Hypertension & depression

1. Hypertension& depression Tianlei Sun 2013/10/29

2. Relationship between hypertension & depression • Hypertensive patients are more likely to be depressive.[1] • People who suffer from psychological problems are more likely to be hypertensive.[2]Depression will aggravate the condition of hypertensive patients.[3] • The use of antidepressant Neurostan helps to decrease the BP of hypertensive patients.[4] hypertension depression

3. Mechanisms • The more hcy, the more severe depresson is.[5] • RAAS:Older hypertensive patients with depression have a higher level of renin, Angiotensin, aldosterone.[6] • Older hypertensive patients with depression has a Lower free triiodothyronine compared to hypertensive patients.[7] • Sympathetic activity is increased in essential hypertension and depression.[8,9,10,11,12] • BP and susceptibility to hypertension are influenced by genetic factors and genetic factors are important in the etiology of mood disorders. [13,14] • Among hypertensive patients, depressive symptoms are independently associated with multiple unhealthy lifestyles.[15]

4. Treatment Drug therapy • Antidepressant • Antihypertensive • Chinese herb Non-pharmaceutical approaches • Psychological nursing intervention is helpful to reduce the BP and improve depression.[16] • Morning exercise can not only decreases BP of old hypertensive patients, but also improve their depression.[17] • Keep healthy lifestyle. • Acupuncture.[18]

5. Conclusion • The relationship between hypertension and depression is complicated, but there’s one thing for sure. That is they’re influenced by each other. So, while treating hypertensive patients with depression, doctors should consider both aspects.

6. 参考文献 [1] 韩晶，殷晓梅，徐斐，等.南京市浦口地区高血压人群抑郁和焦虑状况的病例对照研究[J].中华流行病学杂志，2008，29(2)：125-127. [2] N abi H ，C hastang JF，Lefèvre T，et al. Trajectories of depressive episodes and hypertension over 24 years：the W hitehallⅡprospective cohortstudy ［J］. H ypertension，2011，57 ﹙4﹚：710 −716. [3] GafarovVV, GromovaHA,GagulinIV et al. Arterial hypertension, myocardial in farction and stroke risk of development and psychosocialfactors[J].Alaska Med,2007,49(2 suppl):117-119. [4]刘梅颜,段小春.原发性高血压病患者抑郁程度与血清同型半胱氨酸水平的关系研究[J].中国全科医学,2013,23:2682-2684. [5]杨庆辉,温亮,刘倩倩,等.抗焦虑抑郁药物对高血压治疗作用的临床研[J]究.心血管康复医学杂志,2011,3:234-237. [6]田歌,陶贵周,屈宝泽.RAAS激活与老年高血压合并抑郁的关系[J].医学与哲学.2012,451:22-23. [7]马丽娜，李耘，冯明.老年高血压合并抑郁患者甲状腺激素水平变化分析[J].中华老年心脑血管病杂志.2012,1 [8] Goldstein D, Lake C. Plasma norepinephrine and epinephrine levelsin essential hypertension. Fed. Proc. 1994;43(1):57-62. [9] Devilliers AS, Russell VA, Carsters ME, Aalbers C, Gagiano CA,Chalton DO, et al. Noradrenergic function and hypothalamicpituitary-adrenal axis activity in primary major depressive disorder.Psychiatry Res. 1987;22(2):127-39.

7. [10]Lake CR, Pickar D, Zeigler MG, Lipper S, Slater S, Murphy DL.High plasma norepinephrine levels in patients with major affectivedisorder. Am J Psychiatry. 1982;139(10):1315-8. [11]Roy A, Pickar D, Linnoila M, Potter WZ. Plasma norepinephrinelevels in affective disorders. Relationship to melancholia. ArchGen Psychiatry. 1985;42(12):1181-5. [12]Cooper SJ, Kelly JG, King DJ. Adrenergic receptors in depression.Effects of electroconvulsive therapy. Br J Psychiatry. 1985;147:23-9. [13] Grewen KM, Girdler SS, Hinderliter A, Light K. Depressive symptoms are related to higher ambulatory blood pressure in people with a family history of hypertension. Psychosom Med.2004;66(1):9-16. [14] Lafer B, Vallada Filho H. Genética e fisiopatoloia dos transtornos depressivos. Rev Bras Psiquiatria. 1999;21:S12-S17. [15] Bonnet F,Irving K,Terra JL et al. Depressive symptoms are associated with unhealthy lifestyles in hypertensive patients with the metabolic syndrome. J.Hypertens. 2005Mar,23(3):611-617 [16]郭艳玲,心理护理干预在高血压病合并抑郁患者中的应用[J].当代护士2013,6(中旬刊):13-15. [17]高孟娟，李美莲.社区晨练活动对老年高血压患者血压和抑郁、焦虑情绪的影响[J].中国临床康复.2004,18:3587. [18]符文彬,针灸治疗抑郁性神经症的临床研究.中国针灸学会第六届全国中青年针灸推拿学术交流暨针灸学科发展与建设研讨会论文汇编.2004-10:74-77

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