically significantly less likely to have chronic kidney disease stage C3a. CI according to the Mohs scale and MMSE were more pronounced in the 2nd group. In the 1st group, a direct correlation was found between CI and age, education, blood glucose level and a negative – with creatinine content. In the 2nd group, a positive correlation was found between CI and COVID-19, body mass index, systolic blood pressure and an inverse relationship – between CI and blood triglyceride and bilirubin content. EVD were manifested by subdepression and were significantly more common in the 2nd group. The severity of depression correlated with the total cholesterol content in the 1st group and with glomerular filtration rate in the 2nd group.

Conclusions. The obtained results showed a difference in the combinations of risk factors in the 1st and 2nd groups of patients, which depended on the disease associated with hypertension.

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