Nyárády Balázs Bence, Vértes Miklós, Dósa Edit, Yang Xiao, George Charles J, Kiss Enikő, Baji Ildikó, Kapornai Krisztina, Kovacs Maria
Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary.
Medical Imaging Center, Semmelweis University, 1082 Budapest, Hungary.
J Clin Med. 2024 Aug 8;13(16):4640. doi: 10.3390/jcm13164640.
Depression has been shown to have adverse effects on blood pressure (BP) and is associated with high blood pressure variability (BPV). In turn, high short-term BPV has been related to eventual cardiovascular risk. But it is not clear how early in adulthood the detrimental effects of depression on BPV may be discerned, if being at high risk for depression also compromises BPV, and whether the clinical features of depression moderate its adverse effects. We investigated these three issues among young adults using an office-like setting. In total, 218 subjects with a history of childhood-onset major depressive episodes (probands), 206 never-depressed full biological siblings of the probands (high-risk siblings), and 166 emotionally healthy unrelated controls received a psychiatric evaluation and three standardized-sitting BP measurements 5 min apart. Short-term BPV was defined as the maximum difference between measures (range) for each case. The statistical methods included analyses of variance/covariance, chi-square tests, and multiple regression. Systolic and diastolic BP decreased over consecutive measurements ( < 0.001). After controlling for age, the probands, siblings, and controls did not differ significantly in terms of BPV. However, the number of lifetime depressive episodes did predict the diastolic BP range ( = 0.005): probands with the highest number of depressive episodes had the largest short-term diastolic BPV. On a group level, the adverse effects on BPV of having experienced or being at high risk for depression are not yet evident during young adulthood. However, the number of major depressive episodes, which is an index of lifetime depression burden, predicts higher BPV. Thus, BPV monitoring for young adults with clinical depression histories could be part of an early intervention program to reduce the risk of eventual cardiovascular disease.
抑郁症已被证明对血压(BP)有不良影响,并与高血压变异性(BPV)相关。反过来,高短期BPV与最终的心血管风险有关。但目前尚不清楚在成年早期抑郁症对BPV的有害影响在多早的时候可以被察觉,处于抑郁症高风险状态是否也会影响BPV,以及抑郁症的临床特征是否会减轻其不良影响。我们在类似办公室的环境中对年轻人中的这三个问题进行了调查。总共218名有儿童期起病的重度抑郁发作史的受试者(先证者)、先证者的206名从未患过抑郁症的全血缘兄弟姐妹(高风险兄弟姐妹)以及166名情绪健康的无血缘关系对照者接受了精神科评估,并每隔5分钟进行三次标准化坐姿血压测量。短期BPV被定义为每个病例测量值之间的最大差值(范围)。统计方法包括方差/协方差分析、卡方检验和多元回归。收缩压和舒张压在连续测量中下降(<0.001)。在控制年龄后,先证者、兄弟姐妹和对照者在BPV方面没有显著差异。然而,终生抑郁发作的次数确实可以预测舒张压范围(=0.005):抑郁发作次数最多的先证者具有最大的短期舒张压BPV。在群体水平上,经历过抑郁症或处于抑郁症高风险状态对BPV的不良影响在成年早期尚不明显。然而,重度抑郁发作的次数作为终生抑郁负担的一个指标,可以预测更高的BPV。因此,对有临床抑郁症病史的年轻人进行BPV监测可以作为早期干预计划的一部分,以降低最终患心血管疾病的风险。