Clinical Study On The Relationship Between Essential Hypertension And Anxiety And Depression In Young And Middle-Aged Pe Ople

ObjectiveEssential hypertension is not only a polygenic genetic disorder,but also a psychosomatic disorder.Due to their special social roles,young and middle-aged people have led to greater pressure in society and work,family,life and other aspects,and they are more likely to change anxiety and depression than other age groups.When the two factors of primary hypertension and young and middle-aged people appear at the same time,the relationship between primary hypertension and anxiety and depression in young and middle-aged people is worth studying.Through the consultation of relevant literature,domestic and foreign studies on the relationship between hypertension and anxiety and depression are mainly involved in the elderly,and there are few clinical studies on the relationship between primary hypertension and anxiety and depression in young and middle-aged people.This clinical study mainly proceeds from the following aspects: whether the blood pressure level of young and middle-aged people is affected by anxiety and depression;whether anxiety and depression will promote the complications of young and middle-aged patients with primary hypertension;the impact of psychotherapy on the control of blood pressure in young and middle-aged patients with primary hypertension and anxiety depression on the basis of antihypertensive drugs;and the change of anxiety and depression score.MethodThe self-rating anxiety scale(SAS)was used to assess whether there was anxiety,the self-rating depression scale(SDS)was used to assess whether there was depression,each scale had 20 scoring items,each scale used the Liker 4-level scoring method,according to the frequency of symptoms,the standard score was the sum of the items× 1.25,the higher the score indicated the patient’s anxiety The more severe the depression.From October 2020 to October 2021,260 patients with hypertension and 240 patients with non-hypertension were collected at the Physical Examination Center of Huaihe Hospital of Henan University.The relationship between anxiety,depression score and blood pressure level in 500 participants was analyzed.The prevalence of anxiety and depression in 260 patients with hypertension and 240 patients with non-hypertension was analyzed.Multiple logistic regression was used to analyze whether anxiety and depression were associated with primary hypertension in young and middle-aged people,and whether there were differences in the effects of anxiety and depression on hypertension.According to the SAS and SDS scores,260 hypertensive patients were divided into 68 people in the primary hypertension group and 192 people in the primary hypertension with anxiety and depression group,and the effect of anxiety and depression on the blood pressure compliance rate and the common complications of hypertension were analyzed by comparing the statistical data of the two groups.There were 192 people in the primary hypertension with anxiety and depression group,of which 58 people were able to meet the long-term follow-up conditions,and then according to whether psychological intervention treatment was given,58 people were divided into 30 people in the treatment group and 28 people in the control group,and 58 people were followed up for a period of two months,recording SAS,SDS scores and blood pressure control,and then comparing the changes in blood pressure compliance rates and SAS and SDS scores in the two groups before and after the intervention.Result1.The mean systolic blood pressure of the 500 patients was 136.67 ± 17.34 mm Hg,the mean diastolic blood pressure was 78.98 ± 12.57 mm Hg,the mean anxiety score was 51.20 ± 4.61,and the mean depression score was 52.61 ± 3.26.There was a correlation between anxiety and diastolic blood pressure with a positive correlation(r=0.338,P<0.001),and between depression and diastolic blood pressure with a positive correlation(r=0.257,P<0.001).Among 260 patients with essential hypertension,165(63.5 %)suffered from anxiety,124(47.7 %)from depression,and 97(37.3 %)from both anxiety and depression;among 240 non-hypertensive patients,107(44.6 %)suffered from anxiety and 73(30.4 %)from depression.Of the 240 non-hypertensive patients,107(44.6 %)suffered from anxiety,73(30.4 %)from depression,and 52(21.7 %)from both anxiety and depression.Anxiety was a risk factor for essential hypertension in young and middle-aged people(P=0.001),and depression was also a risk factor for essential hypertension in young and middle-aged people(P=0.001).Regression analysis of risk factors for hypertension showed that B=0.599,OR=1.82 for anxiety and B=0.536,OR=1.709 for depression,and there was no significant difference between the effects of depression and anxiety on essential hypertension in young and middle-aged adults.2.There were no statistical differences in free triiodothyronine(FT3),total cholesterol(TC),and creatinine(CRE)in 192 patients in the primary hypertension with anxiety and depression group compared with 68 patients in the primary hypertension group(P > 0.05),and there were statistical differences in concomitant cervical vascular lesions,cerebrovascular lesions,blood pressure compliance,and hypertension grading(P < 0.05).Grade 3 hypertension accounted for 29.4% in the primary hypertension group and 60.4% in the primary hypertension with anxiety and depression group,and anxiety and depression promote the progression of blood pressure levels in young and middle-aged patients with primary hypertension.The blood pressure control rate was 70.6% in the primary hypertension group and44.3% in the primary hypertension with anxiety and depression group,and the blood pressure control rate in the primary hypertension with anxiety and depression group was more difficult to achieve than that in the primary hypertension group.After multivariate logistic regression analysis,the results showed that anxiety and depression were not statistically significant(P > 0.05)for hypertension complicated by cervical vasculopathy and cerebrovascular lesions.3.Compared with the 30 participants in the treatment group treated with psychological intervention and the 28 participants in the control group without any intervention,the differences between the two groups in general information such as age,gender,and BMI were not statistically significant(P >0.05);the differences in anxiety and depression scores between the two groups before and after the intervention were statistically significant(P < 0.05),and the anxiety and depression scores in the treatment group decreased after the psychological intervention treatment;the differences in blood pressure achievement rate between the two groups before and after the intervention were statistically significant(P <0.05).The difference in blood pressure standard rate between the two groups before and after the intervention was statistically significant(P < 0.05),and after the psychological intervention treatment,the blood pressure standard rate in the treatment group was higher than before.Conclusion1.Anxiety and depression affect blood pressure levels in young and middle-aged adults,mainly affecting diastolic blood pressure.Both anxiety and depression are risk factors for essential hypertension in young and middle-aged adults,and there is no significant difference in the effect of both on hypertension.2.Anxious depression promotes the progression of blood pressure levels in young and middle-aged people with essential hypertension.Essential hypertension with anxiety and depression in young and middle-aged adults is more difficult to achieve blood pressure control compared to essential hypertension only.3.After psychotherapy,blood pressure compliance increased and anxiety and depression scores decreased in middle-aged and young adults with essential hypertension with anxiety and depression.