Correlation Study On Emotional Disorders In Patients With Hypertension

Objective: In recent years,the incidence of hypertension combined with emotional disorders was increasing,which not only affected the antihypertensive effect,but also led to a serious decline in life quality.This study was designed to investigate the incidence and risk factors of anxiety and depression in essential hypertensive patients,and explore the impact of emotional disorders on life quality and cognitive function.The curative effects of psychological intervention on the emotional disorders in these hypertensive patients were also analyzed.Methods : The essential hypertensive patients were selected from June to November 2016 in cardiovascular department of Dalian Medical University Hospital.The anxiety,depression emotional disorders and life quality were evaluated with Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)and World Health Organization Quality of Life-Brief(WHOQOL-BREF),the cognitive function was evaluated with Minimum Mental State Examination(MMSE)among elderly hypertensive patients over 65 years old.Patients were divided into anxiety group,non-anxiety group,depression group,non-depression group and non-emotional disorders group according to the respective scores.The basic data,laboratory tests and physical examination results of hypertensive patients were collected.Hypertensive patients with emotional disorders were treated with health education,psychological intervention with “small daily happiness”.After 4 to 12 weeks’ follow-up,all the evaluations were re-performed,and the differences of these rating scales and blood pressure levels were compared respectively.Results: In total of 182 patients with hypertension were enrolled in this study,theaverage age was 61.57 ± 11.67 years old,with 88 males(48.35%)and 94 females(52.65%).Among them,70 cases(65.46%)were over 65 years old,including 3 cases(4.29%)with cognitive dysfunction.There were 13 cases(7.14%)in hypertension grade2,169 cases(92.86%)in hypertension grade 3.There were 51 patients(28.02%)with anxiety disorder in this study,47 patients(25.82%)with depression disorder.There was a high proportion of female,low educational level in the anxiety group compared with the non-anxiety group.There was a high proportion of female,low educational level,no/less economic sources,high total cholesterol level in the anxiety group compared with the non-emotional disorders group.There was a high proportion of female,low educational level,no/less economic sources,NRR(Nocturnal Reduction Rate)<10%,high LP(a),hs-CRP(High Sensitivity C-Reactive Protein)level in the depression group compared with non–depression and the non-emotional disorders group.Hypertensive patients combined with anxiety,depression,emotional disorders had lower life quality,but there was no effect on cognitive function.Female,low educational level,no/less economic sources,high total cholesterol level were the risk factors(OR=3.240,95%CI=1.589~6.606;OR=0.664,95%CI=0.334~1.322;OR=0.499,95%CI=0.224~1.111;OR=1.091,95%CI=0.802~1.484)for hypertension combined with anxiety disorder;female,high hs-CRP level,low educational level,no/less economic sources were the risk factors(OR=3.828,95% CI=1.671~8.769;OR=1.065,95%CI=1.009~1.125;OR=0.530,95% CI=0.241~1.167;OR=0.321,95% CI=0.135~0.762)for hypertension combined with depression disorder.There was a positive correlation between SAS and SDS(r=0.695,P<0.01),negative correlation among SAS,SDS and WHOQOL BREF in the overall quality of life,general state of health,the domains of physical,psychological,social relationships,environmental scales.Systolic blood pressure(SBP)and diastolic blood pressure(DBP)were lower after psychological intervention treatment(137.63±16.72/82.73±12.33 mm Hg vs.132.25±10.65/79.31±10.25 mmHg,138.87 ± 15.26/82.48 ± 10.83 mmHg vs.132.61 ± 10.89/79.13 ±9.03mmHg),the SAS,SDS scores were decreased,WHOQOL BREF,MMSE scores were increased.Conclusion: The incidence of hypertension combined with anxiety,depression,emotional disorders were higher.Female,low educational level,no/less economic sources,high total cholesterol level were the risk factors for hypertension combined with anxiety disorder;female,low educational level,no/less economic sources,high hs-CRP level were the risk factors for hypertension combined with depression disorder.Hypertensive patients combined with anxiety,depression had lower life quality,but there was no effect on cognitive function.Psychological intervention could improve emotional disorders,life quality and cognitive function in hypertensive patients,and reduced blood pressure levels.