Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China; Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China.
Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
J Affect Disord. 2023 Nov 15;341:176-184. doi: 10.1016/j.jad.2023.08.086. Epub 2023 Aug 19.
We aimed to determine whether depressive, anxiety, stress symptoms were associated with the risk of elevated blood pressure by performing longitudinal cohort and Mendelian Randomization (MR) analyses.
We used data from the Cohort Study on Chronic Disease of Community Natural Population in the Beijing-Tianjin-Hebei region (CHCN-BTH) from 2017 to 2021. The Depression-Anxiety-Stress Scale was used to evaluate the depressive, anxiety, stress symptoms. The longitudinal associations between depressive, anxiety, stress symptoms and elevated blood pressure were estimated using Cox proportional regression models. Two-sample MR analysis was performed using the Inverse-variance weighted (IVW), weighted median, and MR-Egger to explore the causal relationships between depressive, anxiety, stress symptoms and elevated blood pressure.
In total, 5624 participants were included. The risk of SBP ≥ 140 mmHg or DBP ≥ 90 mmHg was significantly higher in participants with baseline anxiety symptoms (HR = 1.48, 95 % CI: 1.03 to 2.12, P = 0.033; HR = 1.56, 95 % CI: 1.05 to 2.32, P = 0.028), especially in men and individuals with higher educational levels, independent of baseline depression and anxiety at the two-year follow-up. The two-sample MR analysis showed positive associations between depressive, anxiety, stress symptoms and elevated blood pressure.
Self-reported mental health symptoms, relatively shorter follow-up duration and the European-derived genome-wide association study data for MR analysis.
Anxiety symptoms were positively associated with elevated blood pressures in the longitudinal analysis independent of depression, stress, and other confounders. The results were verified in MR analysis, providing evidence for causal effects of anxiety symptoms on the risk of elevated blood pressure.
本研究旨在通过纵向队列研究和孟德尔随机化（MR）分析，探讨抑郁、焦虑和压力症状与高血压风险的关系。
我们使用了 2017 年至 2021 年京津冀地区社区自然人群慢性病队列研究（CHCN-BTH）的数据。采用抑郁-焦虑-压力量表（DASS）评估抑郁、焦虑和压力症状。采用 Cox 比例风险回归模型评估抑郁、焦虑和压力症状与高血压之间的纵向关联。采用逆方差加权（IVW）、加权中位数和 MR-Egger 方法进行两样本 MR 分析，以探讨抑郁、焦虑和压力症状与高血压之间的因果关系。
共纳入 5624 名参与者。基线时存在焦虑症状的参与者发生 SBP≥140mmHg 或 DBP≥90mmHg 的风险显著升高（HR=1.48，95%CI：1.03 至 2.12，P=0.033；HR=1.56，95%CI：1.05 至 2.32，P=0.028），且该关联在男性和教育程度较高的个体中更为明显，独立于两年随访时的基线抑郁和焦虑。两样本 MR 分析显示，抑郁、焦虑和压力症状与高血压之间呈正相关。
仅基于自我报告的心理健康症状，随访时间相对较短，且 MR 分析中使用的是欧洲来源的全基因组关联研究数据。
在纵向分析中，焦虑症状与高血压的发生独立于抑郁、压力和其他混杂因素呈正相关。MR 分析的结果验证了这一结果，为焦虑症状与高血压风险之间的因果关系提供了证据。
