Correlation Between Anxiety And Depression And Syndrome Types In Young Patients With Essential Hypertension

Objective: To investigate the effects of anxiety,depression on blood pressure in young patients with essential hypertension.To analyze the incidence and related factors of anxiety,depression and sleep disorders in young patients with essential hypertension,and the correlation with the distribution of TCM syndrome types.To provide reference for the prevention and treatment of young patients with hypertension.Methods: Young patients aged 18-44 years with essential hypertension who visited the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from March 1,2021 to November 30,2022 were selected as the study subjects.Case collection and questionnaire survey were performed,including general data,SAS,SDS,PSQI questionnaire survey,and TCM syndrome types.In the non-hypertensive group,healthy subjects aged 18-44 years with normal blood pressure and no history of hypertension who visited the Affiliated Hospital of Shandong University of Traditional Chinese Medicine during the same period were selected and investigated by SAS,SDS,and PSQI questionnaires.Data were pooled with Excel and data analysis was performed with SPSS.28.Results: 1.A total of 187 young hypertensive patients and 189 non-hypertensive young adults in the control group were included in this study.2.In the young hypertensive group,gender(71.66% male),BMI(68.45% overweight and obese),waist circumference(64.71% abdominal obesity),workload(58.29% heavy and very heavy),exercise habits(55.08% no exercise habits),smoking history(48.13% smoking),drinking history(57.22% drinking),dietary habits(37.97%high salt,high fat and high sugar),comorbidities(44.92% with comorbidities),and family history(79.14% with family history)were statistically significant compared with the non-hypertensive group.The general characteristics of diseases in young hypertensive patients included: the majority had disease course of less than 2 years(64.17%),blood pressure grade was higher(grade 3 accounted for 50.80%),risk stratification was higher(high risk,very high risk accounted for 51.87%);young hypertensive patients had significantly increased diastolic blood pressure(54.55%),low medication rate(40.11% of patients who had not taken antihypertensive drugs),and poor blood pressure control(67.38% of patients with substandard blood pressur at presentation).2.The results of this study showed that the incidence of anxiety was 33.16%(62 cases),depression was 24.06%(45 cases),sleep disorder was 72.73%(136 cases),anxiety combined with depression was 18.18%(34 cases),and anxiety combined with depression combined with sleep disorder was 17.11%(32 cases)in young hypertensive patients.It was significantly higher than the non-hypertensive group,and SAS,SDS,and PSQI scores were significantly increased,and the difference was statistically significant(P<0.05).3.Univariate analysis was performed with anxiety associated with young hypertensive patients as the dependent variable,and multivariate logistic regression analysis was performed with the factors of P<0.05 selected by univariate analysis as independent variables.A total of 187 young hypertensive patients and 189 non-hypertensive young adults in the control group were included in this study.2.In the young hypertensive group,gender(71.66% male),BMI(68.45% overweight and obese),waist circumference(64.71%abdominal obesity),workload(58.29% heavy and very heavy),exercise habits(55.08% no exercise habits),smoking history(48.13% smoking),drinking history(57.22% drinking),dietary habits(37.97% high salt,high fat and high sugar),comorbidities(44.92% with comorbidities),and family history(79.14%with family history)were statistically significant compared with the non-hypertensive group.The general characteristics of diseases in young hypertensive patients included: the majority had disease course of less than2 years(64.17%),blood pressure grade was higher(grade 3 accounted for50.80%),risk stratification was higher(high risk,very high risk accounted for 51.87%);young hypertensive patients had significantly increased diastolic blood pressure(54.55%),low medication rate(40.11% of patients who had not taken antihypertensive drugs),and poor blood pressure control(67.38% of patients with substandard blood pressure at presentation).2.The results of this study showed that the incidence of anxiety was 33.16%(62cases),depression was 24.06%(45 cases),sleep disorder was 72.73%(136cases),anxiety combined with depression was 18.18%(34 cases),and anxiety combined with depression combined with sleep disorder was 17.11%(32cases)in young hypertensive patients.It was significantly higher than the non-hypertensive group,and SAS,SDS,and PSQI scores were significantly increased,and the difference was statistically significant(P<0.05).3.Univariate analysis was performed with anxiety associated with young hypertensive patients as the dependent variable,and multivariate logistic regression analysis was performed with the factors of P<0.05 selected by univariate analysis as independent variables.The results showed that female hypertensive patients,high BMI index,abdominal obesity,heavy workload,long duration of hypertension,substandard blood pressure,and comorbidities were independent risk factors of anxiety associated with hypertension;univariate analysis was performed with depression associated with young hypertensive patients as the dependent variable,and multivariate logistic regression analysis was performed with the factors of P<0.05 selected by univariate analysis as independent variables.The results showed that female hypertensive patients,high BMI index,long duration of hypertension,high blood pressure grade,and high risk stratification were independent risk factors of depression associated with hypertension;univariate analysis was performed with sleep disorders associated with young hypertensive patients as the dependent variable,and multivariate logistic regression analysis was performed with the factors of P<0.05 selected by univariate analysis as independent variables.Results Female sex,high BMI,heavy workload,long duration of hypertension,high blood pressure grade and high risk stratification were independent risk factors of sleep disorder in young patients with hypertension.4.Distribution of TCM syndrome types in young patients with hypertension: 78 cases(41.7%)of phlegm-turbid syndrome,69cases(36.9%)of liver-yang hyperactivity syndrome,17 cases(9.09%)of blood stasis blocking collateral syndrome,12 cases(6.42%)of qi and blood deficiency syndrome,and 11 cases(5.88%)of kidney essence deficiency syndrome.The TCM syndrome types of young patients with hypertension associated with anxiety were liver-yang hyperactivity syndrome >phlegm-turbid internal accumulation syndrome > qi and blood deficiency syndrome > blood stasis blocking collateral syndrome > kidney essence deficiency syndrome.The TCM syndrome types of young patients with hypertension associated with depression were phlegm-turbid syndrome >liver-yang hyperactivity syndrome > qi and blood deficiency syndrome > blood stasis blocking collateral syndrome > kidney essence deficiency syndrome.The TCM syndrome types of young patients with hypertension associated with sleep disorders were phlegm-turbid internal accumulation syndrome > liver-yang hyperactivity syndrome > blood stasis blocking collateral syndrome > qi and blood deficiency syndrome > kidney essence deficiency syndrome.Conclusions: 1.he sex of young patients with hypertension is mainly male,and the incidence is related to high BMI,abdominal obesity,heavy workload,bad living habits(no exercise,smoking,drinking,high salt,high fat and high sugar diet),complications,and family history.The disease characteristics of young patients with hypertension include: shorter duration of disease than the elderly,higher blood pressure grade,higher risk stratification,significantly increased diastolic blood pressure,and poor medication compliance.2.Young hypertensive patients are more likely to have anxiety,depression,and sleep disorders compared with normotensive young adults,with the highest incidence of sleep disorders,followed by anxiety.3.Female sex,overweight or obesity with BMI,duration of hypertension for more than 5 years,blood pressure grade 3,and risk stratification as high or very high risk are common risk factors associated with anxiety,depression,and sleep disorders in young hypertensive patients.Heavy workload is a common risk factor for anxiety and sleep disorders associated with hypertension in young adults.Substandard blood pressure and complications were independent risk factors for hypertension associated with anxiety.4.The distribution rule of TCM syndrome types in young patients with hypertension is: phlegm-turbid internal accumulation syndrome>liver-yang hyperactivity syndrome > blood stasis blocking collateral syndrome>qi and blood deficiency syndrome > kidney essence deficiency syndrome.Young hypertensive patients with liver-yang hyperactivity syndrome had the highest prevalence of associated anxiety,young hypertensive patients with phlegm-turbid internal accumulation syndrome had the highest prevalence of associated depression,and young hypertensive patients with phlegm-turbid internal accumulation syndrome had the highest prevalence of associated sleep disorders.