The Effeet Of Anxiety Depression On Carotid Intima-Media Thickness In Prehypertensive Subjects

Objective: to observe the effect of anxiety depression on carotid-intima-media thickness(CIMT)in prehypertensive subjects,and to provide clues for screening and early clinical intervention in high-risk patients.Methods: One hundred and four prehypertensive(120-139/80-89mmhg)subjects who were hospitalized in the First Affiliated Hospital of Fujian Medical University from February 2018 to March 2019,and all subjects were assessed with Self-Rating Depression Scale(SDS)and Self-Rating Anxiety Scale(SAS).According to the score,50 subjects were divided into anxiety depression group(n = 50)and 54 subjects non-anxiety non-depression group(n = 54).Another 58 healthy subjects with non-anxiety non-depression and normal blood pressure(90-119/60-79mmhg)were selected as control group.The related biochemical indexes,ambulatory blood pressure,heart rate variability and CIMT in three groups were compared and the correlation between anxiety depression and CIMT in prehypertension subjects were studied.Results:(1)LDL FPG and number of smokers in anxiety depression group are higher than non-anxiety non-depression group(p<0.05).The UA,Scr and FPG in non-anxiety non-depression group are higher than that in control group(p<0.05),UA,Scr,FPG and LDL in anxiety depression group are higher than that in control group(p<0.05);anxiety depression group compared with non-anxiety non-depression group,non-anxiety non-depression group compared with control group,anxiety depression group compared with control group,anxiety score and depression score are all increased(p<0.05).(2)Anxiety depression group compared with non-anxiety non-depression group,non-anxiety non-depression group compared with control group,anxiety depression group compared with control group,systolic blood pressure(SBP),diastolic blood pressure(DBP),pulse pressure(PP)and systolic blood pressure load(SBPL)areall increased in 24-hour,day and night(p<0.05),systolic blood pressure-standard deviation(SSD)increase in 24-hour and night(p<0.05).The non-dipper rhythm in anxiety-depression group and non-anxiety-depression group was higher than that in control group(p<0.05).(3)SDNN,SDANN,rMSSD,PNN50 and HF in anxiety depression group are lower than non-anxiety non-depression group(p<0.05).SDNN,SDANN,PNN50 in non-anxiety non-depression group are lower than that in control group(p<0.05),SDNN,SDANN,rMSSD,PNN50,HF in anxiety depression group are lower than in control group(p<0.05);LF/HF in anxiety depression group and non-anxiety non-depression group was higher than that in control group(p<0.05).(4)The mean value of CIMT in anxiety depression group was 0.87±0.10 mm,which was higher than 0.80±0.12 mm(p<0.05)in non-anxiety non-depression group,and the mean value of CMIT in anxiety depression group and non-anxiety non-depression group was higher than that in control group 0.72 ±0.11 mm(p<0.05).(5)Factors related to CIMT: the CIMT was negative correlated with SDNN ?SDANN?RMSDD?PNN50?HF,it was positively correlated with SBP in 24-hour,day and night,DBP in 24-hour and night,PP in 24-hour,day and night,SBPL in24-hour and night,SSD in 24-hour,day and night,DSD in 24-hour,body mass index,cholesterol,LDL,age,smoking,anxiety and depression scores(p<0.05).Depression score,age,smoking,and 24-hour SBP were risk factors for CIMT by multiple regression analysis.Conclusion:(1)Blood pressure variability,blood pressure load,and CIMT thickening in prehypertensive subjects were higher than those in normotensive subjects,blood pressure circadian rhythm disorder,reduced heart rate variability is found in prehypertensive subjects.It suggests autonomic nervous dysfunction in prehypertensive subjects was happened.(2)Compared with prehypertensive subjects with non-anxiety non-depression,There were more cardiovascular risk factors,higher blood pressure level,blood pressure variability,and blood pressure load,and CIMT thickening in prehypertensive subjectswith anxiety depression,reduced heart rate variability is found in CIMT,It suggests further impairment of autonomic nerve function.(3)Depression score,age,smoking and 24 hSBP were important risk factors for CIMT in prehypertensive projects.