Comorbid hypertension in patients with major depressive disorder - Results from a European multicenter study
Comorbid hypertension in patients with major depressive disorder - Results from a European multicenter study
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DOI：
10.1016/j.euroneuro.2019.03.005
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发表时间：
2019-06-01
影响因子：
5.6
通讯作者：
Kasper, Siegfried
中科院分区：
文献类型：
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作者：
Fugger, Gernot;Dold, Markus;Kasper, Siegfried
这项多中心研究的目的是阐明严重抑郁障碍(MDD)和共病高血压之间的相关联系，这两种疾病以在功能性残疾方面频繁共存和相互作用而闻名。共有1410名患者的人口统计学和临床信息被横断面检索。用描述性统计、协方差分析(ANCOVA)和二元Logistic回归分析对合并高血压和不合并高血压的MDD患者的特征进行比较。高血压合并时点患病率为18.9%。合并高血压的MDD患者年龄大、体重重、更有可能有恋爱关系、住院，并被诊断为进一步合并慢性躯体疾病，包括心脏病、糖尿病和甲状腺功能障碍。此外，在当前抑郁发作开始时，患有MDD和合并高血压的个体在蒙哥马利和阿斯伯格抑郁评定量表(MADRS)中表现出更高的得分。抑郁的忧郁特征显示出更高的概率。合并高血压的MDD患者与不合并高血压的MDD患者之间，一线抗抑郁治疗没有显著差异。然而，在MDD+高血压组中，普瑞巴林强化和与一种额外的抗抑郁药联合使用更为常见。总而言之，高血压可能会影响疾病的严重程度，并与MDD患者的不同精神病理有关。与普通人群相比，患有MDD和高血压的患者似乎被低估了，几乎100%的病例都有额外的躯体疾病，因此需要进行相应的筛查和治疗。(C)2019年爱思唯尔和ECNP。版权所有。
The objective of the present multicenter study was to elucidate relevant associations between major depressive disorder (MDD) and comorbid hypertension that are known for their frequent co-occurrence and interaction with regard to functional disability. Demographic and clinical information of altogether 1410 patients were retrieved cross-sectionally. Consecutively, a comparison of patient characteristics between MDD subjects with and without comorbid hypertension were conducted by descriptive statistics, analyses of covariance (ANCOVA) and binary logistic regression analyses. The point prevalence rate for comorbid hypertension was 18.9%. Patients with MDD+comorbid hypertension were significantly older, heavier, more likely to be in a relationship, inpatient and diagnosed with further comorbid chronic somatic diseases including heart disease, diabetes and thyroid dysfunction. In addition, individuals with MDD and comorbid hypertension exhibited a higher score at the Montgomery and Asberg Depression Rating Scale (MADRS) at onset of the current depressive episode. Melancholic features of depression showed a higher probability. The first line antidepressant treatment did not differ significantly between MDD subjects with versus without comorbid hypertension. Augmentation with pregabalin and combination with one additional antidepressant, however, were more common in the MDD+hypertension group. In conclusion, high blood pressure may influence illness severity and is associated with a distinct psychopathology in MDD patients. Patients with MDD and comorbid hypertension, that seems to be underdiagnosed in MDD patients compared to the general population, are subject to additional somatic diseases in almost 100 percent of the cases and hence, need to be screened and treated accordingly. (C) 2019 Elsevier B.V. and ECNP. All rights reserved.