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IS IT IMPORTANT TO EVALUATE SYMPTOMS OF INSOMNIA IN OLDER ADULTS WITH HYPERTENSION?
Introduction: The increase in chronic diseases such as hypertension and their association with cardiovascular mortality in the elderly represents a public health priority. Persistent insomnia is associated with increased risk of hypertension and people with hypertension and symptoms of insomnia have a worse prognosis for the disease. In addition, older adults are more vulnerable to stressful life events and depressive symptoms, which have also been related to hypertension.
Objective: To verify the relation of insomnia symptoms with depressive symptoms and stressful events in older adults with hypertension.
Method: cross-sectional study conducted with 438 older adults (mean age 72.1 years, 71.5% female) with hypertension, participants of the Brazilian Older Adult Frailty Study (FIBRA-Campinas). Insomnia symptoms were the dependent variable, assessed by four questions in the Nottingham Health Profile: disorders of initiating and mantaining sleep, early awakening and non-restorative sleep, grouped into categories by cluster analysis. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS-15) and stressful life events using the Elders Life Stress Inventory (ELSI). Mann-Whitney, Kruskal-Wallis and chi-square tests were used, considering a significance level of 5%.
Results: Three categories were obtained from cluster analysis: Good Sleep; Bad Sleep; Early Awakening. When compared to older adults in the Good Sleep category, the older adults in the Bad Sleep and Early Awakening categories showed higher GDS-15 scores (p<0.0001), as well as reporting the occurrence of stressful events with greater intensity in the Finitude (p=0.007) and Well-being (p<0.0001) domains. There was a higher prevalence of stressful life events in the Well-being domain (p=0.0002) for the Bad Sleep category, and a lower prevalence of stressful life events in the Descendence domain (p=0.017) for the Good Sleep category.
Conclusion: The approach to hypertension in health care should include an assessment of the older adults in their entirety, considering other common complaints at this age, such as sleep complaints and other psychosocial factors that imply detriment and failures during their treatment, such as depressive symptoms. This grouping of symptoms may affect the management of the treatment of their underlying chronic disease and the investigation of them should be expanded.
Descriptors: Hypertension; Depression; Sleep Initiation and Maintenance Disorders
Carla Renata Silva Andrechuk, Carola Rosas, Henrique Ceretta Oliveira, Cleber de Souza Oliveira, Cristina Kano Inazumi, Anita Liberalesso Neri, Maria Filomena Ceolim