Pharmaceuticals 2009, 2(3), 82-93; doi:10.3390/ph2030082
Article

Obsessive-Compulsive and Post Traumatic Avoidance Symptoms Influence the Response to Antihypertensive Therapy: Relevance in Uncontrolled Hypertension

Received: 22 September 2009; in revised form: 9 November 2009 / Accepted: 13 November 2009 / Published: 16 November 2009
(This article belongs to the Special Issue Antihypertensive Drugs)
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract: Aim: To investigate the association of uncontrolled hypertension with psychological factors associated with high cardiovascular morbidity and mortality (type D personality, depression, posttraumatic stress-related symptoms). Methods: 205 consecutive outpatient hypertensives completed three questionnaires evaluating Type D personality (DS 16), post traumatic symptoms (revised Impact of Events Scale), symptoms of anxiety, hostility, depression and obsessive-compulsive traits (subscales of the Symptom Checklist). Uncontrolled hypertension was diagnosed when clinic sitting blood pressure was above 140/90 mmHg (130/80 in the presence of diabetes or nephropathy), despite reported adherence to treatment with at least three antihypertensive medications, including a diuretic. Results: Uncontrolled hypertension (39%), was predicted by lower scores at Symptom Checklist obsessive-compulsive subscale and higher number of post traumatic avoidance symptoms, older age, diabetes, higher systolic pressure at first visit and longstanding hypertension. Type D personality correlated with depression, hostility, anxiety, compulsiveness, history of malignancy, and older age, but not with uncontrolled hypertension. Conclusions: Uncontrolled hypertension is associated with low obsessionality and avoidance symptoms, which reduce compliance to treatment. On the contrary, type D personality is not correlated with uncontrolled hypertension, as it includes compulsiveness, which improves compliance. A multidisciplinary approach to the hypertensive patient is mandatory to establish if the psychological profile affects compliance.
Keywords: avoidance symptoms; compliance; obsessive-compulsive symptoms; uncontrolled hypertension; type D personality
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MDPI and ACS Style

Realdi, A.; Favaro, A.; Santonastaso, P.; Nuti, M.; Parotto, E.; Inverso, G.; Leoni, M.; Macchini, L.; Vettore, F.; Calo, L.; Semplicini, A. Obsessive-Compulsive and Post Traumatic Avoidance Symptoms Influence the Response to Antihypertensive Therapy: Relevance in Uncontrolled Hypertension. Pharmaceuticals 2009, 2, 82-93.

AMA Style

Realdi A, Favaro A, Santonastaso P, Nuti M, Parotto E, Inverso G, Leoni M, Macchini L, Vettore F, Calo L, Semplicini A. Obsessive-Compulsive and Post Traumatic Avoidance Symptoms Influence the Response to Antihypertensive Therapy: Relevance in Uncontrolled Hypertension. Pharmaceuticals. 2009; 2(3):82-93.

Chicago/Turabian Style

Realdi, Anna; Favaro, Angela; Santonastaso, Paolo; Nuti, Marco; Parotto, Emanuela; Inverso, Giulia; Leoni, Matteo; Macchini, Luisa; Vettore, Francesca; Calo, Lorenzo; Semplicini, Andrea. 2009. "Obsessive-Compulsive and Post Traumatic Avoidance Symptoms Influence the Response to Antihypertensive Therapy: Relevance in Uncontrolled Hypertension." Pharmaceuticals 2, no. 3: 82-93.

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