Psychosomatic correlations in non-hypertensive individuals with left ventricular hypertrophy

Objective. The study aim was to evaluate the role of psychological, somatic factors in the development of left ventricular hypertrophy (LVH) in the cohort of persons without hypertension (HTN) and to define their effect on LVH. Design and methods. We included 107 otherwise healthy middle-aged people from an organized population, including 46 men (mean age of 43,7 ± 11,5 years, mean ± SD) and 61 women (mean age 43,1 ± 10,1 years, mean ± SD). All the subjects underwent blood pressure measurement according to the standard procedure, questionnaire survey using validated psychological questionnaires, echocardiography, and fasting blood tests (hormonal, immunological, biochemical). Results. Individuals with LVH were characterized by a significantly higher level of depression, accumulated stress, social frustration, decreased self-evaluation of health state and vitality. In the LVH group, the avoidance strategy is used more often; meanwhile strategies for solving out the problem and finding social support are more rarely applied. There were positive correlations between the left ventricular myocardial massindex and height (r = 0,56); body surface (r = 0,54); the ratio waist circumference/hip circumference (r = 0,62); concentration of triglycerides (r = 0,58); cholesterol of very low density lipoproteins (r = 0,58) (n = 41; p ≤ 0,001). The left ventricular mass index in otherwise healthy non-HTN individuals is determined by 4 factors: the level of apolipoproteins-B, the ratio waist circumference/hip circumference, the concentration of the products of free radical lipid oxidation, and smoking duration. Conclusions. Personal response, which cause an increased susceptibility to stressful influences, also determine the nature and intensity of stress-reactions, their metabolic and hormonal support. LVH in non-HTN subjects is associated with personality characteristics that determine the nature of a multilevel response (somatic, hormonal, biochemical).

1. Konradi AО. Treatment of hypertension in special groups of patients. Left ventricular hypertrophy. Arterial’naya Gipertenziya = Arterial Hypertension. 2005;10(3):137–143. In Russian

2. Kalyuzhin VV, Teplyakov AT, Solovtsov MA, Kalyuzhina EV, Bespalova ID, Terent’eva NN. Left ventricular remodeling: one or more scenarios. Byulleten’ Sibirskoi Meditsiny = Bulletin of Siberian Medicine. 2016;15(4):120–139. In Russian

3. Gavrilova EA. Athletic heart. Stressful cardiomyopathy. Moscow: Soviet Sport, 2007. 200 p. In Russian

4. Zemtsovskii EV, Bondarev SA, Voronenko ES, Larionova VI. Stressor cardiomyopathy due to chronic psycho-emotional overstrain. Independent nosological form or debut of ischemic heart disease. Arterial’naya Gipertenziya = Arterial Hypertension. 2008;14(1):131–136. In Russian

5. Pickering TG. Mental stress as a causal factor in the development of hypertension and cardiovascular disease. Curr Hypertens Rep. 2001;3(3):249–254.

6. Stryuk RI, Dlusskaya IG. Adrenoreactivity and cardiovascular system. Moscow, 2003. 160 p. In Russian

7. Gubachev YuM, Dornichev VM, Kovalev OA. Psychogenic circulatory disorders. St Petersburg: Politekhnika, 1993. 248 p. In Russian

8. Akimova AR. Workshop on the psychology of stress [Praktikum po psikhologii stressa]. Ulyanovsk: Zebra. 2015. 126 p. In Russian

9. Diagnosis and treatment of arterial hypertension: recommendations of the Russian Medical Society on arterial hypertension and the All-Russian Scientific Society of Cardiology (IV revision). Sistemnye Gipertenzii = Systemic Hypertension. 2010;3:5–26. In Russian

10. National guidelines on cardiovascular prevention. Kardiovaskulyarnaya Terapiya i Profilaktika = Cardiovascular Therapy and Prevention. 2011;10(6), Suppl 2:1–64. In Russian

11. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA et al. Recommendations for measurement of the structure and function of heart chambers. Rossiyskiy Kardiologicheskiy Zhurnal = Russian Cardiology Journal. 2012;95(3), Suppl 1:1–28. In Russian

12. Khanin YuL. A short guide to the use of the scale of reactive and personal anxiety Ch. D. Spielberger. L.: LNII FK; 1976. 18 p. In Russian

13. Andrjushhenko AV, Drobizhev MJu, Dobrovol’skij AV. Comparative assessment scales CES-D, BDI and HADS (d) in the diagnosis of depression in general practice. Zhurnal Nevrologii i Psikhiatrii = Journal of Neurology and Psychiatry. 2003;5:11–18. In Russian

14. Vasserman LI, Iovlev BV, Berebin MA. A technique for diagnosing the level of social frustration and its practical application: methodological recommendations. St. Petersburg, 2004. 16 p. In Russian

15. Holmes Т, Rahe R. The Social Readjustment Rating Scale. J Psychosom. Research. 1967;11(2):213–18.

16. Rubinshteyn SYa. Experimental methods of pathological psychology and experience of their application in the clinic: a textbook. St Petersburg, 1998. 168 p. In Russian

17. Vasserman LI, Iovlev BV, Isaeva ER, Trifonova EA, Shchelkova OYu, Novozhilova MYu et al. Methodology for psychological diagnosis methods of coping with stressful and problematic personal situations: a handbook for physicians and medical psychologists. St Petersburg, 2009. 37 p. In Russian

18. Gubachev YuM, Stabrovskii EM. Clinical and physiological basis of psychosomatic relationships. Moscow: Medicine, 1981. 214 p. In Russian

19. Bastrikov OYu, Grigoricheva EA, Belov VV, Nikushkina KV, Mezentseva EA. Psychosomatic aspects in individuals with normal blood pressure and left ventricular hypertrophy. Arterial’naya Gipertenziya = Arterial Hypertension. 2016;22(1): 86–93. doi:10.18705/1607-419X-2016-22-1-86-93 In Russian

20. Sadeghi M, Roohafza H, Afshar H, Rajabi F, Ramzani M, Shemirani H et al. Relationship between depression and apolipoproteins A and B: a case-control study. Clinics. 2011;66 (1):113–117.

21. Kolpakov AR. Cardioprotective properties of serum lipoproteins. Bulleten SO RAMN = Bulletin of the SB RAMS. 2010;30(2):33–36. In Russian

22. Zornoff LA, Matsubara LS, Matsubara BB, Okoshi MP, Okoshi K, Dal Pai-Silva M et al. Beta-carotene supplementation attenuates cardiac remodeling induced by one-month tobacco-smoke exposure in rats. Toxicol Sci. 2006;90(1):259–266.

23. Colombo ES, Davis J, Makvandi M, Aragon M, Lucas SN, Paffett ML et al. Effects of nicotine on cardiovascular remodeling in a mouse model of systemic hypertension. Cardiovasc Toxicol. 2013;13(4):364–369. doi:10.1007/s12012–013–9217-z

24. Meurrens K, Ruf S, Ross G, Schleef R, von Holt K, Schlüter KD. Smoking accelerates the progression of hypertension-induced myocardial hypertrophy to heart failure in spontaneously hypertensive rats. Cardiovasc Res. 2007;76(2):311–322.

25. Yiannikouris F, Gupte M, Putnam K, Cassis L. Adipokines and blood pressure control. Curr Opin Nephrol Hypertens. 2010;19 (2):195–200.

26. Sabbatini AR, Faria AP, Barbaro NR, Corrka NB, Brunelli V, Tanus-Santos JE et al. Adiponectin — 11377 C/G and +276 G/T polymorphisms affect adiponectin levels but do not modify responsivenness to therapy in resistant hypertension. Basic Clin Pharmacol Toxicol. 2014. doi:10.1111/bcpt.12368

27. Bastrikov OYu. Modified proteins and their association with psychoemotional factors in patients with various levels of blood pressure. Rossijskij Fiziologicheskij Zhurnal im. I. M. Sechenova = Russian Journal of Physiology. 2015;101(4):462–467. In Russian

28. Bastrikov OYu. The indicators of lipoprotein metabolism and their association with psycho-emotional factors in healthy individuals. Rossijskij Medicinskij Zhurnal = Russian Medical Journal. 2015;21(1):24–27. In Russian

29. Bastrikov OYu, Belov VV, Tseilikman VE, Sumerkina VA. Indices of endothelial function and their relationships with psychoemotional factors in practically healthy people. Nejrokhimija = Neurochemical Journal. 2014;31(2):158– 163. doi:10.7868/S1027813314020022 In Russian

30. Bastrikov OYu, Belov VV. Structural-functional parameters of the heart and blood vessels in correlation with psychoemotional factors in practically healthy individuals. Akademicheskij Zhurnal Zapadnoj Sibiri = Academic Journal of Western Siberia. 2013;9 (5):70–74. In Russian