Personality Characteristics and Adherence to Treatment in Hypertension Patients

Relevance. The study of psychological mechanisms in the formation of hypertension is a particularly urgent issue in medical psychology, because this disease is the most common among people of working age. Psychological factors in the form of stress, irritability, non-adherence to therapy, high conflict can provoke high blood pressure and lead to complications.
Intention – to study the personality traits and adherence to therapy of patients with hypertension, to compile practical recommendations for medical psychologists in the cardiology department.
Materials and methods. A total of 418 patients with hypertension (215 women and 203 men, average age 45 ± 7.4 years) were examined. At the time of the assessment, the patients were undergoing inpatient treatment at the private healthcare institution “Medical and Sanitary Unit” and were under the supervision of cardiologists and therapists (Astrakhan, Russia). The study used survey methods, in particular, psychodiagnostic techniques: KOP-25 “Quantitative Assessment of Treatment Adherence Questionnaire” (N.A. Nikolaev, Yu.P. Skirdenko), the Big Five personality test questionnaire (in the Russian adaptation by A.B. Khromov). Empirical data were recorded using the Google Forms Internet service. The parameters of descriptive statistics, the linear correlation coefficient and the Spearman rank correlation coefficient were calculated (Statistics 22.0 program).
Results. The findings revealed low treatment adherence among patients, which negatively affects their physical health and increases the risk of complications and mortality. The study identified personality traits associated with various dimensions of adherence: adherence to medication, medical supervision, and lifestyle changes. Traits such as high self-control and attachment were positively associated with better adherence, whereas emotional instability and expressiveness were found to hinder adherence. Importantly, the risk factors for low adherence identified in the study are modifiable.
Conclusion. These studies are necessary as targets for psychological correction of personality traits that have a negative impact on the formation of adherence to therapy in patients with hypertension. Among the effective measures to increase adherence to therapy in patients with hypertension is a comprehensive approach. Training in the “School of Patients with Hypertension” and regular monitoring of blood pressure contribute to higher treatment efficiency.

1. Ageenkova E.K. Arterial’naya gipertenziya v svete vybora spetsificheskikh lichnostnykh etalonov [Arterial hypertension in light of the choice of specific personality standards]. Anan’evskoe chtenie – 2016. Psikhologiya: vchera, segodnya, zavtra. [Ananyevskoe reading – 2016. Psychology: yesterday, today, tomorrow]. Sankt-Petersburg. 2016; 45–46. (In Russ.)

2. Belova G.V. Priverzhennost’ k lecheniyu bol’nykh gipertonicheskoi bolezn’yu i chastota gipertonicheskikh krizov [Adherence to treatment of patients with hypertension and the frequency of hypertensive crises]. Kardiovaskulyarnaya terapiya i profilaktika [Cardiovascular therapy and prevention]. 2019; 18(1): 30-31. (In Russ.)

3. Bereznyak Yu.S., Seleznev S.B. Kliniko-psikhologicheskie osobennosti bol’nykh ishemicheskoi bolezn’yu serdtsa [Clinical and psychological characteristics of patients with coronary heart disease]. Sibirskii zhurnal klinicheskoi i eksperimental’noi meditsiny [Siberian Journal of Clinical and Experimental Medicine]. 2017; 32(1): 87–91. (In Russ.)

4. Buzina T.S., Abdullaeva A.S. Teoreticheskii analiz roli psikhologicheskikh faktorov priverzhennosti k lecheniyu bol’nykh gipertonicheskoi bolezn’yu [Theoretical analysis of the role of psychological factors of adherence to treatment of patients with essential hypertension]. Lichnost’ v menyayushchemsya mire: zdorov’e, adaptatsiya, razvitie [Personality in a changing world: health, adaptation, development]. 2024; 12(1(44)): 46–58. DOI: 10.23888/humJ202412146-58. (In Russ.)

5. Buzina T.S., Abdullaeva A.S. Priverzhennost’ k terapii i stili samoregulyatsii povedeniya u bol’nykh gipertonicheskoi bolezn’yu [Adherence to therapy and styles of self-regulation of behavior in patients with hypertension]. Perspektivy klinicheskoi psikhologii v meditsine i obrazovanii: kollektivnaya monografiya [Prospects of Clinical Psychology in Medicine and Education: Collective monograph]. 2024; 118–128. (In Russ.)

6. Efremova E.V., Shutov A.M., Petrova E.V. Lichnostnye osobennosti i mekhanizmy adaptatsii bol’nykh s arterial’noi gipertenziei i khronicheskoi serdechnoi nedostatochnost’yu [Personality characteristics and adaptation mechanisms of patients with arterial hypertension and chronic heart failure]. Arkhiv” vnutrennei meditsiny [Archives of Internal Medicine]. 2021; (11(1)): 34–42. DOI: 10.20514/2226-6704-2021-11-1-34-42 (In Russ.)

7. Nabieva A.Kh., Bekenova G.T., Alimova N.Z., Priverzhennost’ provodimoi terapii sredi bol’nykh terapevticheskogo profilya [Adherence to therapy among patients with a therapeutic profile]. Vestnik magistratury [Bulletin of the Magistracy]. 2023; (2-1(137)): 16–20. (In Russ.)

8. Five-factor personality questionnaire 5PFQ [electronic resource]. PsyTests. Psychological tests online. URL: https://psytests.org/big5/5pfq.html (In Russ.)

9. Russian universal questionnaire for quantitative assessment of adherence to treatment (COP-25) [electronic resource]. PsyTests. Psychological tests online. URL: https://psytests.org/diag/kop25.html.

10. Rybnikov V.Yu., Ashanina E.N., Kobozev I.Yu., Kubekova A.S. Psikhologicheskie osobennosti bol’nykh psikhosomaticheskogo profilya s razlichnymi strategiyami zashchitno-sovladayushchego povedeniya [Psychological characteristics of psychosomatic patients with various strategies of protective-coping behavior]. Vestnik psikhoterapii [Bulletin of psychotherapy]. 2020; (74(79)): 97–109. (In Russ.).

11. Slobozhaninova E.V., Savinykh E.A., Chepurnykh A.Ya., Shamsutdinova R.A. Vzaimosvyaz’ lichnostnoi trevozhnosti i tipa temperamenta s priverzhennost’yu k lecheniyu u bol’nykh gipertonicheskoi bolezn’yu [The relationship between personal anxiety and temperament type and adherence to treatment in patients with hypertension]. Vyatskii meditsinskii vestnik [Vyatka Medical Bulletin]. 2020; (3(67)): 81–84. DOI 10.24411/2220-7880-2020-10112. (In Russ.)

12. Sorokina A.O. Komplaens patsientov s gipertonicheskoi bolezn’yu [Compliance of patients with hypertension]. Ustoichivoe razvitie nauki i obrazovaniya [Sustainable development of science and education]. 2018; (5): 102–107. (In Russ.)

13. Yakovlev V.V., Ektova T.K. Lichnostnye osobennosti priverzhennosti lecheniyu patsientov s zabolevaniyami serdechno-sosudistoi sistemy [Personal characteristics of adherence to treatment in patients with cardiovascular diseases]. Lichnost’ v menyayushchemsya mire: zdorov’e, adaptatsiya, razvitie [Personality in a changing world: health, adaptation, development]. 2020; 8(4(31)): 418–426. DOI:10.23888/humJ20204418-426 (In Russ.)

14. Nikolic A., Djuric S., Biocanin V. [et al.]. Predictors of non-adherence to medications in hypertensive patients. Iran J Public Health. 2023 Jun; 52(6): 1181–1189. DOI: 10.18502/ijph.v52i6.12960.

15. Williams B., Mancia G., Spiering W. [et al.]. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; (39(33)): 3021–3104. DOI: 10.1093/eurheartj/ehy339

16. Yousuf F.S., Khan M.A.A., Bibi R. [et al.]. Medication adherence in patients with uncontrolled hypertension & hypertensive crisis presenting to a hospital setting in Karachi. Pakistan. Cureus. 2023 Jan 20; (15(1)): e33995. DOI: 10.7759/cureus.33995.