Department of Psychiatry, Namsos Hospital, Nord-Trøndelag Health Trust, Norway.
BMC Public Health. 2011 Jul 28;11:601. doi: 10.1186/1471-2458-11-601.
For decades, symptoms of anxiety and depression have been included among psychological factors associated with development of hypertension. Although this has been questioned in recent studies, most findings have been based on a single assessment of mental distress at baseline. We examined these associations using repeated assessments of anxiety, depression and blood pressure.
Data on 17,410 men and women aged 20 to 67 participating in the Nord-Trøndelag Health Study (HUNT) in Norway in 1984-86 were re-examined 11 and 22 years later. The main outcome was change in mean blood pressure (mm Hg) during follow-up.
We found that a high symptom level score (≥80th percentile) of combined anxiety and depression at baseline, as compared to a lower symptom level, was associated with lower mean systolic (-0.67 mm Hg, p = 0.044) and diastolic (-0.25 mm Hg, p = 0.201) blood pressure at year 22. A high symptom level present at all three examinations was associated with a stronger decrease in mean systolic (-1.59 mm Hg, p = 0.004) and diastolic (-0.78 mm Hg, p = 0.019) blood pressure and with a 20% (p = 0.001) lower risk of developing hypertension (BP ≥140/90 mm Hg) at year 22. The associations were only slightly attenuated in multivariate analyses, with no evidence of a mediating effect of alteration in heart rate.
This study do not support previous hypothesis that emotional stress may be a cause of hypertension. Our findings indicate that symptoms of anxiety and depression are associated with decrease in blood pressure, particularly when a high symptom level can be detected over decades.
几十年来，焦虑和抑郁症状一直被认为是与高血压发展相关的心理因素之一。尽管最近的研究对此提出了质疑，但大多数研究结果都是基于基线时对精神困扰的单次评估。我们使用焦虑、抑郁和血压的重复评估来检验这些关联。
我们重新分析了 1984-1986 年期间参加挪威北特伦德拉格健康研究（HUNT）的 17410 名 20 至 67 岁的男性和女性的数据，这些人在基线时接受了评估，然后在 11 年和 22 年后再次接受了评估。主要结果是随访期间平均血压（mmHg）的变化。
我们发现，与较低的症状水平相比，基线时合并的焦虑和抑郁高症状水平评分（≥80 百分位）与 22 年时的平均收缩压（-0.67mmHg，p=0.044）和舒张压（-0.25mmHg，p=0.201）较低有关。在所有三次检查中都存在高症状水平与平均收缩压（-1.59mmHg，p=0.004）和舒张压（-0.78mmHg，p=0.019）的下降幅度更大有关，并且患高血压（BP≥140/90mmHg）的风险降低了 20%（p=0.001）。在多变量分析中，这些关联略有减弱，没有证据表明心率变化起中介作用。
本研究不支持先前的假设，即情绪压力可能是高血压的一个原因。我们的研究结果表明，焦虑和抑郁症状与血压下降有关，尤其是当高症状水平可以在几十年内检测到时。
