The type of anxiety and the level of anxiety a predictor of the development of arterial hypertension in women with intensive mental work (profession doctor, teacher)
Authors: Podkopaeva D , Stepchenko M A 
Published: October 2021

Abstract

Introduction
Arterial hypertension (AH) is a risk factor for the development of cardio - and cerebrovascular diseases. The pathogenesis of AH is not fully understood. Of particular interest in the development of AH is chronic stress, its stage 1 – the stage of anxiety. AH and anxiety are related to an imbalance in the autonomic nervous system. The relationship between AH and the level of anxiety among the most vulnerable categories – women with intensive intellectual work, who face acute social stress on a daily basis, remains poorly understood.

Aim
To establish a link between the level, type of anxiety and the development of AH in women with professions: school teacher, doctor.

Methods
A random representative sample of 180 women was studied, which were divided into 2 groups of 90 people: 1 group – practicing doctors, 2 group – school teachers. Each group was divided into 2 equal subgroups, according to the presence and absence of AH in the anamnesis. Questionnaires and tests were conducted using the Taylor anxiety scale and the Spielberger-Hanin test. The questionnaire questions related to age, marital status, the presence of children in the family, bad habits, AH, average blood pressure (BP), position, and the need for psychological help. The reliability of the differences between the same indicators of two independent samples was compared by the Mann-Whitney U-test and Wilcoxon.

Results
The average age of group 1 was 54.4±2.8, in group 2 – 56.1±1.7 years. The highest work experience (33.77±1.94), the level of anxiety – LA (27.66±1.25) and personal anxiety – LPA (51.54±1.48) were observed in group 2, compared with the corresponding indicators of group 1 (25,75±2,92; 22,67±1,82; 44,55±1,38), (p&lt;0.001). Assessing the need for psychological help: more often the persons of the 2 group with AH (51,1%), among them a higher LA, LPA (p&lt;0.0001). The number of children is associated with LA (r=−0.69), LPA (r=−0.36), and the level of situational anxiety – LSA (r=0.63), p&lt;0.001. In group 2, without AH, the number of children in the family was reflected in an increase in systolic and diastolic BP, (r=0.42; 0.35, p&lt;0.001). LPA (50.88±3.38) prevailed in married women with 2 or more children in the family with a senior position, compared to divorced women (LPA 45.4±2.01) without children without of a senior position (p=0.005). LA is closely related to age (r=−0.58, as LPA, r=−0.4) experience (r=−0.61) p&lt;0.001.

Conclusions
1. A characteristic type of anxiety for women, regardless of the presence of AH, engaged in highly intellectual stress-related work, is personal anxiety (p&lt;0.001). 2. Personal anxiety is a characteristic reaction to social stress in individuals with AH (statistically significant differences in ULT were registered in subgroups of individuals with AH in groups 1 and 2, compared with individuals without AH (p=0.00017). 3. For women with AH, a direct correlation between LA and LPA is typical (p&lt;0.001).

Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Kursk State Medical University (KSMU)