Zhu Guo-Hua, Sun Xi-Peng, Li Jing, Pi Lin, Tang Hai-Qin, Gao Hai-Qing, Cong Hong-Liang, Qu Peng, Lu Xin-Zheng, Zhang Xin-Jun, Zhao Luo-Sha, Guo Yi-Fang, Liu Dong-Xia, Zhang Liang-Qing, Tang Hua, Hu Yi-Xin, Fan Li, Hua Qi
Department of Cardiology, Xuanwu Hospital Capital Medical University, Beijing, China.
Department of Cardiology, Chuiyangliu Hospital affiliated to Tsinghua University, Beijing, China.
J Geriatr Cardiol. 2019 Aug;16(8):608-613. doi: 10.11909/j.issn.1671-5411.2019.08.001.
Reserpine is currently used by millions of Chinese hypertensive patients, in spite of the continued concern of its depressogenic effect, even when used in low dose. This study aimed to investigate the association between low-dose reserpine use and depression in older Chinese hypertensive patient.
In this cross-sectional, case-control study, we recruited patient aged 60 years or over who had regularly taken one or two tables of "compound reserpine and triamterene tablets (CRTTs)" for more than one year (reserpine user) from 26 community health centers located in 10 provinces in China. For each patient who took CRTTs, we selected an age (within five years) and sex matched hypertensive patient who had never taken any drugs containing reserpine (non-reserpine user) as control. Depressive symptoms were evaluated using a Chinese depression scale adapted from the Zung Self-Rating Depression Scale. Demographic, clinical data and laboratory examination results within six months were collected.
From August 2018 to December 2018, 787 reserpine user and 787 non-reserpine user were recruited. The mean age of all study subjects was 70.3 years, with about equal numbers of males and females. The mean depression score was 40.4 in reserpine users and 40.6 in non-reserpine users ( = 0.7). The majority of study subject had a depression score < 53 (87.6% in reserpine users and 88.2% in non-reserpine users, respectively). There were no significant differences in the prevalence of mild, moderate or severe depression in reserpine users and non-reserpine users.
There is no association between low-dose reserpine use and depression in older hypertensive patient. The role of reserpine in the treatment and control of hypertension should be reconsidered; and further studies, especially randomized, controlled clinical trials to compare efficacy and safety of reserpine and other widely recommended anti-hypertensive agents are needed.
尽管利血平的致抑郁作用一直受到关注,即使是低剂量使用,目前仍有数百万中国高血压患者在使用。本研究旨在调查中国老年高血压患者低剂量使用利血平和抑郁之间的关联。
在这项横断面病例对照研究中,我们从中国10个省份的26个社区卫生中心招募了60岁及以上、规律服用一或两片“复方利血平氨苯蝶啶片(CRTT) ”超过一年的患者(利血平使用者)。对于每一位服用CRTT的患者,我们选择一位年龄(相差不超过5岁)和性别匹配、从未服用过任何含利血平药物的高血压患者(非利血平使用者)作为对照。使用改编自zung自评抑郁量表的中国抑郁量表评估抑郁症状。收集六个月内的人口统计学、临床数据和实验室检查结果。
2018年8月至2018年12月,招募了787名利血平使用者和787名非利血平使用者。所有研究对象的平均年龄为70.3岁,男女数量大致相等。利血平使用者的平均抑郁评分为40.4,非利血平使用者为40.6(P = 0 .7)。大多数研究对象的抑郁评分<53(利血平使用者中为87.6%,非利血平使用者中为88.2%)。利血平使用者和非利血平使用者中轻度、中度或重度抑郁的患病率无显著差异。
老年高血压患者低剂量使用利血平和抑郁之间无关联。应重新考虑利血平在高血压治疗和控制中的作用;需要进一步研究,尤其是随机对照临床试验,以比较利血平和其他广泛推荐的抗高血压药物的疗效和安全性。