Brugnera Agostino, Compare Angelo, Omboni Stefano, Greco Andrea, Carrara Silvia, Tasca Giorgio Angelo, Poletti Barbara, Parati Gianfranco
Department of Human and Social Sciences.
Department of Cardiology.
Health Psychol. 2022 Dec;41(12):946-954. doi: 10.1037/hea0001205. Epub 2022 Jul 21.
Previous research provides support for the role of psychosocial variables in the progression of hypertension. However, few studies have rigorously tested the longitudinal interplay between blood pressure and depressive symptoms, quality of life, and well-being. Fewer still disaggregate the effects of changes of these psychological variables within patients over time from the effects of differences between patients on essential hypertension.
A total of 185 patients with hypertension and metabolic syndrome (130 males, 70.3%; mean age 54 ± 10.93 years) volunteered for this multicentre study. We analyzed the longitudinal associations between office or daytime ambulatory blood pressure with depressive symptoms, well-being, and quality of life, measured at the same three time points (baseline and 36- and 48-week follow-up), through multilevel models and controlling for several sociodemographic and clinical factors.
Within-person increases in depressive symptoms were significant, positive time-varying covariates of both office and daytime blood pressure, even after controlling for several potential confounders (e.g., age, sex, changes over time in risk factors for metabolic syndrome). Within-person increases in well-being and mental health components of quality of life had similar negative associations with the level of blood pressure over time. Between-person differences in these variables tended not to predict blood pressure.
Our findings provide a deeper insight on the relationship between variability of psychological variables within individuals and their levels of blood pressure. The findings support the need for health services to implement evidence-based psychological interventions that can foster a better management of the hypertensive disease. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
先前的研究为心理社会变量在高血压进展中的作用提供了支持。然而，很少有研究严格检验血压与抑郁症状、生活质量和幸福感之间的纵向相互作用。更少的研究将患者内部这些心理变量随时间变化的影响与患者之间原发性高血压差异的影响区分开来。
共有185名高血压和代谢综合征患者（130名男性，占70.3%；平均年龄54±10.93岁）自愿参加这项多中心研究。我们通过多水平模型并控制几个社会人口学和临床因素，分析了在相同的三个时间点（基线以及36周和48周随访）测量的诊室或日间动态血压与抑郁症状、幸福感和生活质量之间的纵向关联。
即使在控制了几个潜在混杂因素（如年龄、性别、代谢综合征危险因素随时间的变化）之后，抑郁症状的个体内增加仍是诊室血压和日间血压显著的、随时间变化的正性协变量。幸福感和生活质量心理健康成分的个体内增加与血压水平随时间有类似的负向关联。这些变量的个体间差异往往不能预测血压。
我们的研究结果为个体内部心理变量的变异性与其血压水平之间的关系提供了更深入的见解。这些结果支持卫生服务机构需要实施基于证据的心理干预措施，以更好地管理高血压疾病。（PsycInfo数据库记录（c）2022美国心理学会，保留所有权利）
