Department of Nursing, Wonkwang University, Iksan, South Korea.
Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea.
Eur J Cardiovasc Nurs. 2022 Nov 23;21(8):791-800. doi: 10.1093/eurjcn/zvac015.
Depressive symptoms in hypertensive patients are linked to poor adherence to treatment. Sedentary behaviours and chronic pain can increase blood pressure and depressive symptoms, respectively. However, the impact of their coexistence on depressive symptoms in older adults with hypertension has not yet been investigated. This study aimed to identify the combined influence of sedentary behaviours and chronic pain on depressive symptoms in older adults with hypertension in Korea.
This cross-sectional study used data from the sixth Korea National Health and Nutrition Examination Survey from January to December 2014. The survey adopted multistage stratified sampling by geographical region, gender, and age. For the data analysis, a total of 573 patients with hypertension aged 65 years or older were included. Approximately, 61.0% of depressed older patients had both sedentary behaviours and chronic pain compared with patients without depressive symptoms. In multivariate logistic regression analysis, compared with patients without either sedentary behaviours or chronic pain, older adults with hypertension who presented both sedentary behaviours, and chronic pain had the highest risk of depressive symptoms (odds ratio = 13.86, 95% confidence interval = 5.87-32.71; P < 0.001).
Coexistence of sedentary behaviours and chronic pain in older hypertensive patients may lead to depressive symptoms. Evaluating both sedentary behaviours and chronic pain when assessing depressive symptoms in patients with hypertension would be beneficial in planning a patient-centred approach for controlling blood pressure. More prospective cohort studies with larger samples are required to identify the causal relationships.
高血压患者的抑郁症状与治疗依从性差有关。久坐行为和慢性疼痛分别会升高血压和增加抑郁症状。然而，它们同时存在对高血压老年患者抑郁症状的影响尚未被研究过。本研究旨在探讨韩国高血压老年患者中久坐行为和慢性疼痛共同存在对抑郁症状的影响。
本横断面研究使用了 2014 年 1 月至 12 月韩国第六次全国健康和营养调查的数据。该调查采用多阶段分层抽样方法，按地理区域、性别和年龄进行抽样。在数据分析中，共纳入了 573 名 65 岁及以上的高血压患者。大约 61.0%的抑郁老年患者既有久坐行为又有慢性疼痛，而没有抑郁症状的患者则没有。在多变量逻辑回归分析中，与没有久坐行为或慢性疼痛的患者相比，同时存在久坐行为和慢性疼痛的高血压老年患者患抑郁症状的风险最高（比值比=13.86，95%置信区间=5.87-32.71；P<0.001）。
高血压老年患者中久坐行为和慢性疼痛的共同存在可能导致抑郁症状。在评估高血压患者的抑郁症状时，评估久坐行为和慢性疼痛将有助于制定以患者为中心的控制血压方法。需要更多具有更大样本量的前瞻性队列研究来确定因果关系。
