Academic journal article The European Journal of Counselling Psychology

The Influence of Stress on the Quality of Life of Hypertensive Patients

Academic journal article The European Journal of Counselling Psychology

The Influence of Stress on the Quality of Life of Hypertensive Patients

Article excerpt


In Portugal cardiovascular diseases are the leading cause of death, and nowadays hypertension is the cardiovascular risk factor with the highest prevalence in Portugal and worldwide. Associated mortality and morbidity are becoming a real public health problem, so is essential to reduce the value of blood pressure to prevent cardiovascular disease (Portugal, Ministério da Saúde, Direcção Geral da Saúde [Portugal, MS, DGS], 2011).

The diagnosis of hypertension is defined as a "a elevação persistente, em várias medições e em diferentes ocasiões, da pressão arterial sistólica igual ou superior a 140mmHg e/ou da pressão arterial diastólica igual ou superior a 90mmHg"i (Portugal, MS, DGS, 2011, p. 1).

About three million Portuguese suffer from hypertension and the World Health Organization predicts a significant worsening in the following years (Macedo et al., 2007).

The study of Macedo et al. (2007) reveals that the prevalence of hypertension in Portugal is 41.2%; it highlights a tendency to increase blood pressure with age and that there is an increased prevalence of hypertension in under 64 year old males. After that age, the difference between genders tends to be attenuated.

The quality of life of the patients can be affected by a simple diagnosis of disease, by the side effects of therapy or even by changes in their lifestyle (Gusmão & Pierin, 2009).

According to the World Health Organization (WHO), quality of life is related to the perception that people has about their lives in a context of culture and value systems in which they live in relation to the goals, expectations, standards and concerns (WHO, 2001).

Quality of life is an indicator of good health and this improvement has become one of the expected outcomes of health professionals in the sector of health promotion and disease prevention (Seidl & Zannon, 2004).

The quality of life is used to evaluate the physical and psychosocial impact that disease causes to patients, thereby allowing a better knowledge of the patient and his perception of disease (Carvalho et al., 2012). Also according to Gusmão and Pierin (2009), quality of life encompasses aspects related to the physical, psychic, social and individual impact of health on their ability to get on with the patient's life.

Previous investigations have shown that clinical and sociodemographic variables affect the patient's quality of life, reporting that in hypertension patients there is a decrease of it (Carvalho et al., 2012; Cavalcante et al., 2007; Melchiors, 2008; Melchiors, Correr, Pontarolo, Santos, & Souza, 2010). However there are studies that have concluded the opposite and state that there is no decrease in the quality of life of hypertension patients (Ramos, Oliveira, & Freitas, 2009).

Evaluate the quality of life of hypertension patients is essential to know what is the real impact of the disease on their lives. However, clinical practice tells us that quality of life is not only affected by chronic illness or by demographic data but also by the stress that can cause illness or even a change in the everyday lives of patients.

Stress raises emotions, behavior changes and interferes with cognitive and biological mechanisms. Due to health, stress may be a precipitating factor in cardiovascular diseases such as hypertension (Vaz-Serra, 2000).

Stress is an exciting potential in the reactivity of hypertensive cardiovascular patients as well as painful episode can be stressful to patients, depending on the level of control of the hypertension person (Lipp, Frare, & Santos, 2007). Vaz-Serra (2000, 2002) states that someone feels stressed out when he thinks that he does not have skills or resources to overcome a situation that requires more handling than usual. Thus that person will develop the perception of having no control over the situation and begins to feel vulnerable to that circumstance. A chronic disease such as hypertension requires more from the person and requires a change in lifestyle as well, although the person may or may not feel able to overcome this new situation. …

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