焦虑抑郁情绪对无临床并发症老年原发性高血压患者动态血压及心率变异性的影响  

Effects of anxiety and depression on ambulatory blood pressure and heart rate variability in elderly patients with essential hypertension without clinical complications

作　　者：丁育钧[1] 段书[2] 蔡文玉[1] 江玉文[1] DING Yujun;DUAN Shu;CAI Wenyu;JIANG Yuwen(Department of Cardiovascular Medicine,Jinjiang Hospital,Jinjiang 362200,China;Department of Cardiovascular Medicine,Xiangya second Hospital,Central South University,Changsha 410011,China)

机构地区：[1]福建省晋江市医院心血管内科,福建晋江362200 [2]中南大学湘雅二医院心血管内科,湖南长沙410011

出　　处：《中国医药科学》2018年第6期14-18,共5页China Medicine And Pharmacy

摘　　要：目的分析焦虑抑郁情绪对无临床并发症老年原发性高血压(EH)患者动态血压和心率变异性的影响。方法以医院焦虑抑郁量表评分≥9分且汉密尔顿焦虑量表评分≥14分或汉密尔顿抑郁量表评分≥20分为焦虑抑郁情绪的标准,将163例无临床并发症老年EH患者分为焦虑抑郁组(n=74)和对照组(n=89),比较两组的相关临床资料、动态血压及心率变异性情况。结果焦虑抑郁组24小时平均收缩压、24小时平均舒张压、白天平均收缩压、夜间平均收缩压、夜间平均舒张压、动态脉压、清晨收缩压、夜间最低收缩压及非杓型的血压昼夜节律发生率均明显高于对照组(P<0.05),心率变异性各时域指标均明显低于对照组(P<0.05)。结论焦虑抑郁情绪可增高无临床并发症老年EH患者的动态血压水平及非杓型血压昼夜节律的发生率,降低心率变异性,提示可增高患者靶器官损害及心血管事件的风险。Objective To investigate the effects of anxiety and depression on ambulatory blood pressure and heart rate variability in elderly patients with essential hypertension without clinical complications.Methods One hundred and sixty-three elderly EH patients without clinical complications were divided into anxiety depression group(n=74)and control group(n=89)according to the criteria of anxiety and depression(the Hospital Anxiety and Depression scale score≥9 points and Hamilton Anxiety Scale score≥14 or Hamilton Depression Scale scores≥20).The clinical data,ambulatory blood pressure and heart rate variability were compared between the two groups.Results In the anxiety and depression group,24 hours mean systolic blood pressure,24 hours mean diastolic blood pressure,daytime mean systolic blood pressure,nighttime mean systolic blood pressure,nocturnal mean diastolic blood pressure,dynamic pulse pressure,early morning systolic blood pressure,nocturnal minimum systolic blood pressure and non-dipper circadian rhythm of blood pressure were significantly higher than that of the control group(P<0.05)and the time domain indexes of heart rate variabiliy were significantly lower than that of the control group(P<0.05).Conclusion Anxiety and depression can increase the level of ambulatory blood pressure and the incidence of non-dipper blood pressure circadian rhythm in elderly EH patients without clinical complications,reduce heart rate variability,and may increase the risk of target organ damage and cardiovascular events.

关 键 词：原发性高血压 焦虑抑郁 动态血压 心率变异性 

分 类 号：R544.1[医药卫生—心血管疾病]