The Relationship of History of Hypertension and Illness Cognitive Representation in Post-Myocardial Infarction

Document Type : Original Article(s)

Authors

1 Assistant Professor, Behavioral Sciences Research Center and Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan

2 Associate Professor, Department of Internal Medicine. School of Medicine, Isfahan University of Medical Sciences, Isfahan

3 Assistant Professor, Department of Psychology, The University of Tehran, Tehran

Abstract

Background:According to self-regulation model of Leventhal, medical patients construct schematic representations of illness which may impact on various dimensions of their adjustment with the medical condition. The purpose of this study was to exam the relationship of the history of hypertension and illness representations among post-myocardial infarction patients.

Methods: One hundred and seventy six consecutive patients following myocardial infarction admitted to the CCU wards were selected based on the inclusive and exclusive criteria. Data obtained by using demographic questionnaire, Brief Illness Perception questionnaire (B-IPQ) and Beck Depression Inventory-II. Their medical data were obtained from medical records and history of hypertension was confirmed by cardiologist based on information recorded, history of patient and taking medications for hypertension. Therefore, the patients were divided into two groups with and without previous hypertension. χ2 test, student’s t-test, MANCOVA and Covariance were used to analyze the data.

Findings: 30.7% had history of hypertension. A significant difference was seen between two groups in B-IPQ scores (F = 2.501, P = 0.033). Also, it showed significant differences in two dimensions of controllability/ treatability (F = 5.45 P = 0.026) and consequences (F = 5.054, P = 0.026). However, there were no significant differences in identity (F = 1.262, P = 0.228) and timeline (F = 0.261, P = 0.549) between two groups.

Conclusion: Generally, the findings confirmed that the post-myocardial infarction patients with history of hypertension explain their cardiac attack as a more adverse event than those without history of hypertension. Also having previous hypertension may be associated with patient`s perception of consequences and controllability/treatability of myocardial infarction. However, these findings did not support such link with perception of identity and timeline of the disease. Thus, the post MI patients with history of hypertension likely develop negative schema about some dimensions of cardiac attack.

Key words: Hypertension, Illness perception, Identity, Consequences, Timeline, controllability, treatability.