Meta-analysis Of The Effect Of Combination Medication In Hypertensive Patients Combined With Anxiety And Depression

Obsjective To study the efficacy of combination medication(anti-hypertensive therapy combined with anti-anxiety and anti-depressant treatment)in hypertension patients with anxiety and depression and to discuss the optimized treatment protocol.Methods A computerized search of PubMed,CNKI,Wanfang database,Sinomed and internet(from 2008 up to 2017)was performed to identify relevant studies.The index words included hypertension,anxiety,depression,antihypertensive agent,antianxiety drugs,antidepressant agent.The strategy used a combination of MeSH terms and free text terms.The quality of the included studies was assessed by the Jadad score.The efficacy of antihypertensive therapy combined with antianxiety and antidepressant treatment in patients with hypertension and anxiety depression were comprehensively evaluated with meta analysis.The outcome measures were the total antihypertensive effective cases,the systolic blood pressure(SBP)and diastolic blood pressure(DBP)of the two groups after the treatment.Odds Ratio(OR),Weighted Mean Difference(WMD)and 95%confidence intervals(CIs)were calculated and pooled using fixed and random effects model respectively.Heterogeneity across studies was tested using the I2 statistic.Subgroup analysis,Sensitivity analysis and evaluating publication bias were performed.Results Six Hundred and forty-three articles were collected,28 trials accord with the inclusive criteria,involving 2388 patients.Patients in 18 studies diagnosed as mixed anxiety and depressive disorder.The objects of 9 studies were hypertension with depressive disorder patients.Only one study included patients who diagnosed as hypertension with anxiety disorders.17 studies counted the antihypertensive effective cases in the experimental group and the control group after the treatment.Combined OR of efficient rate was4.41 and its 95%confidence interval(CI)was[95%CI3.30～5.89],P<0.00001.21 studies compared the systolic blood pressure and diastolic blood pressure of the two groups before and after the treatment.And the weighted mean difference(WMD)of systolic blood pressure was-12.64[950%CI 15.14～-10.14],WMD of diastolic blood pressure was-8.78[95%CI 11.51～-6.04],P<0.00001 for each.Conclusions Compared with Antihypertensive drugs therapy alone,Antihypertensive therapy combined with antianxiety and antidepressant treatment has a more remarkable effect in treating hypertension patients with anxiety and depression.