Статья
Психологические вмешательства при артериальной гипертензии: вопросы обоснованности и эффективности
В статье рассматриваются основные задачи психологического вмешательства у пациентов с артериальной гипертензией (АГ) и предгипертензией. Анализируются исследования эффективности психологических вмешательств в предупреждении АГ, снижении артериального давления (АД) и повышении приверженности лечению пациентов при АГ, в профилактике и коррекции ее психопатологических осложнений. Показано, что по результатам методологически строгих исследований психокоррекционные методы, применяемые в лечении и профилактике АГ, в целом не имеют достаточно высокой эмпирически подтвержденной эффективности. Наименее убедительны данные в пользу применения психологических методов в профилактике АГ, в то же время отдельные методы демонстрируют эффективность в решении задачи снижения АД и обеспечения приверженности лечению при АГ. Доказана эффективность психологических вмешательств в предупреждении и замедлении развития когнитивных нарушений сосудистого генеза, однако в соответствующих исследованиях не учитывался фактор АД. В статье анализируются возможные объяснения ограниченной эффективности психологических вмешательств при АГ по данным современных метааналитических работ и перспективы развития данного направления исследований.
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