Gammoh Omar Salem, Alqudah Abdelrahim, Abu Shaikh Hanan, Al-Shudifat Abdel-Ellah
Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan.
Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, Jordan.
Int J Psychiatry Med. 2024 Jan;59(1):6-19. doi: 10.1177/00912174231173339. Epub 2023 May 3.
This study examined whether antihypertensive medications and other patient characteristics are associated with severe depressive symptoms in patients with hypertension.
Patients with a diagnosis of hypertension were recruited from the internal medicine outpatient clinics of a hospital in Amman, Jordan, into this cross-sectional study. Depression severity was assessed using the Patient Health Questionnaire-9 (PHQ-9); anxiety by the General Anxiety Disorder-7; sleep quality by the Insomnia Severity Index; and psychological stress by the Perceived Stress Scale. Multivariable binary logistic regression was used to examine the association between the different classes of antihypertensive medication and depressive symptoms.
Of the 431 participants, 282 (65.4%) were men; 240 (55.7%) reported having type 2 diabetes; 359 (83.3%) had dyslipidemia; 142 (32.9%) were on beta-blockers; 197 (45.2%) were on ACE inhibitors or angiotensin receptor blockers; 203 (47.1%) were on metformin; and 133 (30.9%) were taking sulfonylurea. Severe depressive symptoms, indicated by scoring above the cut-off of 14 on the PHQ-9, were present in 165 (38.3%) patients. Severe depression was associated with younger age (<55 years) (OR = 3.15, 95% CI = 1.83-5.41, < 0.001), unemployment (OR = 2.15, 95% CI = 1.15-4.00, = 0.01), diabetes (OR = 1.81, 95% CI = 1.09-3.02, = 0.02), severe anxiety (OR = 6.40, 95% CI = 3.64-11.28, < 0.001), and severe insomnia (OR = 4.73, 95% CI = 2.85-7.82, < 0.001).
Severe depressive symptoms were not associated with antihypertensive medications or other drugs used by hypertensive patients. Younger age, diabetes, anxiety, and insomnia were the primary correlates of depression.
本研究探讨抗高血压药物及其他患者特征是否与高血压患者的严重抑郁症状相关。
从约旦安曼一家医院的内科门诊招募诊断为高血压的患者，纳入本横断面研究。使用患者健康问卷-9（PHQ-9）评估抑郁严重程度；使用广泛性焦虑障碍-7评估焦虑；使用失眠严重指数评估睡眠质量；使用感知压力量表评估心理压力。采用多变量二元逻辑回归分析不同类别抗高血压药物与抑郁症状之间的关联。
431名参与者中，282名（65.4%）为男性；240名（55.7%）报告患有2型糖尿病；359名（83.3%）患有血脂异常；142名（32.9%）服用β受体阻滞剂；197名（45.2%）服用血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂；203名（47.1%）服用二甲双胍；133名（30.9%）服用磺脲类药物。PHQ-9评分高于14分表明存在严重抑郁症状，165名（38.3%）患者有此症状。严重抑郁与年龄较轻（<55岁）（比值比[OR]=3.15，95%置信区间[CI]=1.83-5.41，P<0.001）、失业（OR=2.15，95%CI=1.15-4.00，P=0.01）、糖尿病（OR=1.81，95%CI=1.09-3.02，P=0.02）、严重焦虑（OR=6.40，95%CI=3.64-11.28，P<0.001）和严重失眠（OR=4.73，95%CI=2.85-7.82，P<0.001）相关。
严重抑郁症状与高血压患者使用的抗高血压药物或其他药物无关。年龄较轻、糖尿病、焦虑和失眠是抑郁的主要相关因素。
