arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2018-24-2-132-144arthyper-787Research ArticleСтатьиArticlesПсихологические вмешательства при артериальной гипертензии: вопросы обоснованности и эффективностиPsychological interventions in hypertension: rationale and efficiencyАлёхинА. Н.AlekhinA. N.

доктор медицинских наук, профессор, заведующий кафедрой клинической психологии и психологической помощи

MD, PhD, DSc, Professor, Head, Department for Clinical Psychology and Psychological Assistance

ДубининаЕ. А.DubininaE. A.

кандидат психологических наук, доцент, доцент кафедры клинической психологии и психологической помощи ФГОУ ВО «РГПУ им. А.И. Герцена» Минобрнауки России, научный сотрудник лаборатории клинической психологии и психодиагностики ФГБУ «НМИЦ психиатрии и неврологии им. В. М. Бехтерева» Минздрава России

PhD of Psychology, Associate Professor, Department for Clinical Psychology and Psychological Assistance, Herzen State Pedagogical University of Russia, Researcher, Laboratory of Clinical Psychology and Psychodiagnostics, Bekhterev National Medical Research Center of Psychiatry and Neurology

trifonovahelen@yandex.ruФедеральное государственное образовательное учреждение высшего образования «Российский государственный педагогический университет имени А. И. Герцена» Министерства образования и науки Российской Федерации, Санкт-ПетербургРоссияHerzen State Pedagogical University of Russia, St PetersburgRussian FederationФедеральное государственное образовательное учреждение высшего образования «Российский государственный педагогический университет имени А. И. Герцена» Министерства образования и науки Российской Федерации, Санкт-Петербург; Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр психиатрии и неврологии имени В. М. Бехтерева» Министерства здравоохранения Российской Федерации, Санкт-ПетербургРоссияHerzen State Pedagogical University of Russia, St Petersburg; Bekhterev National Medical Research Center of Psychiatry and Neurology, St PetersburgRussian Federation201815052018242132144Copyright © Алёхин А.Н., Дубинина Е.А., 20182018Алёхин А.Н., Дубинина Е.А.Alekhin A.N., Dubinina E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/787

В статье рассматриваются основные задачи психологического вмешательства у пациентов с артериальной гипертензией (АГ) и предгипертензией. Анализируются исследования эффективности психологических вмешательств в предупреждении АГ, снижении артериального давления (АД) и повышении приверженности лечению пациентов при АГ, в профилактике и коррекции ее психопатологических осложнений. Показано, что по результатам методологически строгих исследований психокоррекционные методы, применяемые в лечении и профилактике АГ, в целом не имеют достаточно высокой эмпирически подтвержденной эффективности. Наименее убедительны данные в пользу применения психологических методов в профилактике АГ, в то же время отдельные методы демонстрируют эффективность в решении задачи снижения АД и обеспечения приверженности лечению при АГ. Доказана эффективность психологических вмешательств в предупреждении и замедлении развития когнитивных нарушений сосудистого генеза, однако в соответствующих исследованиях не учитывался фактор АД. В статье анализируются возможные объяснения ограниченной эффективности психологических вмешательств при АГ по данным современных метааналитических работ и перспективы развития данного направления исследований.

 

The paper reviews the main tasks of the psychological intervention in patients with arterial hypertension (HTN) and prehypertension. It presents an analysis of the studies, involving the assessment of psychological intervention efficiency in HTN prevention, lowering blood pressure (BP) and promoting adherence to treatment in HTN patients as well as prevention and correction of psychopathological complications of HTN. According to the results of well-planned studies, the psychological methods, used in the HTN prevention and treatment, do not achieve a satisfactory level of evidence-based efficiency. The findings in favor of the psychological intervention for HTN prevention are the weakest. At the same time, there is evidence of the efficiency of some psychological methods in reducing BP and promoting adherence to treatment. The efficiency of psychological intervention in preventing and slowing progression of vascular cognitive dysfunction is well documented, although the BP is not taken into account in most relevant studies. The authors suggest possible explanations of the limited efficiency of psychological interventions in HTN prevention and treatment according to up-to-date meta-analytic studies and outline future directions of research.

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The authors declare that there are no conflicts of interest present.