老年高血压患者焦虑抑郁状态对血压水平的影响分析
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摘要
目的 探讨老年高血压患者焦虑抑郁状态对血压水平的影响。方法 选取该院2016年3月—2018年5月收治的236例老年高血压患者为研究对象,根据焦虑抑郁筛查结果分为无焦虑抑郁组162例,焦虑抑郁组74例,对两组患者进行24 h动态血压监测,比较其血压水平。结果 无焦虑抑郁组患者的24 h收缩压、24 h舒张压(124.04±5.07)mmHg、(86.39±3.71)mmHg与焦虑抑郁组(143.81±7.34)mmHg、(96.18±5.76)mmHg比较,差异有统计学意义(t=20.984,P=0.000;t=15.661,P=0.000);两组昼间舒张压及收缩压、夜间舒张压及收缩压比较,差异有统计学意义(P<0.05);两组24 hDBP变异性对比差异无统计学意义(P>0.05),焦虑抑郁组24 h收缩压变异性(7.14±1.05),与无焦虑抑郁组对比(10.04±1.34)对比差异有统计学意义(t=16.447,P<0.05),焦虑抑郁组非杓型动态血压节律发生率52.70%,明显高于无焦虑抑郁组23.46%(χ~2=19.765,P<0.05)。结论 老年高血压患者焦虑抑郁状态对血压水平有影响,需要临床加以重视。
Objective To investigate the effect of anxiety and depression on blood pressure in elderly patients with hypertension. Methods A total of 236 elderly patients with hypertension admitted to our hospital from March 2016 to May 2018 were selected as the research objects. According to the results of screening for anxiety and depression, 162 cases were divided into non-anxiety and depression group, with 74 cases in anxiety and depression group. 24-hour ambulatory blood pressure monitoring was carried out to compare the blood pressure level between the two groups. Results The 24-hour systolic blood pressure and 24-hour diastolic blood pressure(124.04±5.07) mmHg,(86.39±3.71) mmHg in the group without anxiety and depression were significantly different from those in the group with anxiety and depression(143.81±7.34) mmHg,(96.18±5.76) mmHg(t=20.984, P=0.000; t=15.661, P=0.000). There were significant differences in daytime diastolic and systolic blood pressure, night diastolic blood pressure and systolic blood pressure be-tween the two groups(P<0.05). 24-hour DBP variability between the two groups had no significant difference(P>0.05). The 24-hour systolic blood pressure variability in anxiety and depression group(7.14±1.05) was significantly higher than that in non-anxiety-depression group(10.04±1.34)(t=16.447, P<0.05). The incidence of non-dipper ambulatory blood pressure rhythm in anxiety-depression group was 52.70%, which was significantly higher than that in non-anxiety-depression group(23.46%)(χ~2=19.765, P<0.05). Conclusion Anxiety and depression in elderly patients with hypertension have an effect on blood pressure level, which needs clinical atten-tion.
Objective To investigate the effect of anxiety and depression on blood pressure in elderly patients with hypertension. Methods A total of 236 elderly patients with hypertension admitted to our hospital from March 2016 to May 2018 were selected as the research objects. According to the results of screening for anxiety and depression, 162 cases were divided into non-anxiety and depression group, with 74 cases in anxiety and depression group. 24-hour ambulatory blood pressure monitoring was carried out to compare the blood pressure level between the two groups. Results The 24-hour systolic blood pressure and 24-hour diastolic blood pressure(124.04±5.07) mmHg,(86.39±3.71) mmHg in the group without anxiety and depression were significantly different from those in the group with anxiety and depression(143.81±7.34) mmHg,(96.18±5.76) mmHg(t=20.984, P=0.000; t=15.661, P=0.000). There were significant differences in daytime diastolic and systolic blood pressure, night diastolic blood pressure and systolic blood pressure be-tween the two groups(P<0.05). 24-hour DBP variability between the two groups had no significant difference(P>0.05). The 24-hour systolic blood pressure variability in anxiety and depression group(7.14±1.05) was significantly higher than that in non-anxiety-depression group(10.04±1.34)(t=16.447, P<0.05). The incidence of non-dipper ambulatory blood pressure rhythm in anxiety-depression group was 52.70%, which was significantly higher than that in non-anxiety-depression group(23.46%)(χ~2=19.765, P<0.05). Conclusion Anxiety and depression in elderly patients with hypertension have an effect on blood pressure level, which needs clinical atten-tion.
引文
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[9]曹爽,丁建伟,李炳,等.慢性束缚应激诱导自发性高血压大鼠出现抑郁焦虑样行为[J].实验动物与比较医学,2014,34(2):93-97.
[10]李海聪,李求兵,杨毅玲.抗抑郁治疗对老年高血压合并抑郁障碍患者血压的影响[J].中华老年心脑血管病杂志,2016,18(2):143-148.
[11]陈冰,肖峰,陈爱年,等.焦虑抑郁状态对高血压性壳核出血血肿周围水肿的影响[J].山东医药,2016,56(36):76-78.
[12]杜铮,蒲瑜,韩艺辉.焦虑抑郁状态对老年高血压患者动态血压影响的研究[J].中国保健营养,2018,28(31):108.
[2]王树娟,张清潭.焦虑抑郁与血压变异性关系研究进展[J].中国全科医学,2018,21(6):637-642.
[3]党爱民,陈炳伟.2013欧洲高血压学会/欧洲心脏病学会高血压管理指南更新要点解读[J].中国循环杂志,2013,28(6):401-403.
[4]韩振,隋瑜,孙雪林.焦虑抑郁状态对老年高血压患者动态血压和血压变异性的影响研究[J].临床和实验医学杂志,2016,15(16):1630-1632.
[5]李晓,张海澄,崔玉贤.高血压合并抑郁和焦虑的临床分析[J].中国医药,2016,11(2):181-184.
[6]王登芹.焦虑抑郁状态对老年高血压患者动态血压影响的研究[J].中华老年心脑血管病杂志,2014,16(7):723-725.
[7]Jackson CA,Mishra GD.Depression and risk of stroke in midaged women:a prospective longitudinal study[J].Stroke;a journal of cerebral circulation,2013,44(6):1555-1560.
[8]杨静.老年高血压伴发抑郁和焦虑情绪患者血压变化规律探讨[J].检验医学与临床,2015,12(21):3214-3216.
[9]曹爽,丁建伟,李炳,等.慢性束缚应激诱导自发性高血压大鼠出现抑郁焦虑样行为[J].实验动物与比较医学,2014,34(2):93-97.
[10]李海聪,李求兵,杨毅玲.抗抑郁治疗对老年高血压合并抑郁障碍患者血压的影响[J].中华老年心脑血管病杂志,2016,18(2):143-148.
[11]陈冰,肖峰,陈爱年,等.焦虑抑郁状态对高血压性壳核出血血肿周围水肿的影响[J].山东医药,2016,56(36):76-78.
[12]杜铮,蒲瑜,韩艺辉.焦虑抑郁状态对老年高血压患者动态血压影响的研究[J].中国保健营养,2018,28(31):108.