The Effect Of Anxiety Depression On Morning Blood Pressure Surge In Patients With Hypertension And Effects Of Multi-intervention

Objective:The aim of this study is to observe the effect of anxiety depression on morning blood pressure surge in patients with hypertension and the clinical effects of multi-intervention.Methods:The 96 patients with essential hypertension had been collected in out-patient department in our hospital from April 2016 to October 2016(by strict inclusion and exclusion criteria).The patients were divided into group A and group B after evaluating by the PHQ-9 scale and the GAD-7 scale.Group A included 54 patients with simple hypertension and group B of 42 patients with the hypertension and anxiety depression.And all subjects were monitored with 24-hours ambulatory blood pressure.Meanwhile evaluating the effect of anxiety depression on morning blood pressure surge in all subjects.The the patients in group B were divided into the group of comprehensive intervention and the group of conventional treatment Randomly.After 8 weeks of intervention,observing the changes of anxiety depression,the anti-hypertensive effective rate and the qualified rate.Results:(1)In this study,the incidence of hypertension with anxiety depression was 43.75%.(2)Group A and Group B were no significant difference in ordinary conditions(P>0.05).(3)Compared with group A,MBPS,24 hSBP,24hDBP,dSBP,dDBP,nSBP and nDBP of group B were significantly higher(P<0.05).(4)There were 12 cases of non-dipper hypertension in group A,and there were 22 cases in group B.Meanwhile,the incidence of non-dipper hypertension in two groups was 22.22% and 52.38% respectively,the difference between the two groups was statistically significant(P<0.05).(5)After 8 weeks of intervention,the PHQ-9 and GAD-7 scores of the conventional treatment group were not changed significantly compared with before(P>0.05).However,the PHQ-9 and GAD-7 scores of the comprehensive intervention group were significantly lower than before intervention(P<0.05).And there was significant difference in PHQ-9 and GAD-7 scores between the two groups after intervention(P<0.05).(6)After 8 weeks of intervention,the clinic blood pressure of two groups were decreased compared with themselves before intervention(P<0.05).Compared with the conventional treatment group,the anti-hypertensive effective rate and the qualified rate of the comprehensive intervention group was significantly higher(P>0.05).Conclusion:In this study,the incidence of hypertension with anxiety depression was43.75%.Meanwhile,compared with the group of simple hypertension,the MBPS,24 hSBP,24hDBP,dSBP,dDBP,nSBP,nDBP and the incidence of non-dipper hypertension of the group of hypertension with anxiety depression were significantly higher(P<0.05).After 8 weeks of intervention,the difference between the PHQ-9 and GAD-7 scores and the anti-hypertensive effective rate and the qualified rate were statistically significant(P<0.05).In order to improve the quality of patients' lives,we should pay more attention to the mental health of the patients with hypertension in control of hypertension.