Impact Of Anxiety-depression On Ambulatory Blood Pressure,ET-1 And NO In Elderly Patients With Hypertension

Objective:To explore impact of anxiety-depression on ambulatory blood pressure,ET-1 and NO in elderly patients with hypertension,and provide theoretical basis for further intervention and treatment in elderly patients with hypertension.Methods:According to the inclusion and exclusion criteria,120 elderly patients with hypertension in our hospital from 2016-11 to 2017-07(male 51 cases,female 69 cases)were included,they were assessed by Zung self rating Anxiety Scale and self rating depression scale,according to anxiety/depression scale results,the elderly hypertensive patients were divided into hypertension group(total 62 cases)and another group of hypertension with anxiety-depression(total 58 cases).The general situation of patients was recorded in detail through medical history inquiry and physical examination,which including:gender,age,height(m),weight(kg),body mass index BMI(BMI=kg/m2),history of alcohol and tobacco use,and the patients basic blood pressure were recorded.The blood of the elbow vein was extracted on the next day,and blood lipid,high sensitive C reactive protein and human blood ET-1 and NO were measured.All patients were monitored for blood pressure variability.The data of two groups of patients were statistically analyzed with SPSS 19.0.Results:The group of hypertension with anxiety-depression had higher blood pressure variability compared with simple hypertension group:the systolic pressure standard deviation of 24 hours(15.14±2.71mmHg vs 13.90±3.02mmHg)、daytime(14.09±2.67mmHg vs 12.95 ± 2.38mmHg),nocturnal(12.55 ± 5.33mmHg vs 10.32 ±4.53mmHg)and the standard deviation of diastolic pressure(9.81 ±3.45mmHg vs 7.26±3.64mmHg)(P values were 0.020、0.015.0.004.0.000).The serum ET-1 level,the patients with anxiety-depression were significantly higher than those in simple hypertension:86.62±224.88ng/l vs 58.39 ± 25.23ng/1,P=0.000;The level of nitric oxide(NO),the group of patients with anxiety-depression were lower than the group of simple hypertension:69.00±5.53umol/l vs 80.86±5.62umoUl/l,P=0.000.Conclusion:The state of anxiety-depression has a significant impact on blood pressure variability in elderly hypertensive patients,and anxiety-depression affect the level of ET-1 and NO in elderly patients with hypertension.Early recognition and intervention of anxiety-depression in elderly patients with hypertension,and targeted psychological intervention will help further control of blood pressure,which can help to delay the vascular endothelial damage in elderly hypertensive patients,and improve the progress and prognosis of elderly patients with hypertension.