原发性蛋白尿性肾小球病患者的精神健康相关患者报告结局与血压的相关性。
Association of mental health-related patient reported outcomes with blood pressure in adults and children with primary proteinuric glomerulopathies.
机构信息
Northwell, Cohen Children's Medical Center, Division of Pediatric Nephrology, New Hyde Park, NY, USA.
Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
出版信息
J Nephrol. 2024 Apr;37(3):647-660. doi: 10.1007/s40620-024-01919-6. Epub 2024 Mar 21.
INTRODUCTION
The prevalence of mental health disorders including anxiety and depression is increasing and is linked to hypertension in healthy individuals. However, the relationship of psychosocial patient-reported outcomes on blood pressure (BP) in primary proteinuric glomerulopathies is not well characterized. This study explored longitudinal relationships between psychosocial patient-reported outcomes and BP status among individuals with proteinuric glomerulopathies.
METHODS
An observational cohort study was performed using data from 745 adults and children enrolled in the Nephrotic Syndrome Study Network (NEPTUNE). General Estimating Equations for linear regression and binary logistic analysis for odds ratios were performed to analyze relationships between the exposures, longitudinal Patient-Reported Outcome Measurement Information System (PROMIS) measures and BP and hypertension status as outcomes.
RESULTS
In adults, more anxiety was longitudinally associated with higher systolic and hypertensive BP. In children, fatigue was longitudinally associated with increased odds of hypertensive BP regardless of the PROMIS report method. More stress, anxiety, and depression were longitudinally associated with higher systolic BP index, higher diastolic BP index, and increased odds of hypertensive BP index in children with parent-proxy patient-reported outcomes.
DISCUSSION/CONCLUSION: Chronically poor psychosocial patient-reported outcomes may be significantly associated with higher BP and hypertension in adults and children with primary proteinuric glomerulopathies. This interaction appears strong in children but should be interpreted with caution, as multiple confounders related to glomerular disease may influence both mental health and BP independently. That said, access to mental health resources may help control BP, and proper disease and BP management may improve overall mental health.
简介
心理健康障碍（包括焦虑和抑郁）的患病率不断上升，并且与健康人群中的高血压有关。然而，原发性蛋白尿肾小球疾病患者的心理社会患者报告结局与血压（BP）之间的关系尚未得到很好的描述。本研究探讨了蛋白尿肾小球疾病患者的心理社会患者报告结局与 BP 状态之间的纵向关系。
方法
使用肾病综合征研究网络（NEPTUNE）中 745 名成人和儿童的数据进行了一项观察性队列研究。采用一般估计方程进行线性回归和二元逻辑分析比值比，以分析暴露、纵向患者报告结局测量信息系统（PROMIS）测量与 BP 和高血压状态作为结局之间的关系。
结果
在成人中，更多的焦虑与收缩压和高血压 BP 呈纵向相关。在儿童中，无论采用哪种 PROMIS 报告方法，疲劳与高血压 BP 的几率增加呈纵向相关。更多的压力、焦虑和抑郁与儿童父母报告的结局中的收缩压指数、舒张压指数升高以及高血压指数的几率增加呈纵向相关。
讨论/结论：慢性不良心理社会患者报告结局可能与原发性蛋白尿肾小球疾病的成人和儿童的 BP 升高显著相关。这种相互作用在儿童中似乎很强，但应谨慎解释，因为与肾小球疾病相关的多种混杂因素可能独立地影响心理健康和 BP。也就是说，获得心理健康资源可能有助于控制 BP，适当的疾病和 BP 管理可能会改善整体心理健康。
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