The Effect Of Anxiety Depression On Blood Pressure And Heart Rate Variability In Patients With Hypertension

Objective:To observe the effect which anxiety depression on ambulatory blood pressure monitorin(ABPM) and heart rate variability(HRV) in patients with essential hypertension (EH), and investigate the effects of anti-anxiety-depression drug on efficacy of ambulatory blood pressure, ambulatory pulse pressure(APP), morning blood pressure surge (MBPS), circadian rhythm(CR) and autonomic nerves in patients for essential hypertension with anxiety depression. Methods:To evaluate 117 EH patients, to divided into anxiety depression group (n=63) and non-anxiety non-depression group(n=54) according to anxiety depression, to compare related clinic information between anxiety depression group and non-anxiety-depression group, ambulatory blood pressure and HRV. All patients of anxiety depression group were given anti-hypertension treatment (amlodipine besilate). Then they were divided into two groups randomly, one was treated with anti-anxiety-depression drug (paroxetine), called anti-anxiety-depression group (n=31), the other was not. called non anti-anxiety-depression group (n=32). Both were followed up 6 weeks, to observe ambulatory blood pressure monitorin and HRV, Finally, all indexes were compareeded within and between them. Results:(1) The 24 hours average blood pressure, the average blood pressure of daytime, the average blood pressure of night, the blood pressure of morning, the lowest blood pressure of night, morning blood pressure surge and ambulatory pulse pressure in anxiety depression group are all higher than non-anxiety non-depression group(P<0.05); Non-dipper circadian rhythm incidence rate of anxiety depression group is higher than non-anxiety non-depression group(P<0.05); (2) The HRV index (SDNN, SDANN, RMSSD) in anxiety depression group are lower than non-anxiety non-depression group (P<0.05); (3)The 24 hours average blood pressure, the average blood pressure of daytime-the average blood pressure of night, the blood pressure of morning and ambulatory puise pressure of anti-anxiety-depression group and non anti-anxiety-depression group to decreasing in post-treatment(P<0.05), but it is significant between anti-anxiety-depression group and non anti-anxiety-depression group (P<0.05); Non-dipper circadian rhythm incidence rate of anti-anxiety-depression group is lower than non anti-anxiety-depression group (P<0.05); (4)The HRV index (SDNN, SDANN, RMSSD) of anti-anxiety-depression group and non anti-anxiety-depression group to increasing in post-treatment (P<0.05), but it is significant between anti-anxiety-depression group and non anti-anxiety-depression group (P<0.05). Conclusion:Anxiety depression increase the ambulatory blood pressure, morning blood pressure surge, ambulatory pulse pressure and non-dipper circadian rhythm incidence rate in essential hypertension patients, damage autonomic nerves system. The anti-anxiety-depression drug, paroxetine has effect on ambulatory blood pressure, morning blood pressure surge and ambulatory pulse pressure, circadian rhythm and heart rate variability in essential hypertension for patients with anxiety depression, to improve function of autonomic nerves.