Department of Psychology, Penn State University, Schuylkill Campus, 200 University Drive, Schuylkill Haven, PA, 17972, USA.
Center for Integrative Medicine, Weill Cornell Medicine, New York, NY, USA.
J Racial Ethn Health Disparities. 2018 Oct;5(5):913-918. doi: 10.1007/s40615-017-0439-9. Epub 2017 Dec 15.
African Americans develop hypertension earlier and have worse cardiovascular outcomes than Caucasians. Accumulating evidence suggests that psychological distress may play a role in the observed racial differences in hypertension. Several studies have investigated the relationship between depression and hypertension while little is still known about the role of demoralization.
Using data from the Trial Using Motivational Interviewing, Positive Affect, and Self-affirmation in African Americans with Hypertension (TRIUMPH), logistic regression models were used to estimate differences in blood pressure control at 12 months among participants with demoralization, depression, and both conditions.
Our logistic models showed that reported psychosocial symptoms significantly differed in predicting success in blood pressure control at 12 months. Contrast analyses showed that, after adjusting for sociodemographic, clinical, and psychosocial variables, demoralized patients were less likely to achieve blood pressure control than participants without affective conditions (p = 0.020). Similar results emerged for patients with depression (p = 0.042) and both conditions (p = 0.022).
Depression can be extremely debilitating and has serious health consequence. Our findings confirm this result and show that, even though depression and demoralization share common features, they are two distinct clinical phenomena with similar negative impact on blood pressure control in African Americans.
非裔美国人比白种人更早出现高血压，且心血管疾病预后更差。越来越多的证据表明，心理困扰可能在高血压的种族差异中起作用。一些研究调查了抑郁与高血压之间的关系，但对沮丧的作用知之甚少。
利用来自“使用动机性访谈、积极情绪和自我肯定治疗非裔高血压患者试验（TRIUMPH）”的数据，使用逻辑回归模型估计沮丧、抑郁以及同时存在这两种情况的患者在 12 个月时血压控制的差异。
我们的逻辑模型表明，报告的社会心理症状在预测 12 个月时血压控制成功方面存在显著差异。对比分析表明，在调整了社会人口统计学、临床和心理社会变量后，沮丧的患者比没有情感障碍的患者更不可能控制血压（p=0.020）。抑郁患者（p=0.042）和同时存在两种情况的患者（p=0.022）也出现了类似的结果。
抑郁可能会使人极度虚弱，并产生严重的健康后果。我们的研究结果证实了这一结果，并表明，尽管抑郁和沮丧具有共同的特征，但它们是两种不同的临床现象，对非裔美国人的血压控制有类似的负面影响。
