Kalmatayeva Zh A, Zholamanova A A
Higher School of Public Health, Ministry of Health of the Republic of Kazakhstan, Almaty, Republic of Kazakhstan.
Ter Arkh. 2015;87(1):64-68. doi: 10.17116/terarkh201587164-68.
To assess the expediency of psychotherapy in patients with essential hypertension (EH) from clinical and economic standpoints.
Seventy-five (37 men, 38 women) with grades 1-2 EH (blood pressure (BP) was 140/90 to 179/109 mm Hg) and the verified psychosomatic background of the disease) were examined and randomized into 2 groups (the mean age in Groups 1 and 2 was 48.5 ± 3.69 and 47.5 ± 4.2 years, respectively). All the patients received medical therapy using the same regimen; however, Group 1 patients had additionally psychotherapy. The decrease in BP and the average number of visits required to reach goal BP were estimated as a criterion for therapeutic effectiveness. A pharmacoeconomic analysis of antihypertensive therapy was made in each group.
The average cost for 24 weeks was 349.67 rbl per person in Group 1 and 435.9 rbl in Group 2, which was 19.78% cheaper. The costs of reductions in systolic-BP (SBP) and diastolic BP (DBP) were also lower in Group 1 (-22.108 and -39.534 rbl, respectively). At the same time, goal BP was achieved more rapidly in Group 1 (in Groups 1 and 2, the reduction in SBP was 5.28 and 3.38 mm Hg weekly and that in DBP was 2.51 and 1.73 mm Hg weekly, respectively). This makes it possible to lower a physicians' load and to save timing budget (p > 0.032).
The treatment policy in Group 1 surpassed that in Group 2 in the rate of BP normalization and the number of required visits to a physician and showed significant economic benefits.
从临床和经济角度评估心理治疗对原发性高血压（EH）患者的适用性。
选取75例1-2级EH患者（血压为140/90至179/109 mmHg）且疾病的心身背景已得到证实，其中男性37例，女性38例。对这些患者进行检查并随机分为2组（第1组和第2组的平均年龄分别为48.5±3.69岁和47.5±4.2岁）。所有患者均采用相同方案进行药物治疗；然而，第1组患者还接受了心理治疗。将血压降低情况以及达到目标血压所需的平均就诊次数作为治疗效果的标准进行评估。对每组的降压治疗进行了药物经济学分析。
第1组每人24周的平均费用为349.67卢布，第2组为435.9卢布，第1组便宜19.78%。第1组收缩压（SBP）和舒张压（DBP）降低的费用也较低（分别为-22.108和-39.534卢布）。同时，第1组更快达到目标血压（第1组和第2组SBP每周降低分别为5.28和3.38 mmHg，DBP每周降低分别为2.51和1.73 mmHg）。这使得可以减轻医生的负担并节省时间预算（p>0.032）。
第1组的治疗策略在血压正常化速度和所需就诊次数方面优于第2组，并显示出显著的经济效益。
