Effect of arterial hypertension on quality of life and anxiety in middle-aged patients with breast cancer

BACKGROUND: Arterial hypertension is one of the key risk factors for the development of cardiotoxicity in cancer patients. The importance for patients with left breast cancer is due to the possibility of the heart getting into the radiation area during treatment. The use of a method for assessing the quality of life and symptoms of anxiety can help improve treatment in such patients by increasing the interaction between a physician and a patient.

AIM: The aim of the study is to assess the quality of life and the level of anxiety in patients with breast cancer, depending on the presence of arterial hypertension.

MATERIALS AND METHODS: 67 patients with HER2neu negative cancer of the left breast have been examined. The average age is 42 (47; 63). All the patients after radical mastectomy and a course of chemotherapy with the inclusion of doxorubicin in a cumulative dose of no more than 360 mg/m² have been hospitalized for 3D conformal radiation therapy. The first group included 32 patients with grade I–II comorbid hypertension; the second group included 35 patients without hypertension. The examination included an assessment of the status of an oncological patient according to the ECOG scale, echocardiography with an assessment of diastolic function, determination of the level of reactive and personal anxiety according to the Spielberger – Khanin scale and quality of life using the SF-36 questionnaire.

RESULTS: In the group of the patients with combined hypertension, left ventricular hypertrophy has been detected in 48 % of cases. In the patients of both groups with preserved ejection fraction, type I diastolic dysfunction has been detected (E/A < 1): in the patients of the first group — in 59.4 % of cases, in the patients of the second — 31.4 % of cases. The difference obtained is due to the effect of hypertension on the left ventricular relaxation disorder. The level of reactive anxiety was significantly higher in the patients of the first group and amounted to 43.8 (41.2; 46.2) versus 38.4 (32.7; 42.6) points in the second group. The level of personal anxiety was high in the patients of both groups, which can be explained by the predominant influence of cancer. In the patients of both groups, there was a decrease in indicators according to the SF-36 questionnaire on all scales. The most significant changes have been obtained on the scales of physical functioning, role-based physical functioning, pain, vitality and general health. Cancer patients with concomitant hypertension rated their health status lower, while they are more likely to note a decrease in daily role activity as a result of their emotional state.

CONCLUSIONS: The data obtained indicate that arterial hypertension has a significant negative effect on the level of reactive anxiety and quality of life indicators of breast cancer patients, which is of great importance in the formation of a patient-oriented approach to the therapeutic support of specific treatment in such patients.