高血压患者中焦虑与左心室肥厚及复极跨壁离散度的性别特异性关联
Sex-Specific Associations of Anxiety With Left Ventricular Hypertrophy and Transmural Dispersion of Repolarization in Hypertensive Patients.
作者信息
Zhu Ling, Cui Qianwei, Zhang Yong, Liu Fuqiang, Zhao Jingsha, Wang Junkui
机构信息
Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, China.
Department of Cardiology, The Third Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
出版信息
Front Cardiovasc Med. 2022 Jun 9;9:858097. doi: 10.3389/fcvm.2022.858097. eCollection 2022.
BACKGROUND
The previous studies have shown that individuals with hypertension and anxiety have a higher mean left ventricular mass index (LVMI) and QTc dispersion. We explored the associations between anxiety and left ventricular hypertrophy (LVH) and between anxiety and transmural dispersion of repolarization (TDR) (as detected by T peak-T end interval/QT interval, Tp-Te/QT ratio) in patients with hypertension.
METHODS
A total of 353 patients with uncomplicated hypertension from the Shaanxi Provincial People's Hospital were enrolled between 2017 and 2021. Anxiety was defined as a Hamilton Anxiety Scale (HAM-A) score ≥ 14. Logistic regression models were used to estimate the association between HAM-A and LVH. The association between HAM-A score and Tp-Te/QT was estimated using linear regression.
RESULTS
Participants were divided into two groups based on the presence of anxiety. LVMI was significantly higher in patients with hypertension and anxiety than in those with hypertension without anxiety (no anxiety: 84.36 ± 23.82, anxiety: 105.75 ± 25.45 g/m, < 0.001). HAM-A score was positively correlated with LVMI ( = 0.578, < 0.001) and with Tp-Te/QT ( = 0.252, < 0.001). Logistic regression models showed that patients with hypertension and anxiety were at higher risk of LVH than were patients with hypertension without anxiety (adjusted , 2.44, 95% , 1.35-4.43, = 0.003). The linear regression analysis showed that the HAM-A score was associated with Tp-Te/QT ratio (adjusted β, 0.001, 95% , 0.001-0.002, = 0.013). There was an interaction between sex and anxiety for LVH risk ( for interaction = 0.035) and for increased Tp-Te/QT ( for interaction = 0.014). After stratification by sex, anxiety was associated with increased risk for LVH in men with hypertension (adjusted , 5.56, 95% , 2.07-14.98, = 0.001), but not in women (adjusted: , 1.44, 95% , 0.64-3.26, = 0.377) with hypertension. The HAM-A score was also positively associated with Tp-Te/QT ratio in male (adjusted β, 0.002, 95% , 0.001-0.003, < 0.001), but not in women (adjusted β, 0.001, 95% , -0.0002-0.002, = 0.165).
CONCLUSION
Our results indicated that anxiety was associated with LVH and with increased TDR in men with hypertension, but not in women with hypertension.
背景
先前的研究表明，患有高血压和焦虑症的个体平均左心室质量指数（LVMI）和QTc离散度更高。我们探讨了高血压患者中焦虑与左心室肥厚（LVH）之间以及焦虑与复极跨壁离散度（TDR）（通过T峰-T末间期/QT间期，Tp-Te/QT比值检测）之间的关联。
方法
2017年至2021年期间，共纳入了陕西省人民医院的353例单纯性高血压患者。焦虑定义为汉密尔顿焦虑量表（HAM-A）评分≥14分。采用逻辑回归模型评估HAM-A与LVH之间的关联。使用线性回归评估HAM-A评分与Tp-Te/QT之间的关联。
结果
根据是否存在焦虑将参与者分为两组。高血压伴焦虑患者的LVMI显著高于无焦虑的高血压患者（无焦虑：84.36±23.82，焦虑：105.75±25.45 g/m²，P<0.001）。HAM-A评分与LVMI呈正相关（r=0.578，P<0.001），与Tp-Te/QT呈正相关（r=0.252，P<0.001）。逻辑回归模型显示，高血压伴焦虑患者发生LVH的风险高于无焦虑的高血压患者（调整后的OR，2.44，95%CI，1.35-4.43，P=0.003）。线性回归分析显示，HAM-A评分与Tp-Te/QT比值相关（调整后的β，0.001，95%CI，0.001-0.002，P=0.013）。在LVH风险方面，性别与焦虑之间存在交互作用（交互作用的P=0.035），在Tp-Te/QT升高方面也存在交互作用（交互作用的P=0.014）。按性别分层后，焦虑与高血压男性发生LVH风险增加相关（调整后的OR，5.56，95%CI，2.07-14.98，P=0.001），但与高血压女性无关（调整后的OR，1.44，95%CI，0.64-3.26，P=0.377）。HAM-A评分在男性中也与Tp-Te/QT比值呈正相关（调整后的β，0.002，95%CI，0.001-0.003，P<0.001），但在女性中无相关性（调整后的β，0.001，95%CI，-0.0002-0.002，P=0.165）。
结论
我们的结果表明，焦虑与高血压男性的LVH和TDR增加相关，但与高血压女性无关。
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