Olga D. Ostroumova

The main purpose of the present study was to assess the role of motivation in the effective cognitive activity of elderly hypertension (HTN) patients provided with antihypertensive treatment; 25 patients with HTN took part in the study, stage 1-2; their mean age was 67.6±6.1. The psychological examination program embraced a quantitative measurement of intelligence quotient (IQ) with the Wechsler Adult Intelligence Scale, and an investigation into the qualitative features of their cognitive processes, applying a pathopsychological study procedure (Zeigarnik, 1962, 1972) and the principles of psychological syndrome analysis (Vygotsky-Luria-Zeigarnik school). The results showed that within the psychological syndrome structure of cognitive disorders in HTN patients, the leading part is played by two syndrome-generating factors: a neurodynamic factor and a motivational factor. The patients with reduced motivation would achieve poor general test results, if compared with the group of highly motivated participants. A correlation analysis of the data revealed the interconnection between frequency disturbances in motivation and the frequency in occurrence of various signs of cognitive decline, such as low efficiency in memorization and delayed recall, as well as lower IQ test results. The data provide a strong argument to support the hypothesis that motivation is of particular importance as a factor in the generation of cognitive disorders in HTN patients.

In the study, psychological and physiological features were assessed during an experimentally designed stressful situation in 85 subjects with hypertension (HTN) in the workplace, 85 patients with essential HTN, and 82 healthy individuals.

It was showed, that patients with HTN in the experimental situation were characterized by a complex of physiological and psychological features, which distinguish them from healthy participants. A reliably greater increase In systolic blood pressure (BP) was recorded in these patients in comparison with healthy individuals (on average by 14 and 3 mmHg respectively). The aspiration level (AL) of these patients was characterized by a reliably greater height, inadequacy, and instability; as for nonverbal behavior, it revealed a reliably greater amount of gestures, and frequent changes in voice tone against similar features of healthy individuals.

The group of patients with HTN at work, when compared with essential HTN patients, was characterized by a reliably greater increase of systolic BP (on the average by 16 and 4 mmHg respectively) as a reaction to emotional stress. The systolic BP increase in this group was revealed in combination with an initially reliably lower catecholamines’ level (CA), a gradual decrease of CA level in urine, and renin and angiotensin-1 in blood plasma during the experiment. This combination is an indicator of chronic stress and psychophysiological exhaustion. The patients did not manifest any increase of anxiety during the experiment; they were characterized, however, by a greater frequency of AL inadequacy and instability. The behavior of patients with HTN at work during the experiment was marked by a limited repertory of poses and gestures, but more vigorous facial expressions, and frequent pitch jumps. Obtained results lead us to confirm that the repression of emotions comes as a significant pathogenetic factor in the genesis of psychosomatic syndrome among patients with HTN at work, as opposed to patients with essential HTN.