高血压合并焦虑、抑郁的发病率和相关危险因素分析

目的　通过调查了解目前高血压病人的焦虑、抑郁状况。方法　在随机抽取的北京市9 所医院的心血管内科门诊,对连续就诊的高血压病人进行访问,填写焦虑自评量表和抑郁自评量表,评定高血压患者中焦虑和抑郁的发病率,并识别相关的危险因素。结果　共入选2 274例高血压患者,其中男性1 025例(45.1%),女性1 249 例(54.9%),焦虑发生率38.5%, 抑郁发生率5.7%,其中男性的焦虑发生率为31.5%,抑郁发生率为3.7%,女性的焦虑发生率为42.7%,抑郁发生率为7.4%。高血压伴发焦虑的独立危险因素为:女性、低年龄组、独身、高教育程度、无业、低收入、病程时间长、高血压分级水平高、有冠心病;高血压伴发抑郁的独立危险因素为高龄、独身、女性、病程时间长、低收入、低教育程度、冠心病、糖尿病。结论　高血压患者中焦虑的发病率高于抑郁。女性、独身、病程时间长、低收入及合并有冠心病是焦虑和抑郁的共同危险因素;此外,低龄、高教育程度、体力劳动者容易发生焦虑。高龄、低教育程度亦是抑郁的危险因素。

Prevalence and Risk Factors of Anxiety and Depression in Hypertensive Patients

Objective To investigate prevalence and risk factors of anxiety and depression in hypertensive patients.Methods The investigation was based on interview with consecutive hypertensive patients selected at random in cardiovascular outpatient clinics from nine hospitals in Beijing (patients with language or movement barriers due to cerebrovascular disease were excluded). The patients were required to fill in Self-Rating Anxiety Scale and Self-Rating Depression Scale. Meanwhile other basic information was also collected.Results A total of 2 274 hypertensive patients were enrolled, with 1 025 males(45.1%) and 1 249 females(54.9%). The prevalence of anxiety was 38.5% and that of depression was 5.7%. The independent risk factors in hypertensive patients for anxiety were: female, juvenility, single, better educational background, blue-collar, lower income, longer course of diseases, higher grade of hypertension and with coronary artery disease. Risk factors in hypertensive patients with depression were: advanced age, single, female, longer course of diseases, lower income, lower education degree, complicated with coronary artery disease, and with diabetes mellitus.Conclusion The prevalence of anxiety in hypertensive patients is significantly higher than that of depression. Female,single, longer course of diseases, lower income, higher grade of hypertension and coronary artery disease are common indepentent risk factors in anxiety and depression. In addition, juvenility, blue-collar patients, better educational background are prone to anxiety; elderly patients with poor educational background are prone to depression.