Neuropsychological and psychosomatic correlates of arterial hypertension in patients with interhemispheric functional asymmetry

Abstract

Aims. This study aims to evaluate the effect of interhemispheric interaction on the clinical and dynamic characteristics of arterial hypertension (AH) through the lens of psychosomatic balancing for developing new prognostic criteria for disease progression. Materials and methods. This cross-sectional study involved 60 patients diagnosed with stage I–II AH (mean age 59.7 ± 10.6 years; 73.2 % female patients). The diagnostic protocol included lateral profile assessment (Zaitsev test), handgrip dynamometry as a measure of motor asymmetry, and 24-hour blood pressure monitoring. Psychosomatic status was evaluated using the Defense Style Questionnaire (DSQ-40) and the SF-36 health survey. Adaptation capacity was evaluated by measuring the time required for oxygen saturation recovery after standardized physical exercise. Statistical analysis was performed using Student’s t-test and Pearson’s correlation coefficient. Results. Deficiency of interhemispheric interaction mechanisms proved to be a statistically significant predictor of a more severe course of arterial hypertension. A strong inverse correlation was found between the effectiveness of interhemispheric transfer and systolic blood pressure. Patients with insufficient interhemispheric interaction demonstrated an imbalanced adaptation pattern: a twofold dominance of immature defense systems (primarily somatization, repression, and denial) accompanied by reduced quality of life in the mental health domain. Physiological rigidity in this population was confirmed by a significant slowing of post-exercise oxygen saturation recovery, indicating inertia of autonomic control and associated with a high risk of hypertensive crises. Conclusion. Weak interhemispheric interaction limits the adaptive potential of the central nervous system, impedes full cognitive representation of affect, and promotes its somatization through increased vascular tone. The obtained results justify the integration of neuropsychological correction and biofeedback into comprehensive rehabilitation programs for patients with arterial hypertension to optimize psychosomatic balance