抑郁症状能否预测美国退伍军人的血压控制情况？
Do Depressive Symptoms Predict Blood Pressure Control in US Veterans?
机构信息
Department of Psychological Sciences, University of Connecticut, Storrs, USA.
Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.
出版信息
J Gen Intern Med. 2022 Jan;37(1):57-63. doi: 10.1007/s11606-021-06709-5. Epub 2021 Mar 26.
BACKGROUND
High blood pressure is the most common chronic condition among US veterans. Blood pressure control is essential to preventing and managing cardiovascular diseases. While depressive symptoms are a known risk factor for uncontrolled blood pressure and veterans experience high rates of depressive symptoms, no research has examined the relationship between depressive symptoms and blood pressure control among US veterans.
OBJECTIVE
We examined whether moderately severe-to-severe depressive symptoms, compared to none-to-minimal, are associated with higher risk of uncontrolled blood pressure among US veterans.
DESIGN
We analyzed a population-based sample of veterans from the National Health and Nutrition Examination Survey (2013-2016). Logistic regression models were adjusted for marital status, age, and body mass index. All analyses were weighted; results are generalizable to US veterans.
PARTICIPANTS
A sample of 864 veterans was analyzed, representing approximately 18.8 million US veterans.
MAIN MEASURES
Depressive symptoms were assessed by the Patient Health Questionnaire-9. Uncontrolled blood pressure was defined as average systolic blood pressure ≥ 130 and/or diastolic blood pressure ≥ 80.
KEY RESULTS
For depressive symptoms, 78.2% (SE = 1.6) of US veterans had none-to-minimal, 18.2% (SE = 1.2) had mild-to-moderate, and 3.5% (SE = 0.8) had moderately severe-to-severe. Forty-three percent (SE = 3.0) of US veterans had uncontrolled blood pressure. Moderately severe-to-severe depressive symptoms, compared to none-to-minimal, were associated with lower risk for uncontrolled blood pressure (aOR = .28, 95% CI [.09, .85]). Mild-to-moderate depressive symptoms were not associated with blood pressure control (aOR = .98, 95% CI [.59, 1.65]).
CONCLUSIONS
US veterans with moderately severe-to-severe depressive symptoms were less likely to have uncontrolled blood pressure than veterans with none-to-minimal symptoms. Future research should examine factors unique to veterans that may explain findings opposite of the hypothesized relationship between depressive symptoms and blood pressure control.
背景
高血压是美国退伍军人中最常见的慢性疾病。控制血压对于预防和管理心血管疾病至关重要。虽然抑郁症状是血压控制不佳的已知危险因素，而且退伍军人的抑郁症状发生率很高，但尚无研究探讨美国退伍军人中抑郁症状与血压控制之间的关系。
目的
我们研究了与无至轻度抑郁症状相比，中重度至重度抑郁症状是否与美国退伍军人血压控制不良的风险增加相关。
设计
我们分析了 2013-2016 年国家健康和营养调查（National Health and Nutrition Examination Survey）中的退伍军人的基于人群的样本。逻辑回归模型调整了婚姻状况、年龄和体重指数。所有分析均进行了加权；结果可推广至美国退伍军人。
参与者
对 864 名退伍军人进行了分析，代表了约 1880 万美国退伍军人。
主要测量指标
抑郁症状通过患者健康问卷-9 进行评估。血压控制不良定义为平均收缩压≥130mmHg 和/或舒张压≥80mmHg。
主要结果
对于抑郁症状，78.2%（SE=1.6）的美国退伍军人无至轻度，18.2%（SE=1.2）为轻度至中度，3.5%（SE=0.8）为中重度。43%（SE=3.0）的美国退伍军人血压控制不良。与无至轻度相比，中重度至重度抑郁症状与血压控制不良的风险较低相关（aOR=0.28，95%CI[0.09,0.85]）。轻度至中度抑郁症状与血压控制无关（aOR=0.98，95%CI[0.59,1.65]）。
结论
与无至轻度症状的退伍军人相比，中重度至重度抑郁症状的退伍军人血压控制不良的可能性较低。未来的研究应该研究退伍军人特有的可能解释与抑郁症状和血压控制之间假设关系相反的发现的因素。
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