| Background and objective: cardiovascular disease has a higher incidence of mental disorders,and cardiovascular disease is more likely to occur in patients with anxiety disorders.Obvious anxiety or depression are independent risk factors of hypertension,not only reduce the effect of drug treatment and prognosis of patients with hypertension,but also because of anxiety,depression and hypertension interaction decreased the quality of life of patients.This study intends to investigate the epidemiological data of patients with hypertension complicated with depression,anxiety and MADD in the city of Nanchang,and compared with normal blood pressure,normal blood pressure with MADD,hypertension,hypertensive patients with anxiety,depression and MADD group,and to explore the effective treatment of hypertension with MADD,and to provide valuable reference for the diagnosis and treatment of hypertension with anxiety,depression or MADD..Methods: a cross-sectional study was conducted to outpatients diagnosed 2000 cases of patients with hypertension as the research object,collection and investigation of patients’ age and sex,blood pressure,vascular endothelial function,platelet factor4,SAS,SDS score and other information.A prospective controlled study was conducted in 6 subjects with normal blood pressure,normal blood pressure with MADD,hypertension,hypertension with anxiety,depression and MADD.Six groups of subjects included in the study were given the individual optimal treatment program,the treatment of hypertension are preferred dihydropyridine calcium antagonist(enalapril),if the blood pressure is not compliance with angiotensin converting enzyme inhibitors,if still can not meet the standard of hypertension,exit the study;Hypertensive patients with anxiety,depression and MADD were given Flupentixol and Melitracen(Trade name: Deanxit;Manufacturer: Denmark lundbeck;Approval Number: H20080175)treatment,patients in 6 groups were treated for 2 months.2months later,recollection of the relevant indicators of patients,and to compare the improvement of the related indexes before and after treatment,and to compare the difference of therapeutic effects between the groups.Results: Cross-sectional study participants included 2000 cases of hypertension patients,including pure high blood pressure,high blood pressure,combined with depression and anxiety,hypertension hypertension combined MADD is respectively1275 cases(63.75%),269 cases(13.45%),283 cases(14.15%)and 173 cases(8.65%).Hypertension combined anxiety group SAS scoring(59.7±18.5)is significantly higher than the other three groups(38.9±11.4,P =0.000;37.8±12.43,P =0.000;38.4±10.6,P =0.000),high blood pressure,merge depression group of SDS score(64.7±18.1)is significantly higher than other three groups(44.1±13.2,P =0.000;44.7±11.9,P =0.000;45.6±12.7,P =0.000),with significant difference.Hypertension group merged MADD RHI(1.49±0.36)significantly lower than the other three groups(1.93±0.54,P =0.000;1.65±0.51,P =0.000;1.62±0.47,P =0.000),platelet factor(49.41±2.73)is significantly higher than other three groups(6.73±2.15,P=0.000;7.19±1.98,P =0.000;7.45±2.10,P =0.000),all have significant difference.Prospective studies were included in the group of normal blood pressure,high blood pressure,with normal blood pressure and MADD group,with high blood pressure and anxiety,with high blood pressure and depression and high blood pressure combined MADD 6 group 40 cases in each.Comparison between groups:hypertension combined MADD RHI group(1.47±0.38)was significantly lower than hypertension group(1.91±0.52),and platelet factor 4(9.14±2.37),dSBP(38.9±35.9)dDBP(117.9±24.2)and nSBP(117.8±24.6),nDBP 24 HSBP standard deviation(94.1±22.2),(16.9±5.4),24 HSBP variation coefficient(31.95),24 HDBP standard deviation(10.9±3.4)and 24 HDBP variation coefficient(31.19)group is significantly higher than high blood pressure.After treatment,the MADD group RHI(1.66 + 0.48)was significantly lower than the hypertension group(1.94±0.56,P=0.017);.Hypertension combined MADD RHI group(1.66 + 0.48)was lower than that in group hypertension with anxiety(1.83±0.56,P=0.04)and hypertension merge depression group(1.82±0.71,P=0.017),all have significant difference.Comparison:in the group after the treatment of high blood pressure with anxiety group SAS scoring 38.2±11.2-59.8±18.6,significantly lower than before treatment hypertension combined depression group of SDS score(43.1±12.8)significantly lower than before treatment(64.8±18.8,P=0.000);After treatment with MADD group,hypertensiongroup,with hypertension with anxiety group and high blood pressure and depression of RHI increased obviously,and platelet factor 4,dSBP,dDBP,nSBP,nDBP,24 24 HSBP HSBP standard deviation,variation coefficient,24 24 HDBP HDBP standard deviation and variation coefficient is decreased obviously;The difference is significant(P < 0.05)Conclusions: Vascular endothelial function in hypertensive patients with MADD was lower than that of hypertension,hypertension with anxiety and depression and higher blood pressure variability,this may indicate poor prognosis;Antihypertensive drugs combined with Deanxit in the treatment of hypertensive patients with anxiety,depression and MADD may delay and even reverse the vascular endothelial dysfunction,and reduce blood pressure variability,is a worthy of clinical reference for the treatment program. |
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