中国中老年人长期就诊血压变化与抑郁之间的关系。

Postgraduate medicine Pub Date : 2024-05-01 Epub Date: 2024-05-24 DOI:10.1080/00325481.2024.2358748
Jinni Liao, Weida Qiu, Dan Huang, Aiqun Cen, Yanli Chen
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引用次数: 0

摘要

背景:在中国成年人中,长期血压变异性(BPV)与随后的抑郁之间是否存在纵向联系仍未确定:在中国成年人中,长期血压变化(BPV)与随后的抑郁之间是否存在纵向联系仍无定论:本研究利用了中国健康与退休纵向研究的全国队列数据,其中包括年龄大于 45 岁、无精神疾病或记忆相关疾病的参与者。研究采用2011年至2015年3次访视的个体内变异系数(CV)和标准差(SD)来检测收缩压(SBP)和舒张压(DBP)的长期变异性。抑郁症状采用10项流行病学研究中心抑郁量表(CES-D-10)进行检测,CES-D-10≥15为中重度抑郁:本次分析共纳入了 5249 名参与者(平均年龄:61.4 ± 8.1 岁,46.5% 为男性)。经多变量调整后,血压 CV 和 SD 均处于最高四分位数的人与处于最低四分位数的人相比,CES-D-10 总分更高。在 3 年的随访期间,有 1070 名参与者(20.4%)患有中度至重度抑郁症。与第一季度的参与者相比,SBP 和 DBP CV 第四季度的参与者患中度至重度抑郁症的几率分别高出 1.23 倍(95% CI:1.01,1.49)和 1.20 倍(95% CI:1.01,1.41)。亚组分析显示,血压变异系数较高的男性出现严重抑郁症状的风险更高(SBP变异系数与性别的交互作用 p = 0.050,SBP变异系数与性别的交互作用 p = 0.025):抑郁症在中国中老年人中很常见,而长期就诊血压变异与抑郁症状呈正相关,这凸显了在中国实施抑郁症强化预防策略和加强血压监测的重要性。
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Association between long-term visit-to-visit blood pressure variability and depression among Chinese middle-aged and older adults.

Background: Whether there is a longitudinal association between long-term blood pressure variability (BPV) and subsequent depression among Chinese adults remains inconclusive.

Methods: This study utilized data from a nationwide cohort of the China Health and Retirement Longitudinal Study, which included participants aged > 45 years without prevalent psychiatric or memory-related diseases. The intra-individual coefficient of variation (CV) and standard deviation (SD) across 3 visits from 2011 to 2015 were used to examine the long-term variability in systolic BP (SBP) and diastolic BP (DBP). The depressive symptoms were examined using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10), and moderate-to-severe depression was defined as CES-D-10 ≥ 15.

Results: A total of 5,249 participants (mean age: 61.4 ± 8.1 years, 46.5% were men) were included in the current analysis. Individuals in the highest quartile of both BP CV and SD were independently correlated with a higher total CES-D-10 score compared to those in the lowest quartile after multivariable adjustment. 1,070 participants (20.4%) had moderate-to-severe depression during the 3-year follow-up period. Participants in the Q4 of SBP and DBP CV had 1.23-fold higher odds (95% CI: 1.01, 1.49) and 1.20-fold higher odds (95% CI: 1.01, 1.41) of moderate-to-severe depression compared to those in Q1. Subgroup analyses revealed that men with higher BP CVs had a greater risk of severe depressive symptoms (p for SBP CV-by-sex interaction = 0.050, p for SBP CV-by-sex interaction = 0.025).

Conclusions: Depression was common among Chinese middle-aged and older adults and long-term visit-to-visit BPV was positively associated with depressive symptoms, highlighting the importance of implementing intensive prevention strategies for depression and enhancing blood pressure monitors in China.

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