Novak-Mazepa K. Psychological indices of health and their relationship with components of the metabolic syndrome in patients with arterial hypertension with different chronotypes

In the dissertation, a new, scientifically based theoretical generalization is given and the solution of the actual task is carried out, which consisted in increasing the effectiveness of the diagnosis of the dispositional optimism/pessimism level and daytime sleepiness and their relationship with the components of the metabolic syndrome in patients with arterial hypertension with different chronotypes. For the first time in Ukraine, the psychological indices and chronotype of patients with arterial hypertension and when combined with the metabolic syndrome were investigated, in particular, the predominance of patients with an evening chronotype, severe daytime sleepiness and high pessimism was established, while the psychological indices of patients with arterial hypertension and the metabolic syndrome were studied, significantly worsen in relation to these patients without metabolic syndrome. It was shown for the first time that the frequency of the metabolic syndrome (52.38 %) and its components – abdominal obesity (61.90 %), hypertriacylglycerolemia (42.86 %), hyperglycemia (26.19 %), a decrease in the level of high-density lipoprotein cholesterol (66.67 %) in patients with arterial hypertension is significantly associated with the level of dispositional optimism, chronotype and level of daytime sleepiness. The significant relations between an increase in blood pressure, waist circumference, disease duration, atherogenic dyslipidemia and dispositional optimism (toward pessimism), chronotype type (toward evening), and progression of daytime sleepiness were established in patients with arterial hypertension. The significant threshold values were established in patients with arterial hypertension with the evening chronotype of dispositional optimism ≤ 8.5 and the level of daytime sleepiness ≥ 14.5 points. The ROC analysis method was used for the first time to analyze the significant prognostic indices of the components of the metabolic syndrome in patients with arterial hypertension with an evening chronotype (waist circumference ≥ 98 cm, glucose concentration ≥ 5.5 mmol/l), with high pessimism (glucose concentration ≥ 4.30 mmol/ l).