László Andrea, Babos Levente, Kis-Igari Zsóka, Pálfy Adrienn, Torzsa Péter, Eőry Ajándék, Kalabay László, Gonda Xenia, Rihmer Zoltán, Cseprekál Orsolya, Tislér András, Hodrea Judit, Lénárt Lilla, Fekete Andrea, Nemcsik János
Department of Family Medicine, Semmelweis University Budapest, Budapest, Hungary.
Department of Pharmacodynamics, Semmelweis University Budapest, Budapest, Hungary ; Department of Clinical and Theoretical Mental Health, Semmelweis University Budapest, Budapest, Hungary ; MTA-SE Neurochemistry Research Group, Budapest, Hungary.
Ann Gen Psychiatry. 2015 Oct 26;14:33. doi: 10.1186/s12991-015-0072-0. eCollection 2015.
Although mood disorders and cardiovascular diseases have widely studied psychosomatic connections, data concerning the influence of the psychopathologically important affective temperaments in hypertension are scarce. To define a possibly higher cardiovascular risk subpopulation we investigated in well-treated hypertensive patients with dominant affective temperaments (DOM) and in well-treated hypertensive patients without dominant temperaments the level of depression and anxiety, arterial stiffness and serum Brain-derived Neurotrophic Factor (seBDNF).
175 hypertensive patients, free of the history of psychiatric diseases, completed the TEMPS-A, Beck Depression Inventory and Hamilton Anxiety Scale questionnaires in two primary care practices. Of those 175 patients, 24 DOM patients and 24 hypertensive controls (matched in age, sex and the presence of diabetes) were selected for measurements of arterial stiffness and seBDNF level.
Beck and Hamilton scores in DOM patients were higher compared with controls. Pulse wave velocity and augmentation index did not differ between the groups while in the DOM patients decreased brachial systolic and diastolic and central diastolic blood pressures were found compared with controls. SeBDNF was lower in the DOM group than in the controls (22.4 ± 7.2 vs. 27.3 ± 7.8 ng/mL, p < 0.05).
Although similar arterial stiffness parameters were found in DOM patients, their increased depression and anxiety scores, the decreased brachial and central diastolic blood pressures as well as the decreased seBDNF might refer to their higher vulnerability regarding the development not only of major mood disorders, but also of cardiovascular complications. These data suggest that the evaluation of affective temperaments should get more attention both with regard to psychopathology and cardiovascular health management.
尽管情绪障碍与心血管疾病之间的心身联系已得到广泛研究，但关于具有重要心理病理学意义的情感气质对高血压影响的数据却很匮乏。为了确定一个可能具有更高心血管风险的亚组人群，我们调查了具有主导情感气质（DOM）的血压控制良好的高血压患者以及无主导情感气质的血压控制良好的高血压患者的抑郁和焦虑水平、动脉僵硬度以及血清脑源性神经营养因子（seBDNF）。
175名无精神疾病病史的高血压患者在两家基层医疗诊所完成了TEMPS - A、贝克抑郁量表和汉密尔顿焦虑量表问卷。在这175名患者中，选取了24名DOM患者和24名高血压对照者（年龄、性别和糖尿病情况相匹配）进行动脉僵硬度和seBDNF水平的测量。
DOM患者的贝克和汉密尔顿评分高于对照组。两组间脉搏波速度和增强指数无差异，但与对照组相比，DOM患者的肱动脉收缩压、舒张压及中心舒张压降低。DOM组的seBDNF低于对照组（22.4 ± 7.2 vs. 27.3 ± 7.8 ng/mL，p < 0.05）。
尽管DOM患者的动脉僵硬度参数相似，但其抑郁和焦虑评分升高、肱动脉和中心舒张压降低以及seBDNF降低可能表明他们不仅在发生严重情绪障碍方面，而且在发生心血管并发症方面具有更高的易感性。这些数据表明，在心理病理学和心血管健康管理方面，情感气质的评估都应得到更多关注。
