Impact of Depression and Demoralization on Blood Pressure Control in African Americans with Hypertension: Findings from the TRIUMPH Trial.
Impact of Depression and Demoralization on Blood Pressure Control in African Americans with Hypertension: Findings from the TRIUMPH Trial.
复制标题
抑郁和士气低落对患有高血压的非裔美国人血压控制的影响：TRIUMPH 试验的结果。
DOI：
10.1007/s40615-017-0439-9
复制
发表时间：
2018
影响因子：
3.9
通讯作者：
Boutin-Foster,Carla
中科院分区：
文献类型：
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作者：
Offidani,Emanuela;Benasi,Giada;Charlson,MaryE;Ravenell,JosephE;Boutin-Foster,Carla
背景非裔美国人比高加索人更早患上高血压，心血管疾病预后也更差。越来越多的证据表明，心理困扰可能在观察到的高血压种族差异中发挥了作用。几项研究已经调查了抑郁和高血压之间的关系，但对精神沮丧的作用仍然知之甚少。方法利用试验数据，使用非裔美国人高血压患者(凯旋)的励志访谈、积极情感和自我肯定，使用Logistic回归模型估计患有道德低落、抑郁和这两种情况的参与者在12个月时血压控制方面的差异。结果我们的Logistic模型显示，所报告的心理社会症状在12个月时预测血压控制成功的差异显著。对比分析显示，在调整了社会人口、临床和心理社会变量后，士气低落的患者比没有情绪性疾病的参与者更不可能实现血压控制(p=0.020)。类似的结果也出现在抑郁症患者(p=0.042)和两种情况下(p=0.022)。结论抑郁症可以使人极度虚弱，并会对健康造成严重影响。我们的发现证实了这一结果，并表明，尽管抑郁和士气低落有共同的特征，但它们是两种截然不同的临床现象，对非裔美国人的血压控制具有相似的负面影响。
BackgroundAfrican Americans develop hypertension earlier and have worse cardiovascular outcomes than Caucasians. Accumulating evidence suggests that psychological distress may play a role in the observed racial differences in hypertension. Several studies have investigated the relationship between depression and hypertension while little is still known about the role of demoralization.MethodsUsing data from the Trial Using Motivational Interviewing, Positive Affect, and Self-affirmation in African Americans with Hypertension (TRIUMPH), logistic regression models were used to estimate differences in blood pressure control at 12 months among participants with demoralization, depression, and both conditions.ResultsOur logistic models showed that reported psychosocial symptoms significantly differed in predicting success in blood pressure control at 12 months. Contrast analyses showed that, after adjusting for sociodemographic, clinical, and psychosocial variables, demoralized patients were less likely to achieve blood pressure control than participants without affective conditions (p= 0.020). Similar results emerged for patients with depression (p= 0.042) and both conditions (p= 0.022).ConclusionsDepression can be extremely debilitating and has serious health consequence. Our findings confirm this result and show that, even though depression and demoralization share common features, they are two distinct clinical phenomena with similar negative impact on blood pressure control in African Americans.