Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Eur J Epidemiol. 2012 Jan;27(1):63-72. doi: 10.1007/s10654-011-9641-y. Epub 2011 Dec 20.
Antihypertensive drugs have been suggested to modulate symptoms of depression and anxiety. It is disputed whether this is due to the hypertension per se, its treatment, or both. The aim of this study was to investigate these associations in a large population sample. 55,472 participants in the Nord-Trøndelag Health Study (HUNT 2, 1995-1997), Norway, who completed the Hospital Anxiety and Depression rating Scale, were divided into 3 groups according to their diastolic blood pressure and antihypertensive treatment status. A cut-off of ≥90 mmHg diastolic blood pressure was used to identify hypertensive status. Differences in anxiety and depression symptom levels in untreated and treated hypertensives (all treatments) versus the normotensive reference group were explained by differences in age and gender distribution in the three groups in this study. However, the receipt of two or more antihypertensive drugs was associated with depressive symptoms alone (OR = 1.40, 95% CI = 1.03-1.90), but not with symptoms of anxiety (OR = 1.14, 95% CI = 0.83-1.57) or mixed anxiety and depression (OR = 1.19, 95% CI = 0.82-1.72) in the fully adjusted model, compared to untreated hypertension. Antihypertensive monotherapy (all agents) nor any single antihypertensive drug class were associated with symptoms of depression, anxiety, or mixed anxiety and depression. There may be a positive association between multi antihypertensive drug use and symptoms of depression, whereas this was not found in persons with symptoms of anxiety or mixed anxiety and depression. This might reflect poor antihypertensive treatment adherence leading to polypharmacy, or other unfavorable health behaviors in people with symptoms of pure depression.
抗高血压药物被认为可以调节抑郁和焦虑症状。目前仍存在争议，即这种作用是源于高血压本身、降压治疗还是两者皆有。本研究旨在大型人群样本中探讨这些相关性。
挪威诺德兰特伦德拉格健康研究（HUNT2，1995-1997 年）中 55472 名参与者完成了医院焦虑和抑郁量表（HADS）的评估，根据舒张压和降压治疗情况将其分为 3 组。使用舒张压≥90mmHg 作为高血压的切点。本研究中，通过比较 3 组间年龄和性别分布的差异，解释了未治疗和治疗的高血压患者（所有治疗）与正常血压参考组之间焦虑和抑郁症状水平的差异。然而，与未治疗的高血压相比，接受两种或更多种降压药物与单纯抑郁症状相关（OR=1.40，95%CI=1.03-1.90），但与焦虑症状（OR=1.14，95%CI=0.83-1.57）或混合性焦虑和抑郁（OR=1.19，95%CI=0.82-1.72）无关。在完全调整模型中，抗高血压单药治疗（所有药物）或任何单一的抗高血压药物类别均与抑郁、焦虑或混合性焦虑和抑郁症状无关。可能存在抗高血压药物联合应用与抑郁症状之间的正相关，而在有焦虑或混合性焦虑和抑郁症状的人群中并未发现这种相关性。这可能反映了单纯抑郁人群中较差的降压治疗依从性导致的药物联合应用增多，或其他不良的健康行为。
