Grewen Karen M, Girdler Susan S, Hinderliter Alan, Light Kathleen C
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7175, USA.
Psychosom Med. 2004 Jan-Feb;66(1):9-16. doi: 10.1097/01.psy.0000106881.60228.16.
We investigated whether parental history of hypertension (FH+) enhances the impact of depressed mood, indexed by Beck Depression Inventory (BDI), on ambulatory blood pressure (ABP).
Twenty-four-hour ABP, urinary norepinephrine (NE), and cortisol were obtained in 314 unmedicated normotensive and hypertensive men and women (age 18-64 years) who also completed the BDI.
Subjects with a positive family history of hypertension (N = 177) exhibited significantly greater mean body mass index (BMI) and ABP compared with subjects without (N = 137). Importantly, when covarying for age, BMI, gender, and race, linear regressions revealed significant FH by BDI interactions. Higher BDI scores were significantly associated with higher 24-hour ABP in FH+ subjects, but not in FH- participants. Relationships were significantly stronger in those with two hypertensive parents vs. those with one vs. those with no hypertensive parents. Increases in BDI scores were significantly related to greater heart rate (HR) and 24-hour urinary NE in both FH+ and FH- groups, although no evidence of a mediational role for NE in the effect of BDI score on blood pressure (BP) or HR was seen.
These findings suggest that depressed mood may be reliably associated with higher BP only among those with an underlying susceptibility to HTN.
我们研究了高血压家族史（FH+）是否会增强以贝克抑郁量表（BDI）为指标的抑郁情绪对动态血压（ABP）的影响。
对314名未接受药物治疗的血压正常和高血压的男性及女性（年龄18 - 64岁）进行了24小时动态血压监测、测定尿去甲肾上腺素（NE）和皮质醇水平，这些受试者还完成了BDI测试。
有高血压家族史的受试者（N = 177）与无高血压家族史的受试者（N = 137）相比，平均体重指数（BMI）和动态血压显著更高。重要的是，在对年龄、BMI、性别和种族进行协变量调整后，线性回归显示出家族史与BDI之间存在显著的交互作用。在FH+受试者中，较高的BDI评分与较高的24小时动态血压显著相关，但在FH-受试者中并非如此。与有一位高血压父母的受试者和无高血压父母的受试者相比，有两位高血压父母的受试者中这种关系显著更强。BDI评分的增加在FH+和FH-组中均与更高的心率（HR）和24小时尿NE显著相关，尽管没有证据表明NE在BDI评分对血压（BP）或HR的影响中起中介作用。
这些发现表明，只有在那些具有高血压潜在易感性的人群中，抑郁情绪才可能与较高的血压可靠相关。
