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坦普勒死亡焦虑量表与白大衣性高血压和焦虑的关系:一项横断面研究。

Templer's death anxiety scale on the relationship between white coat hypertension and anxiety: A cross-sectional study.

机构信息

Basaksehir Cam & Sakura City Hospital, Department of Cardiology, Istanbul, Turkey.

University of Health Sciences, Adana City Training and Research Hospital, Department of Cardiology, Adana, Turkey.

出版信息

J Hum Hypertens. 2024 Jul;38(7):561-567. doi: 10.1038/s41371-024-00920-7. Epub 2024 Jun 6.

DOI:10.1038/s41371-024-00920-7
PMID:38844549
Abstract

The relationship between white coat hypertension (WCH) and anxiety remains not fully elucidated. This study aims to investigate the correlation between WCH and Templer's Death Anxiety Scale (T-DAS) questionnaire. Asymptomatic individuals with a familial history of sudden cardiac death or acute myocardial infarction within the last year, who presented at our cardiology outpatient clinic, were enrolled in this prospective, single-center, cross-sectional study. Among those with elevated blood pressure in the outpatient clinic setting, participants were categorized into normotensive and WCH groups through 24-hour ambulatory blood pressure monitoring. Demographic features, laboratory parameters, and T-DAS scores were documented. Logistic regression and sensitivity analyses were conducted to ascertain WCH occurrence. Among 324 consecutive participants, 90 were diagnosed with WCH. T-DAS scores were significantly elevated in the WCH subgroup, particularly among those seeking early medical attention following bereavement. Multivariable logistic regression highlighted gender, BMI, heart rate, T-DAS, and admission time as independent correlates of WCH. Significantly, T-DAS exhibited the third most substantial contribution to the regression analysis, following admission time and heart rate. The multivariable logistic regression analysis incorporating T-DAS exhibited high robustness, discrimination, fit, and calibration, with a Brier score of 0.106, adjusted R of 0.576, and C-statistic of 0.905 (95% CI: 0.871-0.940, p < 0.001). T-DAS, with a threshold of >8, demonstrated 48% sensitivity and 90% specificity in detecting WCH. Additionally, decision curve analysis verified that the model including T-DAS offers a net benefit in detecting WCH. This study unveils a potential association between WCH and death anxiety.

摘要

白大衣高血压(WCH)与焦虑之间的关系尚未完全阐明。本研究旨在探讨 WCH 与 Templer 死亡焦虑量表(T-DAS)问卷之间的相关性。本前瞻性、单中心、横断面研究纳入了在我们心内科门诊就诊的、有家族性心源性猝死或急性心肌梗死病史且无症状的个体。在门诊就诊时血压升高的患者中,通过 24 小时动态血压监测将患者分为血压正常和 WCH 组。记录了人口统计学特征、实验室参数和 T-DAS 评分。进行了逻辑回归和敏感性分析以确定 WCH 的发生情况。在 324 名连续参与者中,有 90 名被诊断为 WCH。WCH 亚组的 T-DAS 评分显著升高,尤其是在丧亲后寻求早期医疗关注的患者中。多变量逻辑回归强调了性别、BMI、心率、T-DAS 和入院时间是 WCH 的独立相关因素。重要的是,T-DAS 对回归分析的贡献仅次于入院时间和心率,位列第三。包含 T-DAS 的多变量逻辑回归分析具有较高的稳健性、区分度、拟合度和校准度,Brier 评分为 0.106,调整 R 为 0.576,C 统计量为 0.905(95%CI:0.871-0.940,p<0.001)。T-DAS 阈值>8 时,检测 WCH 的敏感性为 48%,特异性为 90%。此外,决策曲线分析证实,包含 T-DAS 的模型在检测 WCH 方面具有净收益。本研究揭示了 WCH 与死亡焦虑之间的潜在关联。

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本文引用的文献

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Mortality rate after coronary revascularization in heart failure patients with coronary artery disease.冠心病心力衰竭患者冠状动脉血运重建术后死亡率。
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