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Rosas CE, Pirzada A, Durazo-Arvizu R, Gallo LC, Talavera GA, Elfassy T, Cai J, Llabre MM, Perreira KM, Wassertheil-Smoller S, Daviglus ML, Sanchez-Johnsen LAP. Associations of Anxiety Symptoms With 6-Year Blood Pressure Changes and Incident Hypertension: Results From the Hispanic Community Health Study/Study of Latinos. Ann Behav Med 2024; 58:488-497. [PMID: 38810223 PMCID: PMC11185088 DOI: 10.1093/abm/kaae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Despite the high burden of anxiety and hypertension in Hispanic/Latino adults, little is known about their association in this population. PURPOSE To examine the associations of anxiety symptoms with 6-year changes in blood pressure (BP) and incident hypertension in Hispanic/Latino adults. METHODS We examined data from a probability sample of 10,881 Hispanic/Latino persons aged 18-74 who attended visits 1 (V1; 2008-2011) and 2 (V2; 2014-2017) of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a prospective cohort study. Anxiety symptoms were assessed at V1 using the 10-item Spielberger Trait Anxiety Scale (M = 17.1; Range = 10-40) and dichotomized using a cut-point of 20, the highest quartile in this cohort. BP was measured at both visits using a standardized protocol. RESULTS Adults with elevated anxiety symptoms had a 1.02 mm Hg greater increase in systolic (p = .02) and a 0.75 mm Hg greater increase in diastolic BP (p = .02) over 6.1 years than those with lower symptoms, after adjusting for sociodemographic and clinical covariates. These associations differed by sex. Elevated anxiety was associated with a greater increase in systolic and diastolic BP in men only. Among persons without hypertension at V1 (N = 7,412), those with elevated anxiety symptoms at V1 had a 22% higher incidence of hypertension (p = .02) 6.1 years later. CONCLUSIONS Our findings underscore the importance of screening for and treating elevated anxiety symptoms to help prevent hypertension. Further research on the role of sex and underlying mechanisms is warranted.
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Affiliation(s)
- Carlos E Rosas
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- South Bay Latino Research Center, San Diego State University, Chula Vista, California, USA
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, Illinois, USA
- Department of Medicine, University of Illinois Chicago, Chicago, Illinois, USA
| | - Ramon Durazo-Arvizu
- Department of Neonatology, Children's Hospital Los Angeles - University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Linda C Gallo
- South Bay Latino Research Center, San Diego State University, Chula Vista, California, USA
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Gregory A Talavera
- South Bay Latino Research Center, San Diego State University, Chula Vista, California, USA
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Tali Elfassy
- Department of Medicine, Katz Family Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jianwen Cai
- Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Martha L Daviglus
- South Bay Latino Research Center, San Diego State University, Chula Vista, California, USA
- Department of Medicine, University of Illinois Chicago, Chicago, Illinois, USA
| | - Lisa A P Sanchez-Johnsen
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Department of Psychology, University of Illinois Chicago, Chicago, Illinois, USA
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Schuchman M, Brady TM, Glenn DA, Tuttle KR, Cara-Fuentes G, Levy RV, Gonzalez-Vicente A, Alakwaa FM, Srivastava T, Sethna CB. Association of mental health-related patient reported outcomes with blood pressure in adults and children with primary proteinuric glomerulopathies. J Nephrol 2024; 37:647-660. [PMID: 38512380 DOI: 10.1007/s40620-024-01919-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/01/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION The prevalence of mental health disorders including anxiety and depression is increasing and is linked to hypertension in healthy individuals. However, the relationship of psychosocial patient-reported outcomes on blood pressure (BP) in primary proteinuric glomerulopathies is not well characterized. This study explored longitudinal relationships between psychosocial patient-reported outcomes and BP status among individuals with proteinuric glomerulopathies. METHODS An observational cohort study was performed using data from 745 adults and children enrolled in the Nephrotic Syndrome Study Network (NEPTUNE). General Estimating Equations for linear regression and binary logistic analysis for odds ratios were performed to analyze relationships between the exposures, longitudinal Patient-Reported Outcome Measurement Information System (PROMIS) measures and BP and hypertension status as outcomes. RESULTS In adults, more anxiety was longitudinally associated with higher systolic and hypertensive BP. In children, fatigue was longitudinally associated with increased odds of hypertensive BP regardless of the PROMIS report method. More stress, anxiety, and depression were longitudinally associated with higher systolic BP index, higher diastolic BP index, and increased odds of hypertensive BP index in children with parent-proxy patient-reported outcomes. DISCUSSION/CONCLUSION Chronically poor psychosocial patient-reported outcomes may be significantly associated with higher BP and hypertension in adults and children with primary proteinuric glomerulopathies. This interaction appears strong in children but should be interpreted with caution, as multiple confounders related to glomerular disease may influence both mental health and BP independently. That said, access to mental health resources may help control BP, and proper disease and BP management may improve overall mental health.
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Affiliation(s)
- Matthew Schuchman
- Northwell, Cohen Children's Medical Center, Division of Pediatric Nephrology, New Hyde Park, NY, USA
| | - Tammy M Brady
- Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dorey A Glenn
- Division of Nephrology and Hypertension, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katherine R Tuttle
- Providence Medical Research Center, Providence Inland Northwest Health, Spokane, WA, USA
- Division of Nephrology, University of Washington School of Medicine, Spokane, WA, USA
| | - Gabriel Cara-Fuentes
- Section of Pediatric Nephrology, Children's Hospital Colorado, University of Colorado, Aurora, CO, USA
| | - Rebecca V Levy
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
- Division of Pediatric Nephrology, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Agustin Gonzalez-Vicente
- Department of Physiology and Biophysics, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Fadhl M Alakwaa
- Department of Internal Medicine, Nephrology Division, University of Michigan, Ann Arbor, MI, USA
| | - Tarak Srivastava
- Pediatric Nephrology, Children's Mercy Hospital, Kansas City, MO, USA
| | - Christine B Sethna
- Northwell, Cohen Children's Medical Center, Division of Pediatric Nephrology, New Hyde Park, NY, USA.
- Feinstein Institutes for Medical Research, Manhasset, NY, USA.
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Nguyen AW, Taylor HO, Taylor RJ, Ambroise AZ, Hamler T, Qin W, Chatters LM. The role of subjective, interpersonal, and structural social isolation in 12-month and lifetime anxiety disorders. BMC Public Health 2024; 24:760. [PMID: 38468204 DOI: 10.1186/s12889-024-18233-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/28/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Anxiety disorders are among the most prevalent psychiatric conditions worldwide, and the incidence of anxiety disorders among adults in the U.S. have increased over the last decade. Anxiety disorders can have debilitating effects on multiple areas of functioning and quality of life. Recently, social isolation has emerged as an important public health problem associated with worse health and well-being outcomes. Research on the connection between social isolation and mental health has found that multiple dimensions of social isolation may negatively impact mental health, but few inquiries have focused on the association between social isolation and anxiety. This study examined the relationships between multiple dimensions of social isolation and anxiety disorders in a nationally representative sample of adults aged 18 and older. METHODS The sample includes 6082 individuals from the National Survey of American Life. This study examined whether three different dimensions of social isolation-subjective, interpersonal, and structural-were associated with 12-month and lifetime anxiety disorders (any anxiety disorder, posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder (PD), social anxiety disorder (SAD), and agoraphobia (AG). Logistic regressions were used to test the associations between the three social isolation variables and the anxiety outcomes. RESULTS This study found that of the three dimensions of social isolation, subjective isolation was most consistently related to both lifetime and 12-month anxiety disorders. Those who were subjectively isolated had increased odds of meeting criteria for any anxiety disorder, PTSD, GAD, PD, and AG over the past 12 months and throughout their lifetimes. Structural isolation was negatively associated with lifetime and 12-month AG. CONCLUSIONS Public health approaches should include mental health and primary care providers and need to target social isolation, especially subjective isolation, which may be key in preventing anxiety disorders and the worsening of anxiety disorders. Future public health research is needed on how and in what ways the differing dimensions of social isolation impact mental health.
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Affiliation(s)
- Ann W Nguyen
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, 44106, Cleveland, OH, USA
| | - Harry Owen Taylor
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, M5S 1V4, Toronto, ON, Canada
| | - Robert Joseph Taylor
- School of Social Work, University of Michigan, 1080 S. University Ave, 48109, Ann Arbor, MI, USA.
| | - Alexis Z Ambroise
- College of Education and Human Development, University of Delaware, 19716, Newark, DE, USA
| | - Tyrone Hamler
- Graduate School of Social Work, University of Denver, 2148 S. High Street, 80210, Denver, CO, USA
| | - Weidi Qin
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, 1350 University Ave, Madison, WI, USA
| | - Linda M Chatters
- School of Social Work, University of Michigan, 1080 S. University Ave, 48109, Ann Arbor, MI, USA
- School of Public Health, University of Michigan, 1415 Washington Heights, 48109, Ann Arbor, MI, USA
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Liu H, Zhang L, Xiong L, Wang H, Liu C, Wang C, Feng Z. The impact of comorbidity on the diagnosis delay, treatment options and prognosis for advanced oral cancer: A retrospective result of the POROMS database. J Craniomaxillofac Surg 2024; 52:260-268. [PMID: 38182475 DOI: 10.1016/j.jcms.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 07/30/2023] [Accepted: 12/30/2023] [Indexed: 01/07/2024] Open
Abstract
This study aimed to reveal the underlying mechanisms linking advanced oral squamous cell carcinoma (OSCC) with its comorbidities. Data extracted from the POROMS database included 448 advanced OSCC patients in stage III or IV (AJCC 8th) with primary tumors between August 2015 and August 2021. Time to diagnosis delay increased from 4.5, 5.3-6.5 months when the Adult Comorbidity Evaluation-27 (ACE-27) worsened from none, mild (RR: 1.155, 1.043-1.279; P = 0.006) to moderate-severe (RR: 1.431, 1.251-1.636; P < 0.001). With the number of comorbidities increased from 0, 1-2 (RR: 1.188, 1.078-1.310; P = 0.001) to 3 (RR: 1.563, 1.296-1.885; P < 0.001), the time to diagnosis delay increased from 4.5, 5.4-7.1 months. As the level and number of comorbidities increased, the likelihood of treatment completion gradually declined, especially in those older than 65 years (P = 0.003). The presence of comorbidity was an independent prognostic factor for disease-free survival (HR: 1.431, 1.022-2.005; P = 0.037). Comorbidities may lead to poorer prognosis by directly causing delays in diagnosis, limiting treatment options, and increasing the risk of death in advanced OSCC patients.
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Affiliation(s)
- Huan Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Lirui Zhang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Lei Xiong
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Hao Wang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Chang Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Chong Wang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China.
| | - Zhien Feng
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China.
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Xiao T, Wu A, Wang X, Guo Z, Huang F, Cheng X, Shen X, Tao L. Anti-hypertensive and composition as well as pharmacokinetics and tissues distribution of active ingredients from Alpinia zerumbet. Fitoterapia 2024; 172:105753. [PMID: 37992780 DOI: 10.1016/j.fitote.2023.105753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/11/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023]
Abstract
Alpinia zerumbet is a food flavor additive and a traditional medicine herb around the world. Several studies have reported that A. zerumbet has excellent effects on a variety of cardiovascular diseases, but its potential hypertensive applications, and pharmacokinetic features of main active substances have not been fully investigated. The mechanism of anti-hypertension with ethyl acetate extracts of A. zerumbet fruits (AZEAE) was evaluated by L-NNA-induced hypertensive rats and L-NAME-injured human umbilical vein endothelial cells (HUVECs). Blood pressure, echocardiographic cardiac index and H&E staining were used to preliminary evaluate the antihypertensive effect of AZEAE, the levels of TNF-α, IL-6, and IL-1β were evaluated by ELISA, and the proteins expression of IL-1β, IL-18, AGTR1, VCAM, iNOS, EDN1 and eNOS were also evaluated. In addition, isolation, identification, and activity screening of bioactive compounds were carried ou. Next, pharmacokinetics and tissues distribution of dihydro-5,6-dehydrokavain (DDK) in vivo were measured, and preliminary absorption mechanism was conducted with Caco-2 cell monolayers. AZEAE remarkably enhanced the state of hypertensive rats. Twelve compounds were isolated and identified, and five compounds were isolated from this plant for the first time. The isolated compounds also exhibited good resistance against injury of HUVECs. Moreover, pharmacokinetics and Caco-2 cell monolayers demonstrated AZEAE had better absorption capacity than DDK, and DDK exhibited differences in tissues distribution and gender difference. This study was the first to assess the potential hypertensive applications of A. zerumbet in vivo and vitro, and the first direct and concise study of the in vivo behavior of DDK and AZEAE.
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Affiliation(s)
- Ting Xiao
- The State Key Laboratory of Functions and Applications of Medicinal Plants, School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China; The Department of Pharmacology of Materia Medica (The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou Province and The High Educational Key Laboratory of Guizhou Province for Natural Medicinal Pharmacology and Druggability), School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China; The Key Laboratory of Optimal Utilization of Natural Medicine Resources (The Union Key Laboratory of Guiyang City-Guizhou Medical University), School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China.
| | - Ai Wu
- The State Key Laboratory of Functions and Applications of Medicinal Plants, School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China; The Department of Pharmacology of Materia Medica (The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou Province and The High Educational Key Laboratory of Guizhou Province for Natural Medicinal Pharmacology and Druggability), School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China; The Key Laboratory of Optimal Utilization of Natural Medicine Resources (The Union Key Laboratory of Guiyang City-Guizhou Medical University), School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China
| | - Xiaowei Wang
- The State Key Laboratory of Functions and Applications of Medicinal Plants, School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China; The Department of Pharmacology of Materia Medica (The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou Province and The High Educational Key Laboratory of Guizhou Province for Natural Medicinal Pharmacology and Druggability), School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China; The Key Laboratory of Optimal Utilization of Natural Medicine Resources (The Union Key Laboratory of Guiyang City-Guizhou Medical University), School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China
| | - Zhenghong Guo
- School of Pharmacy, Guizhou University of Traditional Chinese Medicine, Guiyang 550025, Guizhou, China
| | - Feilong Huang
- The State Key Laboratory of Functions and Applications of Medicinal Plants, School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China; The Department of Pharmacology of Materia Medica (The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou Province and The High Educational Key Laboratory of Guizhou Province for Natural Medicinal Pharmacology and Druggability), School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China; The Key Laboratory of Optimal Utilization of Natural Medicine Resources (The Union Key Laboratory of Guiyang City-Guizhou Medical University), School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China
| | - Xingyan Cheng
- The State Key Laboratory of Functions and Applications of Medicinal Plants, School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China; The Department of Pharmacology of Materia Medica (The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou Province and The High Educational Key Laboratory of Guizhou Province for Natural Medicinal Pharmacology and Druggability), School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China; The Key Laboratory of Optimal Utilization of Natural Medicine Resources (The Union Key Laboratory of Guiyang City-Guizhou Medical University), School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China
| | - Xiangchun Shen
- The State Key Laboratory of Functions and Applications of Medicinal Plants, School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China; The Department of Pharmacology of Materia Medica (The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou Province and The High Educational Key Laboratory of Guizhou Province for Natural Medicinal Pharmacology and Druggability), School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China; The Key Laboratory of Optimal Utilization of Natural Medicine Resources (The Union Key Laboratory of Guiyang City-Guizhou Medical University), School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China.
| | - Ling Tao
- The State Key Laboratory of Functions and Applications of Medicinal Plants, School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China; The Department of Pharmacology of Materia Medica (The High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou Province and The High Educational Key Laboratory of Guizhou Province for Natural Medicinal Pharmacology and Druggability), School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China; The Key Laboratory of Optimal Utilization of Natural Medicine Resources (The Union Key Laboratory of Guiyang City-Guizhou Medical University), School of Pharmaceutical Sciences, Guizhou Medical University, NO. 6 Ankang avenue, Guian New District, 561113, Guizhou, China.
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Stamoulis T, Dragioti E, Gouva M, Mantzoukas S, Κourakos M. Unveiling the Nexus: Depressive Symptoms and Medication Adherence in Hypertensive Patients' Self-care: A Systematic Review. Mater Sociomed 2024; 36:65-72. [PMID: 38590593 PMCID: PMC10999142 DOI: 10.5455/msm.2024.36.65-72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/25/2024] [Indexed: 04/10/2024] Open
Abstract
Background Hypertension, a significant public health concern, is frequently linked to emotional disorders like depression. Research shows a reciprocal link between depression and hypertension, potentially influencing patients' adherence to self-care routines. Objective This systematic review aimed to examine the association between depressive symptoms and aspects of self-care, with a focus on medication adherence in individuals diagnosed with hypertension. Methods Following PRISMA guidelines, a systematic review was conducted by searching PubMed, PsycINFO and Scopus until March 17, 2023. The included studies involved quantitative primary research conducted in English, focusing on adults (≥18 years) diagnosed with hypertension and experiencing depressive symptoms. Observational studies were assessed using the Newcastle-Ottawa Scale, and randomized controlled trials were evaluated using the revised Cochrane Risk of Bias Tool (RoB 2.0). Due to the great diversity of these studies, a narrative synthesis of the results was undertaken. Results: A total of 18 studies involving 6,131 people with hypertension, that met our eligibility criteria were ultimately included. The reported rates of depressive symptoms ranged from 4% to 43%. Of these studies, nine reported a statistically significant association, showcasing an adverse impact of depressive symptoms on medication adherence. The remaining nine did not confirm the above. Conclusion This systematic review highlights the diverse body of research exploring depressive symptoms and medication adherence among individuals with hypertension. The review suggests a need for increased attention to self-care practices, particularly in relation to adherence to antihypertensive medication. However, it recommends the conduction of more robust longitudinal studies to comprehensively explore this relationship.
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Affiliation(s)
- Theofilos Stamoulis
- Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina
| | - Elena Dragioti
- Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina
| | - Mary Gouva
- Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina
| | - Stefanos Mantzoukas
- Research Laboratory of Integrated Health, Care and Well-being, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina
| | - Michael Κourakos
- Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina
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Wang H, Zhou Y, Dai P, Guan Y, Zhong J, Li N, Yu M. Anxiety symptoms and associated factors among school students after 2 years of the COVID-19 pandemic: a cross-sectional study in Zhejiang Province, China. BMJ Open 2023; 13:e079084. [PMID: 38154892 PMCID: PMC10759112 DOI: 10.1136/bmjopen-2023-079084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/30/2023] [Indexed: 12/30/2023] Open
Abstract
OBJECTIVES To ascertain the prevalence and associated factors of anxiety symptoms among middle and high school students in Zhejiang after 2 years of the COVID-19 pandemic. DESIGN A school-based cross-sectional study. SETTING 30 counties/districts in Zhejiang Province, China. PARTICIPANTS 27 019 students attending middle and high schools. OUTCOME MEASURES Anxiety symptoms were assessed using the Generalised Anxiety Disorder 7-item scale (GAD-7). A total score of 10 or more is considered indicative of anxiety symptoms. RESULTS The overall prevalence (95% CI) of anxiety symptoms was 14.2% (13.4 to 15.0), higher among girls (18.6%, 95% CI: 17.5 to 19.7) than boys (10.2%, 95% CI: 9.5 to 10.9) (p<0.001), higher among rural students (15.1%, 95% CI: 14.1 to 16.2) than urban students (12.5%, 95% CI: 11.6 to 13.4) (p<0.001). Older age (14-15 years, OR=1.25, 95% CI: 1.09 to 1.44; ≥16 years, OR=1.32, 95% CI: 1.07 to 1.63), being girls (OR=1.76, 95% CI: 1.58 to 1.96), living in rural areas (OR=1.14, 95%CI: 1.01 to 1.29), poor academic performance (OR=1.20, 95% CI: 1.03 to 1.41), alcohol drinking (OR=1.15, 95% CI: 1.01 to 1.30), inadequate fruits (OR=1.31, 95% CI: 1.19 to 1.45) and vegetables intake (OR=1.32, 95% CI: 1.10 to 1.57), insomnia (sometimes, OR=2.14, 95% CI: 1.93 to 2.38; often/always, OR=4.73, 95% CI: 4.03 to 5.56), loneliness (sometimes, OR=2.97, 95%CI: 2.59 to 3.41; often/always, OR=8.35, 95% CI: 7.20 to 9.69), sadness (OR=2.51, 95% CI: 2.25 to 2.79) and physical fight (OR=1.29, 95% CI: 1.13 to 1.48) were positively associated with anxiety symptoms, while studying at vocational high school (OR=0.61, 95% CI: 0.49 to 0.75), coming from family with middle income (OR=0.76, 95% CI: 0.64 to 0.89), being physically active 3-7 days weekly (OR=0.85, 95% CI: 0.75 to 0.95) were negatively associated with anxiety symptoms. CONCLUSION Anxiety symptoms prevailed among middle and high school students in China. A variety of factors, containing sociodemographic factors, lifestyle behaviours, mental health, academic performance and physical fight should be taken in consideration in addressing prevention and intervention of anxiety symptoms.
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Affiliation(s)
- Hao Wang
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yi Zhou
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Pinyuan Dai
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yunqi Guan
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - JieMing Zhong
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Na Li
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Min Yu
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
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Standeven LR, Miller KN, Mallow A, Berger R, Little V. Reduction of anxiety symptoms among women within a collaborative care model and women's health settings. Prim Health Care Res Dev 2023; 24:e69. [PMID: 38047371 PMCID: PMC10790713 DOI: 10.1017/s1463423623000440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/23/2023] [Accepted: 07/20/2023] [Indexed: 12/05/2023] Open
Abstract
AIM The purpose of this study is to focus on changes in anxiety symptoms among women treated in women's health practices and under a collaborative care model. BACKGROUND Research on collaborative care has largely focused on improving depressive and anxiety symptoms among adults in primary care settings. The applicability of collaborative care in other healthcare settings is underreported with limited research investigating if collaborative care has advantages in subpopulations treated in both traditional primary care settings and other healthcare settings, such as women's health practices. METHODS This study, completed through secondary data analysis of the electronic record of N = 219 women across three women's healthcare centers, evaluated if instituting a collaborative care model is associated with reduced anxiety symptoms and which factors (eg, primary diagnosis, duration of care, and use of psychotropic medications) are associated with anxiety outcomes. Anxiety symptoms were assessed using the Generalized Anxiety Disorder 7-item scale (GAD-7) at entry into and at termination from collaborative care services. RESULTS Overall, there was a significant reduction in average anxiety scores from baseline to termination of collaborative care (t(218) = 12.41, P < 0.001). There was a main effect for the duration of time receiving collaborative care services on anxiety score reduction (β = -0.28, SE = 0.06, P < 0.001) with a significant reduction in anxiety symptoms at the 90-day mark (t(218) = 10.58, P < 0.001). Therefore, collaborative care can be useful in women's health practices in reducing anxiety symptoms over a 90-day time period.
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Affiliation(s)
- Lindsay R. Standeven
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Reproductive Mental Health Center, Baltimore, MD, USA
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Kristen N. Miller
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Reproductive Mental Health Center, Baltimore, MD, USA
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Alissa Mallow
- School of Social Work, Adelphi University, Poughkeepsie, NY, USA
| | - Roni Berger
- School of Social Work, Adelphi University, Poughkeepsie, NY, USA
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McCall T, Foster M, Tomlin HR, Schwartz TA. Black American women's attitudes toward seeking mental health services and use of mobile technology to support the management of anxiety. JAMIA Open 2023; 6:ooad088. [PMID: 37860603 PMCID: PMC10582519 DOI: 10.1093/jamiaopen/ooad088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/23/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023] Open
Abstract
Objectives This study aimed to understand Black American women's attitudes toward seeking mental health services and using mobile technology to receive support for managing anxiety. Methods A self-administered web-based questionnaire was launched in October 2019 and closed in January 2020. Women who identified as Black/African American were eligible to participate. The survey consisted of approximately 70 questions and covered topics such as, attitudes toward seeking professional psychological help, acceptability of using a mobile phone to receive mental health care, and screening for anxiety. Results The findings of the study (N = 395) showed that younger Black women were more likely to have greater severity of anxiety than their older counterparts. Respondents were most comfortable with the use of a voice call or video call to communicate with a professional to receive support to manage anxiety in comparison to text messaging or mobile app. Younger age, higher income, and greater scores for psychological openness and help-seeking propensity increased odds of indicating agreement with using mobile technology to communicate with a professional. Black women in the Southern region of the United States had twice the odds of agreeing to the use of mobile apps than women in the Midwest and Northeast regions. Discussion Black American women, in general, have favorable views toward the use of mobile technology to receive support to manage anxiety. Conclusion Preferences and cultural appropriateness of resources should be assessed on an individual basis to increase likelihood of adoption and engagement with digital mental health interventions for management of anxiety.
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Affiliation(s)
- Terika McCall
- Division of Health Informatics, Department of Biostatistics, Yale School of Public Health, New Haven, CT 06510, United States
- Section of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT 06510, United States
- Center for Interdisciplinary Research on AIDS (CIRA), Yale School of Public Health, New Haven, CT 06510, United States
| | - Meagan Foster
- Division of Health Informatics, Department of Biostatistics, Yale School of Public Health, New Haven, CT 06510, United States
| | - Holly R Tomlin
- Division of Health Informatics, Department of Biostatistics, Yale School of Public Health, New Haven, CT 06510, United States
- Department of Population Health Sciences, Health Analytics, Weill Cornell Medicine, New York, NY 10065, United States
| | - Todd A Schwartz
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
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10
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Ozisik GG, Kiraz S. Evaluation of retinal thickness measured by optical coherence tomography in patients with generalized anxiety disorder. Photodiagnosis Photodyn Ther 2023; 44:103766. [PMID: 37640207 DOI: 10.1016/j.pdpdt.2023.103766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/24/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE To compare the peripapillary retinal nerve fiber layer thickness, macular thickness, ganglion cell layer thickness, and inner plexiform layer thickness determined by Optic Coherence Tomography in the patient group diagnosed with a generalized anxiety disorder who did not receive any psychiatric medication with the healthy control group. METHODS Forty newly diagnosed, drug-free Generalized Anxiety Disorder patients and 43 healthy age- and gender-matched control subjects were included in the study. Macular thickness, ganglion cell layer thickness, inner plexiform layer thickness, and peripapillary retinal nerve fiber layer thickness were measured using optical coherence tomography. Structured Clinical Interviews and a State-Trait Anxiety Scale were applied to both groups. RESULTS Gender distributions (P = 0.965) and mean ages were similar between the groups (P = 0.340). Retinal nerve fiber layer thickness measurements were not significantly different between the groups. We observed statistically significant thinning in the inner superior, inner nasal, inner temporal, inner inferior, and outer inferior quadrants of the macula in the patient group compared to the control group (P = 0.046, P = 0.046, P = 0.020, P = 0.007, P = 0.014). We found thinning at the Ganglion cell layer in the inner inferior and outer temporal quadrants (Respectively P = 0.018, P = 0.049), inner plexiform layer in the inner nasal, inner temporal, and inner inferior quadrants (Respectively P = 0.046, P = 0.044, P = 0.011) compared to the control group. CONCLUSIONS This is the first study to reveal thinning in the macula, ganglion cell layer, and inner plexiform layer in newly diagnosed, drug-free Generalized Anxiety Disorder patients compared to the control group.
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Affiliation(s)
- Gulce Gokgoz Ozisik
- Department of Ophthalmology, Faculty of Medicine, Hitit University, Corum, Turkey.
| | - Seda Kiraz
- Department of Psychiatry, Faculty of Medicine, Hitit University, Corum, Turkey
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11
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What is resistant arterial hypertension? Blood Press 2023; 32:2185457. [PMID: 36891929 DOI: 10.1080/08037051.2023.2185457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
PURPOSE The current review is to describe the definition and prevalence of resistant arterial hypertension (RAH), the difference between refractory hypertension, patient characteristics and major risk factors for RAH, how RAH is diagnosed, prognosis and outcomes for patients. MATERIALS AND METHODS According to the WHO, approximately 1.28 billion adults aged 30-79 worldwide have arterial hypertension, and over 80% of them do not have blood pressure (BP) under control. RAH is defined as above-goal elevated BP despite the concurrent use of 3 or more classes of antihypertensive drugs, commonly including a long-acting calcium channel blocker, an inhibitor of the renin-angiotensin system (angiotensin-converting enzyme inhibitor or angiotensin receptor blocker), and a thiazide diuretic administered at maximum or maximally tolerated doses and at appropriate dosing frequency. RAH occurs in nearly 1 of 6 hypertensive patients. It often remains unrecognised mainly because patients are not prescribed ≥3 drugs at maximal doses despite uncontrolled BP. CONCLUSION RAH distinctly increases the risk of developing coronary artery disease, heart failure, stroke and chronic kidney disease and confers higher rates of major adverse cardiovascular events as well as increased all-cause mortality. Timely diagnosis and treatment of RAH may mitigate the associated risks and improve short and long-term prognosis.
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12
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Qi H, Wen FY, Xie YY, Liu XH, Li BX, Peng WJ, Cao H, Zhang L. Associations between depressive, anxiety, stress symptoms and elevated blood pressure: Findings from the CHCN-BTH cohort study and a two-sample Mendelian randomization analysis. J Affect Disord 2023; 341:176-184. [PMID: 37598715 DOI: 10.1016/j.jad.2023.08.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 08/08/2023] [Accepted: 08/14/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND We aimed to determine whether depressive, anxiety, stress symptoms were associated with the risk of elevated blood pressure by performing longitudinal cohort and Mendelian Randomization (MR) analyses. METHODS We used data from the Cohort Study on Chronic Disease of Community Natural Population in the Beijing-Tianjin-Hebei region (CHCN-BTH) from 2017 to 2021. The Depression-Anxiety-Stress Scale was used to evaluate the depressive, anxiety, stress symptoms. The longitudinal associations between depressive, anxiety, stress symptoms and elevated blood pressure were estimated using Cox proportional regression models. Two-sample MR analysis was performed using the Inverse-variance weighted (IVW), weighted median, and MR-Egger to explore the causal relationships between depressive, anxiety, stress symptoms and elevated blood pressure. RESULTS In total, 5624 participants were included. The risk of SBP ≥ 140 mmHg or DBP ≥ 90 mmHg was significantly higher in participants with baseline anxiety symptoms (HR = 1.48, 95 % CI: 1.03 to 2.12, P = 0.033; HR = 1.56, 95 % CI: 1.05 to 2.32, P = 0.028), especially in men and individuals with higher educational levels, independent of baseline depression and anxiety at the two-year follow-up. The two-sample MR analysis showed positive associations between depressive, anxiety, stress symptoms and elevated blood pressure. LIMITATION Self-reported mental health symptoms, relatively shorter follow-up duration and the European-derived genome-wide association study data for MR analysis. CONCLUSIONS Anxiety symptoms were positively associated with elevated blood pressures in the longitudinal analysis independent of depression, stress, and other confounders. The results were verified in MR analysis, providing evidence for causal effects of anxiety symptoms on the risk of elevated blood pressure.
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Affiliation(s)
- Han Qi
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China; Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Fu-Yuan Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Yun-Yi Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Xiao-Hui Liu
- Center for Evidence-Based Medicine, Beijing Luhe Hospital Affiliate to Capital Medical University, Beijing 101199, China
| | - Bing-Xiao Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Wen-Juan Peng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Han Cao
- Department of Biostatistics, Peking University First Hospital, Beijing 100034, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
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13
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Storer B, Kershaw KA, Braund TA, Chakouch C, Coleshill MJ, Haffar S, Harvey S, Newby JM, Sicouri G, Murphy M. Global Prevalence of Anxiety in Adult Cardiology Outpatients: A Systematic Review and Meta-analysis. Curr Probl Cardiol 2023; 48:101877. [PMID: 37336306 DOI: 10.1016/j.cpcardiol.2023.101877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/21/2023]
Abstract
Anxiety and anxiety disorders are associated with adverse cardiovascular outcomes, and reduced quality of life. Despite this, no comprehensive study on the global prevalence of anxiety symptoms and disorders among adult cardiology outpatients exists. This systematic review and meta-analysis aims to provide cardiologists with a precise estimate of the prevalence of anxiety in their outpatient clinics. PubMed, Embase, Cochrane and PsycINFO databases and Google Scholar were searched from database inception to January 23, 2023. Data characteristics were extracted independently by 2 investigators. Ninety-three studies, n = 36,687 participants across 31 countries, were included. Global prevalence of anxiety symptoms/disorders was 28.9% (95%CI 25.7-32.4; 8927/36, 687; I2 = 97.33; n = 93). The highest rates were found in patients presenting with hypertension, 43.6%. Subgroup analyses revealed higher prevalence estimates when using self-report screening compared to gold-standard diagnostic interview. When using diagnostic interview, the highest rates were reported in outpatients with undifferentiated chest pain/palpitations, 19·0%. Panic disorder was the most frequent diagnosis 15.3%, and rates were significantly higher in patients with undifferentiated chest pain/palpitations compared to ischemic heart disease. Higher rates of anxiety were found in studies of outpatients from developing countries, and female outpatients tended to have higher rates compared to males. Anxiety occurred frequently among cardiology outpatients and at a higher rate than estimated in the general population. Given the impact anxiety has on patient outcomes, it is important that effective identification and management strategies be developed to support cardiologists in identifying and treating these conditions in their clinics.
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Affiliation(s)
- Ben Storer
- The Black Dog Institute, Sydney, Australia
| | | | - Taylor A Braund
- The Black Dog Institute, Sydney, Australia; Psychiatry and Mental Health Department, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | | | | | - Sam Haffar
- The Black Dog Institute, Sydney, Australia
| | - Samuel Harvey
- The Black Dog Institute, Sydney, Australia; Psychiatry and Mental Health Department, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Jill M Newby
- The Black Dog Institute, Sydney, Australia; School of Psychology, Faculty of Science, University of New South Wales, Sydney, Australia
| | - Gemma Sicouri
- The Black Dog Institute, Sydney, Australia; School of Psychology, Faculty of Science, University of New South Wales, Sydney, Australia
| | - Michael Murphy
- The Black Dog Institute, Sydney, Australia; Psychiatry and Mental Health Department, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
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14
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Gournay LR, Ferretti ML, Bilsky S, Vance E, Nguyen AM, Mann E, Williams P, Leen-Feldner EW. The effects of cannabidiol on worry and anxiety among high trait worriers: a double-blind, randomized placebo controlled trial. Psychopharmacology (Berl) 2023; 240:2147-2161. [PMID: 37552290 DOI: 10.1007/s00213-023-06437-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/24/2023] [Indexed: 08/09/2023]
Abstract
RATIONALE Evidence suggests cannabidiol (CBD) displays broad therapeutic potential in the context of anxiety; however, no study has examined the effects of CBD on worry, a defining, cognitive feature of anxiety. Additionally, no study has examined the effects of an acute, single dose of CBD compared to repeated CBD administration. OBJECTIVES Within a sample of 63 individuals with elevated trait worry, the current study aimed to assess the effects of an empirically-derived high dose of CBD (i.e., 300mg) compared to a commercially-derived dose of CBD (i.e., 50mg) versus placebo on worry severity and anxiety symptoms after an acute dose and after a 2-week administration period. RESULTS Results indicated no effect of acute CBD dosing on worry severity or anxiety symptoms. Repeated CBD administration similarly did not impact worry severity; however, 300mg of CBD reduced anxiety symptoms across the 2-week administration period compared to placebo. CONCLUSIONS Taken together, these findings suggest 300mg of oral CBD does not attenuate cognitive symptoms of anxiety (i.e., worry), following both acute and repeated administration. Some evidence for repeated administration of 300mg on physical symptoms of anxiety was obtained. Findings from the current study suggest CBD's modest anxiolytic effects may be specific to the physical aspects of anxious arousal.
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Affiliation(s)
- L Riley Gournay
- University of Arkansas, 216 Memorial Hall, Fayetteville, AR, 72701, USA.
| | - Morgan L Ferretti
- University of Arkansas, 216 Memorial Hall, Fayetteville, AR, 72701, USA
| | | | - Emily Vance
- University of Arkansas, 216 Memorial Hall, Fayetteville, AR, 72701, USA
| | - Anna Marie Nguyen
- University of Arkansas, 216 Memorial Hall, Fayetteville, AR, 72701, USA
| | - Eric Mann
- University of Arkansas, 216 Memorial Hall, Fayetteville, AR, 72701, USA
- Laureate Institute for Brain Research, Tulsa, USA
| | - Parker Williams
- University of Arkansas, 216 Memorial Hall, Fayetteville, AR, 72701, USA
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15
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Li S, Shang S, Wang J, Yang B, Jiang W. Research on the psychological status of medical staff during the COVID-19 epidemic in China: A longitudinal study. Medicine (Baltimore) 2023; 102:e34750. [PMID: 37653813 PMCID: PMC10470679 DOI: 10.1097/md.0000000000034750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/24/2023] [Accepted: 07/24/2023] [Indexed: 09/02/2023] Open
Abstract
An online questionnaire, including the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), was used to assess the psychological status of medical staff in Wuhan during the COVID-19 epidemic. Lasso-Logistic regression analysis was performed to analyze the risk factors of abnormal psychological status (anxiety or depression). 36.6% of the study subjects experienced anxiety, and 41.5% experienced depression. Female (OR [odds ratio] = 7.22, 95% CI [confidence interval]: 0.58-89.33), basic diseases (OR = 17.95, 95% CI: 1.59-202.49), suspected exposure history (OR = 9.63, 95% CI: 1.40-66.29), smoking (OR = 6.07, 95% CI: 0.38-96.78) were risk factors for anxiety. Female (OR = 5.00, 95% CI: 0.45-55.91), basic diseases (OR = 37.19, 95% CI: 2.70-512.73), suspected exposure history (OR = 5.10, 95% CI: 0.78-33.10), drinking wine (OR = 6.27, 95% CI: 0.38-103.85) were risk factors for depression. The results of the re-sampling evaluation after 2 years showed that some medical staff still showed anxiety (42.4%) and depression (27.3%), and the proportion of females was higher. Early intervention should be carried out, and short-term and long-term intervention plans should be formulated.
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Affiliation(s)
- Shanshan Li
- Department of Medicine College, Jiangsu Vocational College of Medicine, Jiangsu Yancheng, China
| | - Shasha Shang
- Department of cardiovascular, The First Affiliated Hospital of Henan University of CM, Henan Zhengzhou, China
| | - Junrong Wang
- Department of Obstetrics and Gynecology, Suzhou Ruihua Hospital, Jiangsu Suzhou, China
| | - Boyi Yang
- Department of geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Wuhan, China
| | - Wei Jiang
- Department of Medicine College, Jiangsu Vocational College of Medicine, Jiangsu Yancheng, China
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Choi SO, Choi JG, Yun JY. A Study of Brain Function Characteristics of Service Members at High Risk for Accidents in the Military. Brain Sci 2023; 13:1157. [PMID: 37626513 PMCID: PMC10452066 DOI: 10.3390/brainsci13081157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/23/2023] [Accepted: 07/29/2023] [Indexed: 08/27/2023] Open
Abstract
Military accidents are often associated with stress and depressive psychological conditions among soldiers, and they often fail to adapt to military life. Therefore, this study analyzes whether there are differences in EEG and pulse wave indices between general soldiers and three groups of soldiers who have not adapted to military life and are at risk of accidents. Data collection was carried out using a questionnaire and a device that can measure EEG and pulse waves, and data analysis was performed using SPSS. The results showed that the concentration level and brain activity indices were higher in the general soldiers and the soldiers in the first stage of accident risk. The body stress index was higher for each stage of accident risk, and the physical vitality index was higher for general soldiers. Therefore, it can be seen that soldiers who have not adapted to military life and are at risk of accidents have somewhat lower concentration and brain activity than general soldiers, and have symptoms of stress and lethargy. The results of this study will contribute to reducing human accidents through EEG and pulse wave measurements not only in the military but also in occupations with a high risk of accidents such as construction.
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Affiliation(s)
| | | | - Jong-Yong Yun
- Department of Protection and Safety Engineering, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea
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17
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Su YR, Yu XP, Huang LQ, Xie L, Zha JS. Factors influencing postoperative anxiety and depression following Iodine-131 treatment in patients with differentiated thyroid cancer: A cross-sectional study. World J Psychiatry 2023; 13:486-494. [PMID: 37547735 PMCID: PMC10401505 DOI: 10.5498/wjp.v13.i7.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 07/17/2023] Open
Abstract
BACKGROUND Differentiated thyroid cancer (DTC) often seriously impacts patients’ lives. Radionuclide Iodine-131 (131I) is widely used in treating patients with DTC. However, most patients know little about radionuclide therapy, and the treatment needs to be performed in a special isolation ward, which can cause anxiety and depression.
AIM To explore anxiety and depression status and their influencing factors after 131I treatment in patients with DTC.
METHODS A questionnaire survey was conducted among postoperative patients with DTC who received 131I treatment at our hospital from June 2020 to December 2022. General patient data were collected using a self-administered demographic characteristics questionnaire. The self-rating depression scale and self-rating anxiety scale were used to determine whether patients were worried about their symptoms and the degree of anxiety and depression. The patients were cate-gorized into anxiety, non-anxiety, depression, and non-depression groups. Single-variable and multiple-variable analyses were used to determine the risk factors for anxiety and depression in patients with thyroid cancer after surgery.
RESULTS A total of 144 patients were included in this study. The baseline mean score of self-rating anxiety and depression scales were 50.06 ± 16.10 and 50.96 ± 16.55, respectively. Notably, 48.62% (70/144) had anxiety and 47.22% (68/144) of the patients had depression. Sex, age, education level, marital status, household income, underlying diseases, and medication compliance significantly differed among groups (P < 0.05). Furthermore, multivariate logistic regression analysis showed that education level, per capita monthly household income, and medication compliance level affected anxiety (P = 0.015, 0.001, and 0.001 respectively. Patient’s sex, marital status, and underlying diseases affected depression (P = 0.007, 0.001, and 0.009, respectively).
CONCLUSION Nursing interventions aiming at reducing the risk of anxiety and depression should target unmarried female patients with low education level, low family income, underlying diseases, and poor adherence to medications.
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Affiliation(s)
- Ying-Rui Su
- Department of Nuclear Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Xiao-Peng Yu
- Department of Nuclear Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Li-Qun Huang
- Department of Nuclear Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Long Xie
- Department of Nuclear Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Jin-Shun Zha
- Department of Nuclear Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
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18
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Beaver JN, Weber BL, Ford MT, Anello AE, Ruffin KM, Kassis SK, Gilman TL. Generalization of contextual fear is sex-specifically affected by high salt intake. PLoS One 2023; 18:e0286221. [PMID: 37440571 PMCID: PMC10343085 DOI: 10.1371/journal.pone.0286221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/10/2023] [Indexed: 07/15/2023] Open
Abstract
A hallmark symptom of many anxiety disorders, and multiple neuropsychiatric disorders more broadly, is generalization of fearful responses to non-fearful stimuli. Anxiety disorders are often comorbid with cardiovascular diseases. One established, and modifiable, risk factor for cardiovascular diseases is salt intake. Yet, investigations into how excess salt consumption affects anxiety-relevant behaviors remains little explored. Moreover, no studies have yet assessed how high salt intake influences generalization of fear. Here, we used adult C57BL/6J mice of both sexes to evaluate the influence of two or six weeks of high salt consumption (4.0% NaCl), compared to controls (0.4% NaCl), on contextual fear acquisition, expression, and generalization. Further, we measured osmotic and physiological stress by quantifying serum osmolality and corticosterone levels, respectively. Consuming excess salt did not influence contextual fear acquisition nor discrimination between the context used for training and a novel, neutral context when training occurred 48 prior to testing. However, when a four week delay between training and testing was employed to induce natural fear generalization processes, we found that high salt intake selectively increases contextual fear generalization in females, but the same diet reduces contextual fear generalization in males. These sex-specific effects were independent of any changes in serum osmolality nor corticosterone levels, suggesting the behavioral shifts are a consequence of more subtle, neurophysiologic changes. This is the first evidence of salt consumption influencing contextual fear generalization, and adds information about sex-specific effects of salt that are largely missing from current literature.
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Affiliation(s)
- Jasmin N. Beaver
- Department of Psychological Sciences, Kent State University, Kent, Ohio, United States of America
- Brain Health Research Institute, Kent State University, Kent, Ohio, United States of America
| | - Brady L. Weber
- Department of Psychological Sciences, Kent State University, Kent, Ohio, United States of America
- Brain Health Research Institute, Kent State University, Kent, Ohio, United States of America
| | - Matthew T. Ford
- Department of Psychological Sciences, Kent State University, Kent, Ohio, United States of America
| | - Anna E. Anello
- Department of Psychological Sciences, Kent State University, Kent, Ohio, United States of America
- Brain Health Research Institute, Kent State University, Kent, Ohio, United States of America
| | - Kaden M. Ruffin
- Department of Psychological Sciences, Kent State University, Kent, Ohio, United States of America
| | - Sarah K. Kassis
- Department of Psychological Sciences, Kent State University, Kent, Ohio, United States of America
- Brain Health Research Institute, Kent State University, Kent, Ohio, United States of America
| | - T. Lee Gilman
- Department of Psychological Sciences, Kent State University, Kent, Ohio, United States of America
- Brain Health Research Institute, Kent State University, Kent, Ohio, United States of America
- Healthy Communities Research Institute, Kent State University, Kent, Ohio, United States of America
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19
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Seifaei A, Askarinejad A, Bazrafshan Drissi H, Keshtvarz Hesam Abadi A, Sasannia S, Moghadami M, Izadpanah P, Bazrafshan H. General Anxiety Disorder and Primary Hypertension: Is There a Link? J Nerv Ment Dis 2023; 211:525-529. [PMID: 37166043 DOI: 10.1097/nmd.0000000000001650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
ABSTRACT Chronic forms of morbidity, including mental disorders and hypertension, play a dominant role in determining a disease load in the developing world. This article investigates the associations between the diagnoses of primary hypertension and generalized anxiety disorder (GAD) and the severity of GAD in individuals with primary hypertension. The association of GAD and age, sex, marriage, education level, income, chronic medical conditions, family history of mental disorders, adverse life events, and hypertension was assessed in 470 patients with the diagnosis of primary hypertension. Data analysis was performed with IBM SPSS Statistics software version 16. A significant relationship was found between the prevalence of GAD and the following variables: history of mental disorders ( p < 0.0001), chronic medical conditions ( p < 0.0001), and adverse life events ( p < 0.0001). The mean anxiety score was higher among patients with uncontrolled blood pressure, and a significant relationship was observed between the prevalence of GAD and blood pressure ( p < 0.0001). Because of the significant association between GAD and primary hypertension, it is recommended that anxiety disorders be considered in patients in whom primary hypertension is not controlled easily. This may lead to more proper control of hypertension while taking fewer antihypertensive medications.
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Affiliation(s)
| | | | | | | | | | | | - Peyman Izadpanah
- Department of Cardiology, School of Medicine, Namazi Teaching Hospital
| | - Hanieh Bazrafshan
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Fontes MAP, Marins FR, Patel TA, de Paula CA, Dos Santos Machado LR, de Sousa Lima ÉB, Ventris-Godoy AC, Viana ACR, Linhares ICS, Xavier CH, Filosa JA, Patel KP. Neurogenic Background for Emotional Stress-Associated Hypertension. Curr Hypertens Rep 2023; 25:107-116. [PMID: 37058193 PMCID: PMC10103037 DOI: 10.1007/s11906-023-01235-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE OF REVIEW The response to natural stressors involves both cardiac stimulation and vascular changes, primarily triggered by increases in sympathetic activity. These effects lead to immediate flow redistribution that provides metabolic support to priority target organs combined with other key physiological responses and cognitive strategies, against stressor challenges. This extremely well-orchestrated response that was developed over millions of years of evolution is presently being challenged, over a short period of time. In this short review, we discuss the neurogenic background for the origin of emotional stress-induced hypertension, focusing on sympathetic pathways from related findings in humans and animals. RECENT FINDINGS The urban environment offers a variety of psychological stressors. Real or anticipatory, emotional stressors may increase baseline sympathetic activity. From routine day-to-day traffic stress to job-related anxiety, chronic or abnormal increases in sympathetic activity caused by emotional stressors can lead to cardiovascular events, including cardiac arrhythmias, increases in blood pressure and even sudden death. Among the various alterations proposed, chronic stress could modify neuroglial circuits or compromise antioxidant systems that may alter the responsiveness of neurons to stressful stimuli. These phenomena lead to increases in sympathetic activity, hypertension and consequent cardiovascular diseases. The link between anxiety, emotional stress, and hypertension may result from an altered neuronal firing rate in central pathways controlling sympathetic activity. The participation of neuroglial and oxidative mechanisms in altered neuronal function is primarily involved in enhanced sympathetic outflow. The significance of the insular cortex-dorsomedial hypothalamic pathway in the evolution of enhanced overall sympathetic outflow is discussed.
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Affiliation(s)
- Marco Antônio Peliky Fontes
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil.
| | - Fernanda Ribeiro Marins
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Tapan A Patel
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Cristiane Amorim de Paula
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Liliane Ramos Dos Santos Machado
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Érick Bryan de Sousa Lima
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Ana Caroline Ventris-Godoy
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Ana Clara Rocha Viana
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | - Isadora Cristina Souza Linhares
- Department of Physiology & Biophysics, Federal University of Minas Gerais, Federal de Minas Gerais, Belo Horizonte, MG, 31270 901, Brazil
| | | | | | - Kaushik P Patel
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
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Shamsuddin S, Davis K, Moorhouse L, Mandizvidza P, Maswera R, Dadirai T, Nyamukapa C, Gregson S, Chigogora S. Relationship between psychological distress, health behaviours and future reports of hypertension among adults in East Zimbabwe: a cohort study. Open Heart 2023; 10:e002346. [PMID: 37385733 DOI: 10.1136/openhrt-2023-002346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/16/2023] [Indexed: 07/01/2023] Open
Abstract
INTRODUCTION Extensive cross-sectional evidence has demonstrated an association between psychological distress (PD) and hypertension. However, evidence on the temporal relationship is limited, especially in low-income and middle-income countries. The role of health risk behaviours including smoking and alcohol consumption in this relationship is also largely unknown. The aim of this study was to investigate the association between PD and later development of hypertension, and how this association may have been influenced by health risk behaviours, among adults in east Zimbabwe. METHODS The analysis included 742 adults (aged 15-54 years) recruited by the Manicaland general population cohort study, who did not have hypertension at baseline in 2012-2013, and who were followed until 2018-2019. In 2012-2013, PD was measured using the Shona Symptom Questionnaire, a screening tool validated for use in Shona-speaking countries including Zimbabwe (cut-off point: 7). Smoking, alcohol consumption and use of drugs (health risk behaviours) were also self-reported. In 2018-2019, participants reported if they had diagnosed with hypertension by a doctor or nurse. Logistic regression was used to assess the association between PD and hypertension. RESULTS In 2012, 10.4% of the participants had PD. The odds of new reports of hypertension were 2.04 times greater (95% CI 1.16 to 3.59) among those with PD at baseline, after adjusting for sociodemographic and health risk behaviour variables. Female gender (adjusted odds ratio, AOR 6.89, 95% CI 2.71 to 17.53), older age (AOR 2.67, 95% CI 1.63 to 4.42), and greater wealth (AOR 2.10, 95% CI 1.04 to 4.24 more wealthy, 2.88, 95% CI 1.24 to 6.67 most wealthy) were significant risk factors for hypertension. The AOR for the relationship between PD and hypertension did not differ substantially between models with and without health risk behaviours. CONCLUSION PD was associated with an increased risk of later reports of hypertension in the Manicaland cohort. Integrating mental health and hypertension services within primary healthcare may reduce the dual burden of these non-communicable diseases.
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Affiliation(s)
- Shehla Shamsuddin
- Department of Health and Social Care, UK Government, London, UK
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
| | - Katherine Davis
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
| | - Louisa Moorhouse
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
| | - Phyllis Mandizvidza
- Manicaland Centre for Public Health Research, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Rufurwokuda Maswera
- Manicaland Centre for Public Health Research, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Tawanda Dadirai
- Manicaland Centre for Public Health Research, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Constance Nyamukapa
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
- Manicaland Centre for Public Health Research, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Simon Gregson
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
- Manicaland Centre for Public Health Research, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Sungano Chigogora
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
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22
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Shah RM, Doshi S, Shah S, Patel S, Li A, Diamond JA. Impacts of Anxiety and Depression on Clinical Hypertension in Low-Income US Adults. High Blood Press Cardiovasc Prev 2023:10.1007/s40292-023-00584-3. [PMID: 37261618 PMCID: PMC10233551 DOI: 10.1007/s40292-023-00584-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/23/2023] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION Depression and anxiety are common leading causes of disability and are associated with systemic effects including cardiovascular comorbidities. Low-income populations may experience higher frequencies of depressive or anxiety-related symptoms, and be at greater risk for developing hypertension. AIM We performed a cross-sectional study of low-income participants who completed hypertension and disability questionnaires as part of the 2017-2018 cycle of the National Health and Nutrition Examination Survey (NHANES) to identify associations between depressive/anxiety-related symptoms and hypertension status. METHODS Multivariable logistic regressions were performed to identify whether (1) frequency of depressive symptoms, (2) frequency of anxiety-related symptoms, (3) self-reported depression medication use, or (4) self-reported anxiety medication use predicted previous hypertension diagnosis. RESULTS A total of 74,285,160 individuals were represented in our cohort. Participants that reported taking depression (OR 2.72; 95% CI 1.41-5.24; P = 0.009) and anxiety (OR 2.50; 95% CI 1.42-4.41; P = 0.006) medications had greater odds of hypertension. Individuals with depressive feelings daily, monthly, and few times per year were more likely to have hypertension. Respondents with daily (OR 2.28; 95% CI 1.22-4.24; P = 0.021) and weekly (OR 1.88; 95% CI 1.05-3.38; P = 0.040) anxiety symptoms were more likely to have hypertension. CONCLUSIONS Low-income adults in the United States with symptoms of anxiety or depression have higher likelihood of hypertension than those with no symptoms. Respondents who indicated taking medication for anxiety disorders or depression were more likely to have been diagnosed with hypertension.
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Affiliation(s)
- Rohan M Shah
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Sahil Doshi
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sareena Shah
- University of Missouri-Kansas City School of Medicine, Kansas-City, MO, USA
| | - Shiv Patel
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Angela Li
- Hofstra Northwell School of Medicine, Hempstead, NY, USA
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Qiu T, Jiang Z, Chen X, Dai Y, Zhao H. Comorbidity of Anxiety and Hypertension: Common Risk Factors and Potential Mechanisms. Int J Hypertens 2023; 2023:9619388. [PMID: 37273529 PMCID: PMC10234733 DOI: 10.1155/2023/9619388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/09/2023] [Accepted: 05/15/2023] [Indexed: 06/06/2023] Open
Abstract
Anxiety is more common in patients with hypertension, and these two conditions frequently coexist. Recently, more emphasis has been placed on determining etiology in patients with comorbid hypertension and anxiety. This review focuses on the common risk factors and potential mechanisms of comorbid hypertension and anxiety. Firstly, we analyze the common risk factors of comorbid hypertension and anxiety including age, smoking, alcohol abuse, obesity, lead, and traffic noise. The specific mechanisms underlying hypertension and anxiety were subsequently discussed, including interleukin (IL)-6 (IL-6), IL-17, reactive oxygen species (ROS), and gut dysbiosis. Increased IL-6, IL-17, and ROS accelerate the development of hypertension and anxiety. Gut dysbiosis leads to hypertension and anxiety by reducing short-chain fatty acids, vitamin D, and 5-hydroxytryptamine (5-HT), and increasing trimethylamine N-oxide (TAMO) and MYC. These shared risk factors and potential mechanisms may provide an effective strategy for treating and preventing hypertension and comorbid anxiety.
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Affiliation(s)
- Tingting Qiu
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
- The Central Hospital of Changsha City, Hengyang Medical School, University of South China, Changsha, Hunan 410000, China
| | - Zhiming Jiang
- Department of Cardiology, The Fourth Hospital of Changsha, Changsha, Hunan 410006, China
| | - Xuancai Chen
- Urinary Surgery, Affiliated Nanhua Hospital, University of South China, Hengyang 421002, China
| | - Yehua Dai
- Nursing College, University of Xiangnan, Chenzhou, Hunan 423000, China
| | - Hong Zhao
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
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Kong X, Wu Y, Wang X, Sun Y, Chen K, Li Q, Li J. Analysis of the prevalence and influencing factors of anxiety and depression in the Chinese population: A cross-sectional survey. Heliyon 2023; 9:e15889. [PMID: 37215825 PMCID: PMC10192403 DOI: 10.1016/j.heliyon.2023.e15889] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 04/17/2023] [Accepted: 04/25/2023] [Indexed: 05/24/2023] Open
Abstract
To explore the prevalence and influencing factors of anxiety and depression symptoms among Chinese people in 2021. Investigation teams were recruited in 120 cities across the country. Based on the data from "the Seventh National Population Census in 2021″, quota sampling was conducted on the residents of these cities to obtain samples that conformed to population characteristics. Next, baseline information on research objects was collected, and the questionnaire survey was conducted through the online questionnaire Wenjuanxing platform. The Patient Health Questionnaire-9 (PHQ-9) rating scale was used to evaluate the mental state of the subjects. The correlation between baseline information and different PHQ-9 risk intervals was analyzed using the Chi-square test and Logit model. The impact of relevant risk factors on PHQ-9 scores was analyzed using the decision tree. The Chi-square test results revealed that place of residence (p = 0.438) and obesity (p = 0.443) was not significantly correlated with PHQ-9 risk intervals. According to Logit model analysis, age (p = 0.001, 95%CI 0.84-0.96), marital status (p < 0.001, 95%CI 0.71-0.89), drinking (p < 0.001, 95%CI 1.07-1.18), diabetes or hypertension (p = 0.001, 95%CI 1.11-1.47), health care (p < 0.001, 95%CI 0.53-0.66), economic welfare (p = 0.022, 95%CI 0.85-0.99), COVID-19 vaccine (p < 0.001, 95%CI 1.28-1.72), and HPV vaccine (p < 0.001, 95%CI 0.46-0.57) were potential influencing factors of PHQ-9 risk intervals. Decision tree analysis results showed that the grouping strategy in the PHQ-9 two-side groups had a better classification effect on the questionnaire population according to the PHQ-9 score characteristics. The prevalence rate of moderate to severe depression among Chinese people was about 8.29%. Age, marital status, drinking, diabetes or hypertension, health care, economic well, COVID-19 vaccine, and HPV vaccine were potential influencing factors of anxiety and depression symptoms in Chinese people.
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Affiliation(s)
- Xinyi Kong
- Department of Cardiovascular Intervention, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, 100191, China
| | - Xinpei Wang
- Medical Equipment Department, Peking University First Hospital, Beijing, 100043, China
| | - Yike Sun
- College of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, 272111, China
| | - Ke Chen
- Department of Psychology, Anhui University, Anhui Province, Hefei, China
| | - Qiyu Li
- School of Humanities and Health Management, Jinzhou Medical University, Jinzhou, 121000, China
| | - Jie Li
- Department of Internal Medicine, Jiangxi Chest Hospital, Nanchang, 330006, China
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25
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Lepilkina TА, Beniashvili AG, Cheremin RA, Malyukova NG, Morozova MA, Bogdanov MA, Burminsky DS, Potanin SS, Rodkina SV, Rupchev GE, Eip MN. Efficacy of a Relaxation Scenario in Virtual Reality for the Comorbid Symptoms of Anxiety and Asthenia in a General Hospital Setting: A Pilot Comparative Randomized Open-Label Study. CONSORTIUM PSYCHIATRICUM 2023; 4:38-51. [PMID: 38239567 PMCID: PMC10790732 DOI: 10.17816/cp221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/14/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Patients in general hospitals often display concomitant signs of mental maladjustment: low mood, anxiety, apathy, asthenia, all of which can have a negative impact on the course of the underlying disease and the recovery process. One of the non-pharmacological approaches that has gained wider acceptance in medical practice in recent years is the use of procedures based on virtual reality. AIM Assess the efficacy of the new domestic, virtual reality application Flow as relates to symptoms of anxiety and asthenia in patients undergoing inpatient treatment. METHODS The study was open-label and had a comparison group; the patients were assigned to the experimental or control group using a randomization table. The patients were assessed using the Spielberger State Anxiety Inventory; the Fatigue Symptom Rating Scale; the Well-being, Activity, Mood questionnaire; the Depression Anxiety Stress Scale; and the Clinical Global Impression Scale. Physical parameters were measured before and after each virtual reality session. The obtained data were statistically processed. RESULTS The study involved 60 patients. In 40 patients, the treatment program included a course of five daily relaxation sessions in virtual reality; the control group consisted of 20 patients, who were treated in accordance with the usual practice of the institution. The addition of virtual reality sessions to the standard treatment course yielded significant advantage in terms of affective symptoms reduction in patients both after a single session and as a result of undergoing the full course, and several days after its completion. The patients in the experimental group also showed a significant decrease in blood pressure after the sessions, and this was most pronounced in individuals who initially had elevated and high blood pressure. CONCLUSION The use of relaxation program courses in the virtual reality application Flow is an effective and promising means of non-pharmacological care for non-psychiatric inpatients showing symptoms of anxiety, apathy, depressive mood, as well as hypertension.
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Kuo WC, Ersig AL, Johnson HM, Brown RL, Oakley LD, Hagen EW, Barnet JH, Peppard PE. Association between stressful life events and non-optimal lipid levels among women with hyperlipidaemia. Eur J Cardiovasc Nurs 2023; 22:210-219. [PMID: 35714051 DOI: 10.1093/eurjcn/zvac032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 11/14/2022]
Abstract
AIMS Psychological stress has been linked to lipid dysregulation with noticeable gender differences, but it remains unclear whether women are more susceptible to non-optimal lipid levels than men, when experiencing stressful life events. This study aims to examine the association between stressful life events and non-optimal lipid levels among persons with hyperlipidaemia and whether the association differs between men and women. METHODS AND RESULTS A nested case-control study was performed using data from the Wisconsin Sleep Cohort (WSC) Study from 2011 to 2015, including 224 participants with hyperlipidaemia and without a history of myocardial infarction or heart failure. Among them, 63 participants with non-optimal LDL cholesterol or triglyceride levels were identified as cases, and 161 participants with optimal LDL cholesterol and triglyceride levels were identified as controls. Cases and controls were traced back to their self-reported life events collected through the Retirement and Sleep Trajectories study during 2010-11. The association between stressful life events and non-optimal lipid levels was examined using multivariable logistic regression; confounding effects were addressed using propensity score weighting and Mahalanobis distance matching; gender differences were examined using subgroup analysis. Results showed that a higher number of stressful life events during 2010-11 was associated with greater odds of non-optimal lipid levels during 2011-15 (odds ratio = 1.45, P = 0.03) among women with hyperlipidaemia, whereas the association was not significant among men with hyperlipidaemia (P = 0.910). CONCLUSION Future studies are needed to examine the underlying mechanisms that explain gender differences in the association between stressful life events and non-optimal lipid levels. REGISTRATION ClinicalTrials.gov NCT00005557.
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Affiliation(s)
- Wan-Chin Kuo
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Anne L Ersig
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Heather M Johnson
- Christine E. Lynn Women's Health and Wellness Institute, Boca Raton Regional Hospital/Baptist Health South Florida, Florida Atlantic University, Boca Raton, FL, USA
| | - Roger L Brown
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Linda D Oakley
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Erika W Hagen
- School of Medicine and Public Health, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Jodi H Barnet
- School of Medicine and Public Health, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Paul E Peppard
- School of Medicine and Public Health, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
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Chastaingt L, Gbaguidi GN, Magne J, Preux PM, Aboyans V, Houinato D, Lacroix P. Cardiovascular risk factors in Sub-Saharan African women. VASA 2023; 52:186-192. [PMID: 37122278 DOI: 10.1024/0301-1526/a001058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Summary: Background: Cardiovascular risk factors (CVRF) are associated with major cause of death and disability in Sub-Saharan Africa, especially in women. The contribution of obstetrical, psychological, and socio-economic factors in CVRF are not yet well described in Africa. We aimed to compare the prevalence of CVRF between men and women, and to determine the factors associated to these sex-related differences. Patients and methods: A cross-sectional study was conducted on the 2019 data of the TAHES cohort in a geographically defined general population in Benin. A standardized questionnaire adapted from the World Health Organization (WHO) STEPS instrument was used to collect data. Univariate and multivariate analysis has been performed to determine CVRF differences in both sexes. Women-specific logistic regressions have been performed on CVRF previously identified as positively associated to female sex, to assess their association with socio-economic, psychological, and obstetrical factors. Results: We included 1583 patients, with a median age of 39 years [range: 32–53 years]. Prevalence of diabetes (1.2% vs. 3.4%, p=0.0042), abnormal kidney function (15.5% vs. 8.4%, p=0.0002), obesity (12.5% vs. 4.1%, p<0.0001), tobacco-smoking (3.4% vs. 14.1%, p<0.0001) and reduced physical activity (69.9% vs. 50.7%, p<0.0001) differed significantly between women and men, respectively. In multivariate analysis, female sex was independently and significantly associated with obesity, anxiety, depression and reduced physical activity. Number of pregnancies was associated with a reduced physical activity. Hypertension was associated with gestational hypertension. Conclusions: Obesity and reduced physical activity are significantly and independently more frequent in Beninese women than the male counterparts. Hypertension prevalence in Benin is alarming in both sexes. Targeted prevention strategies against obesity, gestational hypertension and sedentary lifestyle are advocated in African women.
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Affiliation(s)
- Lucie Chastaingt
- Department of Vascular Medecine, Dupuytren 2 University Hospital, Limoges, France
- Univ. Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
- Inserm, U1094, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Limoges, France
- IRD, U270, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Limoges, France
| | - Gwladys N. Gbaguidi
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
- Univ. Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Julien Magne
- Department of Cardiology, Dupuytren 2 University Hospital, Limoges, France
- Univ. Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
- Inserm, U1094, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Limoges, France
- IRD, U270, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Limoges, France
| | - Pierre-Marie Preux
- Univ. Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
- Inserm, U1094, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Limoges, France
- IRD, U270, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Limoges, France
| | - Victor Aboyans
- Department of Cardiology, Dupuytren 2 University Hospital, Limoges, France
- Univ. Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
- Inserm, U1094, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Limoges, France
- IRD, U270, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Limoges, France
| | - Dismand Houinato
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - Philippe Lacroix
- Department of Vascular Medecine, Dupuytren 2 University Hospital, Limoges, France
- Univ. Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
- Inserm, U1094, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Limoges, France
- IRD, U270, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Limoges, France
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Liu D, Zhang Q, Zhao Z, Chen M, Hou Y, Wang G, Shen H, Zhu H, Ji Y, Ruan L, Lou Z. Benzodiazepine-Receptor Agonist Utilization in Outpatients with Anxiety Disorder: A Retrospective Study Based on Electronic Healthcare Data from a Large General Tertiary Hospital. Healthcare (Basel) 2023; 11:healthcare11040554. [PMID: 36833088 PMCID: PMC9956167 DOI: 10.3390/healthcare11040554] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
Benzodiazepine-receptor agonists (BZRAs), including benzodiazepines (BZDs) and drugs related to BZDs (Z-drugs), are commonly used for anxiety, but often have side effects. We retrospectively investigated the utilization and prescription characteristics of BZRAs for patients with anxiety disorders in a large tertiary care general hospital between 2018 and 2021, based on electronic healthcare records. We also examined the pattern of simultaneous consumption of multiple BZRA drugs, and the diseases coexisting with anxiety that are associated with this. The numbers of patients and BZRA prescriptions increased over the 4 years. Moreover, 7195 prescriptions from 694 patients contained two or more BZRAs, of which 78.08% contained both BZDs and Z-drugs, 19.78% contained multiple BZDs, and 2.14% contained multiple Z-drugs. For anxiety patients with concomitant Alzheimer's disease or Parkinson's disease, and dyslipidemia, they were more likely to consume multiple BZRAs simultaneously, whereas patients with concomitant insomnia, depression, hypertension, diabetes, or tumors were less likely to consume multiple BZRAs (all p < 0.05). Furthermore, older patients who consume multiple BZRAs simultaneously may have higher probabilities of long-term drug use. Better interventions supporting standardized BZD utilization may be needed to minimize the side effects of inappropriate BZRA administration.
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Affiliation(s)
- Denong Liu
- School of Medicine, Ningbo University, Ningbo 315211, China
- Department of Psychosomatic Medicine, Zhejiang Regional Medical Center Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo 315010, China
| | - Qingyu Zhang
- Department of Psychosomatic Medicine, Zhejiang Regional Medical Center Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo 315010, China
| | - Zhijia Zhao
- School of Medicine, Ningbo University, Ningbo 315211, China
| | - Mengjia Chen
- Department of Pharmacy, Ningbo Yinzhou No.2 Hospital, Ningbo 315199, China
| | - Yanbin Hou
- Department of Psychosomatic Medicine, Zhejiang Regional Medical Center Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo 315010, China
| | - Guanjun Wang
- Department of Psychosomatic Medicine, Zhejiang Regional Medical Center Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo 315010, China
| | - Haowei Shen
- School of Medicine, Ningbo University, Ningbo 315211, China
| | - Huaqiang Zhu
- Department of Pharmaceutical Engineering, Zhejiang Pharmaceutical University, Ningbo 315199, China
| | - Yunxin Ji
- Department of Psychosomatic Medicine, Zhejiang Regional Medical Center Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo 315010, China
| | - Liemin Ruan
- Department of Psychosomatic Medicine, Zhejiang Regional Medical Center Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo 315010, China
- Correspondence: (L.R.); (Z.L.)
| | - Zhongze Lou
- Department of Psychosomatic Medicine, Zhejiang Regional Medical Center Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo 315010, China
- Zhejiang Key Laboratory of Precision Medicine for Atherosclerotic Diseases, Central Laboratory of the Medical Research Center, Zhejiang Regional Medical Center Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo 315010, China
- Correspondence: (L.R.); (Z.L.)
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Zhang Y, Jiang W, Sun W, Guo W, Xia B, Shen X, Fu M, Wan T, Yuan M. Neuroprotective Roles of Apelin-13 in Neurological Diseases. Neurochem Res 2023; 48:1648-1662. [PMID: 36745269 DOI: 10.1007/s11064-023-03869-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/24/2022] [Accepted: 01/21/2023] [Indexed: 02/07/2023]
Abstract
Apelin is a natural ligand for the G protein-coupled receptor APJ, and the apelin/APJ system is widely distributed in vivo. Among the apelin family, apelin-13 is the major apelin isoform in the central nervous system and cardiovascular system, and is involved in the regulation of various physiopathological mechanisms such as apoptosis, neuroinflammation, angiogenesis, and oxidative stress. Apelin is currently being extensively studied in the nervous system, and apelin-13 has been shown to be associated with the onset and progression of a variety of neurological disorders, including stroke, neurodegenerative diseases, epilepsy, spinal cord injury (SCI), and psychiatric diseases. This study summarizes the pathophysiological roles of apelin-13 in the development and progression of neurological related diseases.
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Affiliation(s)
- Yang Zhang
- Department of Neurology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Weiwei Jiang
- Hengyang Medical College, University of South China, Hengyang, 421001, Hunan, China
| | - Wenjie Sun
- Department of Neurology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Weiming Guo
- Department of Sports Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, 518060, China
| | - Beibei Xia
- Hengyang Medical College, University of South China, Hengyang, 421001, Hunan, China
| | - Xiangru Shen
- Hengyang Medical College, University of South China, Hengyang, 421001, Hunan, China
| | - Mingyuan Fu
- Hengyang Medical College, University of South China, Hengyang, 421001, Hunan, China
| | - Teng Wan
- Department of Neurology, Huazhong University of Science and Technology Union Shenzhen Hospital, The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, 518060, China. .,Hengyang Medical College, University of South China, Hengyang, 421001, Hunan, China.
| | - Mei Yuan
- Department of Neurology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
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Gu Z, Yang C, Tang L, Wu H. Interaction of anxiety and hypertension on quality of life among patients with gynecological cancer: a cross-sectional study. BMC Psychiatry 2023; 23:26. [PMID: 36631792 PMCID: PMC9832796 DOI: 10.1186/s12888-023-04521-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 01/04/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Patients with gynecological cancer are prone to anxiety, and many of them are accompanied by hypertension, which seriously affects the quality of life (QOL). The study was to explore the interaction of anxiety and hypertension on QOL, and the moderating effect of perceived social support (PSS) in the impact of anxiety and hypertension on QOL of patients with gynecological cancer. METHODS A cross-sectional study was conducted in 2020, and 566 patients have been collected from the Affiliated Hospital of China Medical University. The Self-Rating Anxiety Scale (SAS), the Functional Assessment of Cancer Therapy Genera tool (FACT-G), and the Multidimensional Scale of Perceived Social Support Scale (MSPSS) were used. The interaction was analyzed by additive model, and the moderating effect was conducted by regression analysis and the simple slope analysis. RESULTS We found that 68.8% of patients had poor QOL due to the interaction between anxiety and hypertension. The relative excess risk ratio (RERI) was 22.238 (95%CI:44.119-88.596); the attribution ratio (AP) was 0.688 (95%CI:0.234-1.142); The interaction index (S) was 3.466 (95%CI: 0.823-14.435). The interaction items of PSS and anxiety were negatively correlated with QOL (β = -0.219, P < 0.01) and explained an additional 4.0% variance (F = 68.649, Adjusted R2 = 0.399, ΔR2 = 0.040, P < 0.01); PSS and blood pressure interaction item was not associated with QOL (β = 0.013, F = 55.138, Adjusted R2 = 0.365, ΔR2 = 0.001, P = 0.730). CONCLUSIONS When anxiety and hypertension coexist, the QOL was affected. PSS played a moderating role in the impact of anxiety on QOL. Healthcare providers should take intervention measures to improve patients' social support to reduce the impact of anxiety on QOL.
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Affiliation(s)
- ZhiHui Gu
- grid.412449.e0000 0000 9678 1884Department of Social Medicine, School of Health Management, China Medical University, Shenyang North New District, No. 77 Puhe Road, Shenyang, Liaoning 110122 People’s Republic of China
| | - ChenXin Yang
- grid.412449.e0000 0000 9678 1884Department of Social Medicine, School of Health Management, China Medical University, Shenyang North New District, No. 77 Puhe Road, Shenyang, Liaoning 110122 People’s Republic of China
| | - Lin Tang
- grid.412449.e0000 0000 9678 1884Department of Social Medicine, School of Health Management, China Medical University, Shenyang North New District, No. 77 Puhe Road, Shenyang, Liaoning 110122 People’s Republic of China
| | - Hui Wu
- Department of Social Medicine, School of Health Management, China Medical University, Shenyang North New District, No. 77 Puhe Road, Shenyang, Liaoning, 110122, People's Republic of China.
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Mental health of UK firefighters. Sci Rep 2023; 13:62. [PMID: 36627314 PMCID: PMC9832123 DOI: 10.1038/s41598-022-24834-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/21/2022] [Indexed: 01/12/2023] Open
Abstract
Exposure to trauma, high-stress situations, and disrupted sleep are well known risk factors affecting firefighters' mental health. Little is known about the association between firefighters' exposure to fire contaminants and mental health disorders. The UK Firefighter Contamination Survey assessed firefighters' health and capacity for occupational exposure to contaminants. Participants were invited to anonymously complete its 64 questions online. Logistic regression analyses assessed the associations between self-reported mental health disorders and proxies of contaminant exposure. Results found that firefighters who notice soot in their nose/throat for more than a day after attending fires (Odds Ratio (OR) = 1.8, 1.4-2.4), and those who remain in their personal protective equipment (PPE) for over 4 h after fires (OR = 1.9, 1.2-3.1), were nearly twice as likely to report mental health disorders. Significantly increased odds ratios for all three outcomes of interest (anxiety, depression and/or any mental health disorders) were also found among firefighters who take PPE home to clean. Sleeping problems were reported by 61% of firefighters. These firefighters were 4.2 times more likely to report any mental health disorder (OR = 4.2, 3.7-4.9), 2.9 times more likely to report anxiety (OR = 2.9, 2.4-3.5) and 2.3 times more likely to report depression (OR = 2.3, 1.9-2.8) when compared to firefighters who did not report sleep issues. Effective decontamination measures within UK Fire and Rescue Services, together with firefighters' wellness, may play a crucial role in protecting firefighters' mental health.
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Yin J, Kong L, Cui Y. Association Analyses of Physical Fitness Parameters and Anxiety Symptoms in Chinese College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:623. [PMID: 36612943 PMCID: PMC9820032 DOI: 10.3390/ijerph20010623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Poor physical fitness is related to many negative health outcomes, including mental disorders. However, the relationship between physical fitness and anxiety symptoms among college students remains unclear. Therefore, this study investigated whether physical fitness is related to anxiety symptoms in Chinese college students. Cross-sectional data were collected from 6635 men and 4482 women. Physical fitness was measured via a 50-m sprint, a sit-and-reach test, vital capacity, and a standing long jump for both sexes; 1000-m run and pull-up tests for males; and 800-m run and sit-up tests for females. The seven-item Generalized Anxiety Disorder Scale (GAD-7) was used to evaluate anxiety symptoms. Multivariate linear regression showed that better physical fitness was related to lower GAD-7 scores. In addition, multivariate logistic regression analysis showed that better ability in the 50-m sprint, sit-and-reach test, pull-up test, and vital capacity was related with a lower risk of anxiety symptoms in males, and better ability in the 800-m run and standing long jump was related with a lower risk of anxiety symptoms in females. In conclusion, physical fitness was inversely associated with anxiety symptoms in male and female college students. This association was also independent of confounding factors.
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Affiliation(s)
- Jianjun Yin
- Department of Physical Education, Guangdong University of Finance and Economics, Guangzhou 510320, China
| | - Lingfeng Kong
- Department of Physical Education, Hohai University, 1 Xikang Road, Nanjing 210098, China
| | - Yufei Cui
- Department of Physical Education, Huaiyin Institute of Technology, Huai’an 223003, China
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Mediating role of anxiety and depression in the relationship between perceived stress and essential hypertension. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04098-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Zhou Y, Wang Q, Ren H, Yang WFZ, Ma Y, Wu Q, Luo Y, Yang D, Liu T, Zhang X. Prevalence and related factors of anxiety in first episode and drug naïve Chinese Han outpatients with psychotic major depression. J Affect Disord 2022; 316:217-222. [PMID: 35964768 DOI: 10.1016/j.jad.2022.08.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Anxiety frequently occurs with major depressive disorder (MDD) but to a different extent in the various subtypes. Psychotic major depression (PMD) is a severe subtype of MDD that is under-identified and under-studied. We investigated the prevalence and related risk factors of anxiety in PMD patients. METHODS A total of 1718 first episode and drug naïve MDD patients were recruited. Measures included the Hamilton Depression Scale (HAMD), Clinical Global Impression-Severity scale (CGI-S), Hamilton Anxiety Scale (HAMA), and positive symptom scale of the Positive and Negative Syndrome Scale (PANSS), thyroid hormone levels, and metabolic parameters. RESULTS 171 of the entire MDD study sample met the criteria for the PMD subtype. The prevalence of severe anxiety was much higher in PMD patients (22.8 %) than in non-PMD patients (0.4 %) (χ2 = 294.69, P < 0.001, OR = 75.88, 95 % CI = 31.55-182.52). Compared to PMD patients without severe anxiety, PMD patients with severe anxiety had higher HAMD score, CGI-S score, positive symptom subscale score, suicide attempts, blood pressure, thyroid-stimulating hormone (TSH), anti-thyroglobulin (TgAb), and thyroid peroxidases antibody (TPOAb) levels. Furthermore, logistic regression analysis indicated that HAMD score and TSH levels were associated with severe anxiety in PMD patients. LIMITATIONS Our cross-sectional study cannot explain the causal relationship between anxiety severity and risk factors in PMD patients. CONCLUSIONS Our results suggest that PMD patients are more likely to experience severe anxiety than non-PMD patients. The severity of depression and TSH levels are independent risk factors for anxiety in PMD patients.
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Affiliation(s)
- Yanan Zhou
- Department of Psychiatry, Brain Hospital of Hunan Province (The Second People's Hospital of Hunan Province), Changsha, China; Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Qianjin Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Honghong Ren
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Winson Fu Zun Yang
- Department of Psychological Sciences, College of Arts & Sciences, Texas Tech University, Lubbock, TX, United States
| | - Yuejiao Ma
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Qiuxia Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yinli Luo
- Department of Psychiatry, Brain Hospital of Hunan Province (The Second People's Hospital of Hunan Province), Changsha, China
| | - Dong Yang
- Department of Psychiatry, Brain Hospital of Hunan Province (The Second People's Hospital of Hunan Province), Changsha, China
| | - Tieqiao Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
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Ge R, Feng C, Cao X, Li X. Self-Management and Its Influential Factors Among Individuals With Anxiety Disorders: A Cross-Sectional Study. J Psychosoc Nurs Ment Health Serv 2022; 61:27-35. [PMID: 36198120 DOI: 10.3928/02793695-20220929-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Self-management has been proposed as a crucial pathway to recovery from mental disorders. The aim of the current study was to explore self-management and its influential factors among individuals with anxiety disorders. Data were from a cross-sectional survey of 180 individuals diagnosed with anxiety disorders. Sociodemographic characteristics, anxiety, self-management, and social support were investigated and analyzed. Participants' mean self-management score was 79.04, with a score rate of 63%. Economic burden, number of relapses, and anxiety severity significantly influenced self-management among participants. Increased social support was correlated with greater self-management. Mental health nursing services should be directed toward individuals with anxiety disorders. [Journal of Psychosocial Nursing and Mental Health Services, 61(4), 27-35.].
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Małyszczak K, Janocha A. The circadian rhythm of blood pressure in patients with panic disorder and generalized anxiety disorder. J Psychosom Res 2022; 161:110999. [PMID: 36007358 DOI: 10.1016/j.jpsychores.2022.110999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/31/2022] [Accepted: 08/01/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Anxiety disorders affect blood pressure both during the day and at night. Little is known about the effect of individual anxiety disorders on the circadian rhythm of blood pressure. OBJECTIVES The purpose of this study is to compare the nocturnal drop in blood pressure in patients with panic disorder (PD), generalized anxiety disorder (GAD), and healthy individuals. METHODS The study was conducted on fifty consecutive outpatients with anxiety disorders and personality disorders who participated in intensive group psychotherapy. Diagnoses were made according to DSM-IV-TR criteria using the PSE-10 questionnaire. Out of 50 patients under study, 17 were diagnosed with PD and 21 with GAD. The control group consisted of 40 healthy people recruited in the course of other studies. The resulting three groups were compared in terms of circadian blood pressure using the ABPM method. RESULTS Mean nocturnal falls in systolic and diastolic blood pressure were the following: 2% and 3% (PD), 11% and 12% (GAD), 27% and 23% (control). Four people out of PD group had higher systolic and diastolic blood pressure at night than during the day. The ratios between non-dippers/dippers were: 0/15 (PD), 8/21 (38% - GAD) and 40/40 (100% - control). CONCLUSIONS The patients with PD were characterized by an almost flat course of circadian blood pressure. The patients with GAD had a lower mean nocturnal fall in blood pressure than the control group, but significantly higher than the patients with PD. The differences in the circadian course of blood pressure between PD and GAD are so large that the impact of these disorders should be investigated separately.
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Affiliation(s)
- Krzysztof Małyszczak
- Division of Psychotherapy and Psychosomatic Disorders, Department of Psychiatry, Wroclaw Medical University, Poland.
| | - Anna Janocha
- Division of Pathophysiology, Department of Physiology and Pathophysiology, Wroclaw Medical University, Poland
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Bin Abdulrahman KA, Alsharif AY, Alotaibi AB, Alajaji AA, Alhubaysh AA, Alsubaihi AI, Alsubaie NE. Anxiety and Stress among Day Traders in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11252. [PMID: 36141519 PMCID: PMC9517472 DOI: 10.3390/ijerph191811252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND People nowadays are more concerned about their financial status and how to improve their quality of life; one method is day trading. This study aims to investigate the association between stress or anxiety and day trading among day traders in Saudi Arabia. METHODS We collected the data through DASS-21, a set of three self-report scales designed to measure the emotional states of depression, anxiety, and stress. It tells if the person has mild, moderate, severe, or extremely severe emotional status. Our study will focus on two domains: stress and anxiety. Day traders scoring between 0 and 7 on the anxiety scale were classified as normal anxiety. Scoring between 8 and 9 on the anxiety scale, mild anxiety, and between 10 and 14 on the anxiety scale as moderate anxiety. Those scoring between 15 and 19 were classified as severe, and those scoring >20 as extremely severe. RESULTS Our results showed that out of 387 valid surveys, day traders scoring < 14 on the stress scale were classified as everyday stress (N = 249, 64.3%), and those scoring between 15 and 18 as mild (N = 49, 12.7%) and those scoring between 19 and 25 as moderate (N = 46, 11.9%), those scoring between 26 and 33 as severe (N = 34, 8.8%), and those scoring > 34 were classified as extremely severe (N = 9, 2.3%). CONCLUSIONS The prevalence of anxiety and stress is considerable among day-traders. Therefore, it is fundamental to develop more effective health promotion strategies for the target population to make them aware of and learn how to control and prevent these harmful emotional feelings.
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Affiliation(s)
- Khalid A. Bin Abdulrahman
- Department of Medical Education, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 13317, Saudi Arabia
| | - Abdulaziz Yahya Alsharif
- Department of Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 13317, Saudi Arabia
| | - Abdulrahman Bandar Alotaibi
- Department of Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 13317, Saudi Arabia
| | - Abdulrahman Ali Alajaji
- Department of Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 13317, Saudi Arabia
| | - Abdullah Ali Alhubaysh
- Department of Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 13317, Saudi Arabia
| | | | - Nahaa Eid Alsubaie
- Department of Mathematics, Alkhurmah University College, Taif University, Taif 21974, Saudi Arabia
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Obesity-Associated Anxiety Is Prevalent among College Students and Alleviated by Calorie Restriction. Nutrients 2022; 14:nu14173518. [PMID: 36079775 PMCID: PMC9460559 DOI: 10.3390/nu14173518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/20/2022] [Accepted: 08/23/2022] [Indexed: 11/22/2022] Open
Abstract
Anxiety is a common disorder among college students, especially those with obesity. Obesity contributes to metabolic disorders and disturbs the neural functions, further leading to anxiety. In this cross-sectional study, we aimed to determine the association between obesity and anxiety among college students and identified the potential factors for obesity-associated anxiety. We evaluated the intervention effects of calorie restriction on anxiety. Self-reported questionnaires were distributed to 1381 college students from January to March in 2021. Anxiety was measured by the State-Trait Anxiety Inventory (STAI). Participants were classified into anxiety and non-anxiety groups according to their STAI scores. Chi-squared test and logistic regression were used to analyze the potential factors. We found that 383 college students exhibited anxiety, accounting for 30.1% among all included college students, which was higher than the global average. The association between anxiety and obesity was observed among college students (p = 0.009), especially in males (p = 0.007). We identified that pre-obesity (p = 0.012), unhealthy calorie intake (p = 0.001), dieting (p = 0.003) and high academic year (p = 0.006) as the risk factors for anxiety and found that the long sleep duration was a protective factor for anxiety (p < 0.001). We found that more obese students showed an improvement of anxiety than the underweight students after calorie restriction (p < 0.001). Collectively, our findings suggest that obesity-associated anxiety is prevalent among the college students and could be alleviated by moderate calorie restriction. It is necessary for students to receive anxiety management in their college life. Additionally, the proper calorie restriction should be promoted to help students protect against obesity and obesity-associated anxiety.
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Ikegame S, Yoshimoto M, Miki K. Simultaneous measurement of central amygdala neuronal activity and sympathetic nerve activity during daily activities in rats. Exp Physiol 2022; 107:1071-1080. [PMID: 35857391 DOI: 10.1113/ep090538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 07/14/2022] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? The functional relationships between central amygdala neuronal activity and sympathetic nerve activity in daily activities remain unclear. We aimed to measure central amygdala neuronal activity, renal and lumbar sympathetic nerve activity, heart rate, and arterial pressure simultaneously in freely moving rats. What is the main finding and its importance? Central amygdala neuronal activity (CeANA) is significantly related to renal and lumbar sympathetic nerve activity (RSNA and LSNA, respectively) and heart rate (HR) in a behavioural state-dependent and regionally different manner; meanwhile, CeANA was tightly associated with RSNA and HR across all behavioural states. Thus, it is likely that the amygdala is one of the components of neural networks for generating regional differences in renal and lumbar sympathetic nerve activity. ABSTRACT The central amygdala (CeA) is involved in generating diverse changes in sympathetic nerve activity (SNA) in response to changes in daily behavioural states. However, the functional relationships between CeA neuronal activity (CeANA) and SNA in daily activities are still unclear. In the present study, we developed a method for simultaneous and continuous measurement of CeANA and SNA in freely moving rats. Wistar rats were chronically instrumented with multiple electrodes (100-μm stainless-steel wire) for the measurement of CeANA, of renal SNA (RSNA) and of lumbar SNA (LSNA), and electroencephalogram, electromyogram (EMG), and electrocardiogram electrodes as well as catheters for measurement of arterial pressure (AP). During the transition from non-rapid-eye movement (NREM) sleep to quiet wakefulness, moving, and grooming states, a significant linear relationship was observed between CeANA and RSNA (P < 0.0001), between CeANA and LSNA (P = 0.0309), between CeANA and heart rate (HR) (P = 0.0123), and between CeANA and EMG (P = 0.0089), but no significant correlation was observed between CeANA and AP (P = 0.5139). During rapid eye movement sleep, the relationships between CeANA and RSNA, LSNA, HR, AP, and EMG deviated from the previously observed linear relationships, but the time course of RSNA and HR changes was the mirror image of that of CeANA, while the time course of changes in LSNA and AP was not related to that of CeANA. In conclusion, CeANA was related to RSNA, LSNA, and HR in a behavioural state-dependent and regionally different manner, while CeANA was tightly associated with RSNA and HR across all behavioural states. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Shizuka Ikegame
- Autonomic Physiology Laboratory, Faculty of Life Science and Human Technology, Nara Women's University, Kita-Uoya Nishimachi, Nara, 630-8506, Japan
| | - Misa Yoshimoto
- Autonomic Physiology Laboratory, Faculty of Life Science and Human Technology, Nara Women's University, Kita-Uoya Nishimachi, Nara, 630-8506, Japan
| | - Kenju Miki
- Autonomic Physiology Laboratory, Faculty of Life Science and Human Technology, Nara Women's University, Kita-Uoya Nishimachi, Nara, 630-8506, Japan
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Acupuncture in Arterial Hypertension: Evaluation of its Efficacy with Both Office and Ambulatory Blood Pressure Measurements. High Blood Press Cardiovasc Prev 2022; 29:429-434. [PMID: 35761147 PMCID: PMC9537129 DOI: 10.1007/s40292-022-00530-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/07/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction A possible alternative to pharmacological antihypertensive therapies in grade 1 low risk hypertensive patients or in those experienced drugs adverse effects could be acupuncture. Aim we focused on its possible effects on BP both as Office BP (OBP) and as Ambulatory BP Monitoring (ABPM) evaluating it before starting a 6 weeks twice weekly (total 12 session) acupuncture cycle and after 2 months from its completion. Methods in this prospective study we treated with acupuncture 45 patients: 24 of them presents high-normal BP values and low cardiovascular risk while 21 patients were on anti-hypertensive drug with slightly uncontrolled BP values (from 140 to 145 mmHg for Systolic BP—SBP—and/or from 90 to 95 mmHg for Diastolic BP—DBP). Results regarding SBP, a significant reduction have been observed for office values (from 134.2 ± 15.7 to 125.1 ± 12.2, p = 0.03), and for ABPM 24 h (from 131.1 ± 10.7 to 126.0 ± 10.1, p = 0.01) and day-time values (from 134.7 ± 10.5 to 127.1 ± 18.4, p = 0.02). For DBP, only ABPM 24 h and day-time values showed significant changes (from 85.3 ± 9.1 to 82.1 ± 7.5, p = 0.03; and from 88.5 ± 9.3 to 85.7 ± 7.8, p = 0.02). Within session SBP decrease was − 5.8 mmHg (-3.75%) during the first session while it falls to – 2.1 mmHg (– 1.25%) and stands firmly under 2 mmHg for all the next session. At the last session SBP reduction was − 1.9 mmHg (– 1.6%). Conclusions we found a significant reduction in office, 24 h and day-time ABPM SBP determined by a 6-weeks twice weekly acupuncture cycle that lasts at least for the first two months after its completion. Supplementary Information The online version contains supplementary material available at 10.1007/s40292-022-00530-9.
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Gramaglia C, Gattoni E, Gambaro E, Bellan M, Balbo PE, Baricich A, Sainaghi PP, Pirisi M, Binda V, Feggi A, Jona A, Marangon D, Prosperini P, Zeppegno P. Anxiety, Stress and Depression in COVID-19 Survivors From an Italian Cohort of Hospitalized Patients: Results From a 1-Year Follow-Up. Front Psychiatry 2022; 13:862651. [PMID: 35782424 PMCID: PMC9247238 DOI: 10.3389/fpsyt.2022.862651] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
Background Mental health-related symptoms can persist over time beyond the most common respiratory clinical features of COVID-19. A recent meta-analysis underlined that mental health sequalae may be relevant for COVID-19 survivors and reported the following prevalence rates: 20% for post-traumatic stress disorder, 22% for anxiety, 36% for psychological distress, and 21% for depression. In the context of a multi-disciplinary follow-up project, we already investigated the mid-term (4 months) psychiatric outcomes in a sample of COVID-19 survivors. Patients were re-assessed after 1-year since hospital discharge. Methods Follow-up conducted after 1 year involved 196 individuals recovered from COVID-19. Patients were assessed with a multi-disciplinary approach; including both a clinical interview performed by an experienced psychiatrist, trained in the use of the Mini-International Neuropsychiatric Interview (MINI) to assess the presence of anxiety, stress, and depressive symptoms and the following self-administered questionnaires: Beck Anxiety Inventory, Beck Depression Inventory-II, Resilience Scale for Adults, Impact of Event Scale, and COVID-19 Peritraumatic Distress Index (CPDI). Results Anxiety (p < 0.0001) and depressive (p < 0.0003) symptoms registered at the clinical interview showed a significant improvement from the 4 to 12-months follow-up. Logistic regression model showed that female gender (p = 0.006), arterial hypertension (p = 0.01), obesity (0.04), anxiety (p < 0.0001), and depressive (p = 0.02) symptoms at 4-months follow-up were associated with persistence of anxiety symptoms at 12 months. At logistic regression analysis female gender (p = 0.02) and depressive symptoms at 4-months follow-up (p = 0.01) were associated with depressive symptoms after 12 months. Conclusion Severity of the disease in the acute phase, in this study, was not a determining factor in identifying subjects at risk of developing clinically relevant anxiety and depression as a consequence of COVID-19 disease. Findings from the logistic regressions suggest that the factors most affecting depression and anxiety in COVID survivors after 12 months were female gender, the presence of anxiety and depression after 4 months and some physical symptoms, not necessarily COVID-related. Impact of infection and consequent hospitalization for COVID-19 did no longer represent a relevant issue for depressive symptoms, compared to other general factors.
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Affiliation(s)
- Carla Gramaglia
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Eleonora Gattoni
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Eleonora Gambaro
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Mattia Bellan
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | | | - Alessio Baricich
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Pier Paolo Sainaghi
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Mario Pirisi
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Valeria Binda
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Alessandro Feggi
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Amalia Jona
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Debora Marangon
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | | | - Patrizia Zeppegno
- Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
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Xu L, Chen S, Xu K, Wang Y, Zhang H, Wang L, He W. Prevalence and associated factors of depression and anxiety among Chinese diabetic retinopathy patients: A cross-sectional study. PLoS One 2022; 17:e0267848. [PMID: 35482738 PMCID: PMC9049521 DOI: 10.1371/journal.pone.0267848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/14/2022] [Indexed: 01/18/2023] Open
Abstract
The purposes of this study were to evaluate the mental health among patients with diabetic retinopathy (DR) and to explore its' influencing factors. A cross-sectional survey was conducted in Liaoning Province, China. A total of 200 patients volunteered to participate in the survey. Psycho-social variables included stress, self-efficacy, resilience, and social support. logistic regression analysis was used to explore the effect of psycho-social factors on depression and anxiety in DR patients. The prevalence of depression and anxiety was 25% and 13.5% among DR patients. Regression analysis showed that social support had a significant protective effect on depression (95%CI 0.931-0.997) and anxiety (95%CI 0.900-0.995). Stress had a significant acceleration of depression (95%CI 1.055-1.253) and anxiety (95%CI 1.120-1.457). Family history of diabetes (95%CI 1.856-18.057) and other chronic diseases (95%CI 1.485-12.508) were risk factors for anxiety. The high prevalence of depression (25.0%) and anxiety (13.5%) among DR patients should receive more attention in Chinese medical settings. Stress, social support, family history of diabetes and other chronic diseases seemed to be crucial in relation to depressive symptoms. Efficient interventions such as improving social support and decreasing stress with patients should be considered by health administrators aiming at alleviating depressive and anxiety among Chinese DR patients.
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Affiliation(s)
- Ling Xu
- He Eye Specialist Hospital, Shenyang, China
| | - Siqi Chen
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Kai Xu
- He Eye Specialist Hospital, Shenyang, China
| | - Yixin Wang
- He Eye Specialist Hospital, Shenyang, China
| | | | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Wei He
- He Eye Specialist Hospital, Shenyang, China
- * E-mail:
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Boettler MA, Shahwan KT, Cusick A, Avila C, Carr DR. Safety and Efficacy of Oral Benzodiazepines for Periprocedural Anxiolysis: A Systematic Review. Dermatol Surg 2022; 48:508-515. [PMID: 35245230 DOI: 10.1097/dss.0000000000003407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Oral benzodiazepines (BZDs) are useful tools for periprocedural anxiolysis. The United States Food and Drug Administration (FDA) recently issued a black-box warning of their risks of abuse and dependence. We performed a systematic review evaluating the safety and efficacy of oral BZDs for periprocedural anxiolysis in outpatient dermatologic, plastic surgery, dental, and ophthalmologic procedures performed under local anesthesia. METHODS A systematic review of 5 databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Oral benzodiazepine safety and efficacy data were extracted from eligible articles. RESULTS A total of 43 articles and 4,060 subjects were included. Oral BZDs consistently imparted a positive anxiolytic effect and demonstrated superior or equivalent scores in patient satisfaction, surgeon satisfaction, pain, and anxiety to comparator groups in most studies. Thirty-five subjects experienced transient hypoxia, and 2 experienced transient hypertension. A total of 195 mild, self-limited adverse effects were reported. None of the studies addressed the risks of abuse and dependence in this clinical setting. CONCLUSION Short-term use of oral BZDs for periprocedural anxiolysis seems to be safe and effective. The 2020 FDA black-box warning should not deter their appropriate use in dermatologic surgery and other low-risk outpatient procedures.
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Affiliation(s)
| | - Kathryn T Shahwan
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
- Department of Dermatology, Altru Health System, University of North Dakota Medical School, Grand Forks, North Dakota
| | - Austin Cusick
- Department of Medicine, OhioHealth Riverside Methodist Hospital, Columbus, Ohio
| | - Christina Avila
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - David R Carr
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
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Vargas EA, Chirinos DA, Wong M, Carnethon MR, Carroll AJ, Kiefe CI, Carson AP, Kershaw KN. Psychosocial profiles and longitudinal achievement of optimal cardiovascular risk factor levels: the Coronary Artery Risk Development in Young Adults (CARDIA) study. J Behav Med 2022; 45:172-185. [PMID: 34671896 PMCID: PMC10083095 DOI: 10.1007/s10865-021-00259-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 09/22/2021] [Indexed: 11/24/2022]
Abstract
Psychosocial factors are associated with the achievement of optimal cardiovascular disease risk factor (CVDRF) levels. To date, little research has examined multiple psychosocial factors simultaneously to identify distinguishing psychosocial profiles among individuals with CVDRF. Further, it is unknown whether profiles are associated with achievement of CVDRF levels longitudinally. Therefore, we characterized psychosocial profiles of individuals with CVDRF and assessed whether they are associated with achievement of optimal CVDRF levels over 15 years. We included 1148 CARDIA participants with prevalent hypertension, hypercholesterolemia and/or diabetes mellitus in 2000-2001. Eleven psychosocial variables reflecting psychological health, personality traits, and social factors were included. Optimal levels were deemed achieved if: Hemoglobin A1c (HbA1c) < 7.0%, low-density lipoprotein (LDL) cholesterol < 100 mg/dl, and systolic blood pressure (SBP) < 140 mm Hg. Latent profile analysis revealed three psychosocial profile groups "Healthy", "Distressed and Disadvantaged" and "Discriminated Against". There were no significant differences in achievement of CVDRF levels of the 3 targets combined across profiles. Participants in the "Distressed and Disadvantaged" profile were less likely to meet optimal HbA1c levels compared to individuals in the "Healthy" profile after demographic adjustment. Associations were attenuated after full covariate adjustment. Distinct psychosocial profiles exist among individuals with CVDRF, representing meaningful differences. Implications for CVDRF management are discussed.
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Affiliation(s)
- Emily A Vargas
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Diana A Chirinos
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mandy Wong
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Allison J Carroll
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Catarina I Kiefe
- Department of Population and Quantitative Health Services, University of Massachusetts Medical School, Worcester, MA, USA
| | - April P Carson
- Departments of Medicine and Population Health Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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DEMİR GÜNDOĞMUŞ P, GÜNDOĞMUŞ İ. Esansiyel Hipertansiyon Tanılı Hastaların Üstbilişsel Süreçlerinin İncelenmesi: Vaka-Kontrol Çalışması. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2022. [DOI: 10.17517/ksutfd.1039089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Amaç: Üstbilişsel değişkenlere odaklanan bu araştırma, hipertansiyon hastaları ve sağlıklı kontrol grubu arasında üstbilişsel inançlar, bilişsel dikkat kilitlenmesi sendromu ve anksiyete belirtilerini karşılaştırmayı amaçlamaktadır.
Gereç ve Yöntemler: Vaka-kontrol çalışması şeklinde dizayn edilen mevcut çalışmanın örneklemini kardiyoloji polikliniğine ardışık başvuran 128 hipertansiyon hastası ve 231 sağlıklı kontrol oluşturmaktadır. Çalışmaya dahil edilen gönüllülere sosyodemografik veri formu, Beck Anksiyete Envanteri (BAE), Üstbilişler-30 ölçeği (ÜBÖ-30) ve Bilişsel Dikkat Kilitlenmesi Ölçeği (CAS-1) uygulanmıştır. Elde edilen veriler usulüne uygun hesaplanarak istatistiki işleme tabi tutulmuştur.
Bulgular: Çalışmaya dahil edilen katılımcıların yaş ortalaması 51.81±8.07 yıldı ve %75.5’i (n=271) kadındı. İki çalışma grubu arasında sosyodemografik verilerin karşılaştırılmasında istatiksel olarak fark saptanmamıştır (p>0.05). Esansiyel hipertansiyon ve sağlıklı kontrol grubu arasında BAE (t=-3.700, p
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Repova K, Aziriova S, Krajcirovicova K, Simko F. Cardiovascular therapeutics: A new potential for anxiety treatment? Med Res Rev 2022; 42:1202-1245. [PMID: 34993995 PMCID: PMC9304130 DOI: 10.1002/med.21875] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 12/15/2022]
Abstract
Besides the well‐recognized risk factors, novel conditions increasing cardiovascular morbidity and mortality are emerging. Undesirable emotions and behavior such as anxiety and depression, appear to participate in worsening cardiovascular pathologies. On the other hand, deteriorating conditions of the heart and vasculature result in disturbed mental and emotional health. The pathophysiological background of this bidirectional interplay could reside in an inappropriate activation of vegetative neurohormonal and other humoral systems in both cardiovascular and psychological disturbances. This results in circulus vitiosus potentiating mental and circulatory disorders. Thus, it appears to be of utmost importance to examine the alteration of emotions, cognition, and behavior in cardiovascular patients. In terms of this consideration, recognizing the potential of principal cardiovascular drugs to interact with the mental state in patients with heart or vasculature disturbances is unavoidable, to optimize their therapeutic benefit. In general, beta‐blockers, central sympatholytics, ACE inhibitors, ARBs, aldosterone receptor blockers, sacubitril/valsartan, and fibrates are considered to exert anxiolytic effect in animal experiments and clinical settings. Statins and some beta‐blockers appear to have an equivocal impact on mood and anxiety and ivabradine expressed neutral psychological impact. It seems reasonable to suppose that the knowledge of a patient's mood, cognition, and behavior, along with applying careful consideration of the choice of the particular cardiovascular drug and respecting its potential psychological benefit or harm might improve the individualized approach to the treatment of cardiovascular disorders.
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Affiliation(s)
- Kristina Repova
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Silvia Aziriova
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Kristina Krajcirovicova
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Fedor Simko
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.,3rd Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia.,Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
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Considering Psychosocial Factors When Investigating Blood Pressure in Patients with Short Sleep Duration: A Propensity Score Matched Analysis. Int J Hypertens 2021; 2021:7028942. [PMID: 34888099 PMCID: PMC8651353 DOI: 10.1155/2021/7028942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/16/2021] [Accepted: 11/23/2021] [Indexed: 11/30/2022] Open
Abstract
Few studies have considered psychosocial characteristics when investigating the associations between sleep duration and blood pressure (BP). In this study, we took propensity score matching (PSM) to adjust for psychosocial characteristics when comparing BP between individuals with short sleep duration and those with normal sleep duration. A total of 429 participants were included. 72 participants with sleep duration ≤6 h and 65 participants with sleep duration >6 h were matched after PSM. We compared office BP, 24-hour BP, and prevalence of hypertension in the populations before and after PSM, respectively. In the unmatched population, participants with sleep duration ≤6 h were observed with higher office diastolic BP (DBP) and 24-h systolic BP (SBP)/DBP (all P < 0.05). In the matched populations, the differences between the two groups (sleep duration ≤6 h vs. sleep duration >6 h) in office DBP (88.4 ± 10.9 vs. 82.5 ± 11.1 mm Hg; P=0.002), 24-h SBP (134.7 ± 12.0 vs. 129.3 ± 11.6 mm Hg; P=0.009), and 24-h DBP (83.4 ± 9.9 vs. 78.1 ± 10.1 mm Hg; P=0.002) become more significant. Participants with sleep duration ≤6 h only show higher prevalence of hypertension based on 24-h BP data, while analysis after PSM further revealed that these with sleep duration ≤6 h presented about 20% higher prevalence of elevated BP up to office diagnosed hypertension threshold. Therefore, psychosocial characteristics accompanied with short sleep duration should be fully valued in individuals at risks for elevated BP. This trial is registered with NCT03866226.
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Luo J. Association between migraine and anxiety symptoms: Results from the study of women's health across the nation. J Affect Disord 2021; 295:1229-1233. [PMID: 34706437 DOI: 10.1016/j.jad.2021.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study aimed to examine the relationship between migraine and anxiety in US midlife women. METHODS This study was conducted on the baseline data from the Study of Women's Health Across the Nation (SWAN), a multi-site longitudinal population-based study of the US midlife women. Logistic regression was performed to assess the odds ratios (ORs) and 95% confidence intervals (CIs) between migraine and anxiety, adjusting for the main potential confounders. RESULTS A total of 3,302 midlife women aged from 42 to 52 with complete assessment of migraine and anxiety were enrolled. In both the crude model (OR: 1.47, 95% CI: 1.19-1.82, p < 0.001) and model 1 (OR: 1.31, 95% CI: 1.04-1.64, p = 0.022) indicated that anxiety was positive associated with migraine. After adjustment for age, ethnicity, family income, body mass index (BMI), smoking, alcohol drinking, physical activity, hypertension, diabetes, hypercholesterolemia, menopausal status, estradiol, dehydroepiandrosterone sulfate, follicle-stimulating hormone, sex hormone-binding globulin, testosterone, and thyroid stimulating hormone in full adjusted model 2, the association between migraine and anxiety remained statistically significant (OR: 1.28, 95% CI: 1.01-1.61, p = 0.038). CONCLUSION Migraine may be positively associated with anxiety in middle-aged women. Further large-scale prospective cohort studies are needed to investigate the causality between migraine and anxiety.
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Affiliation(s)
- Jing Luo
- Department of Clinical and Public Health, School of Health and Rehabilitation, Jiangsu College of Nursing, Huai'an, Jiangsu 223300, China.
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Qin Z, Zhou C, Zhu Y, Wang Y, Cao H, Li W, Huang Z. Virtual Reality for Hypertension in Tooth Extraction: A Randomized Trial. J Dent Res 2021; 101:400-406. [PMID: 34825613 DOI: 10.1177/00220345211049393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Tooth extraction is one of the most common causes of dental anxiety and pain, leading to the elevation of blood pressure (BP) and heart rate (HR). Such effects may be exaggerated and cause life-threatening accidents in patients with hypertension. Therefore, the pain and anxiety management of these patients is imperative. Virtual reality (VR) has been demonstrated to be a distraction method to relieve anxiety and pain in clinical operations. Thus, we hypothesized that VR can control the elevation of BP and HR in patients with hypertension. In this study, 96 eligible patients with controlled hypertension who needed tooth extraction were randomized to the VR or standard care group by stratified randomization of anxiety grade and gender. Their BP and HR were dynamically monitored. The corresponding systolic and diastolic BP and HR values were selected when systolic BP was at the highest point of the process. BP was converted into mean arterial pressure (MAP) for comparison per the following formula: MAP = (systolic BP + 2 × diastolic BP)/3. Statistical analyses were by intention to treat and conducted in SPSS. Nonparametric rank sum tests were used to compare the difference of ΔMAP and ΔHR between the VR and standard care groups. Multivariate linear regression was applied to evaluate the effect of VR on ΔMAP and ΔHR. The results showed that the VR technique significantly decreased the elevation of MAP (P < 0.001) and HR (P < 0.001), and this effect was found even after adjusting for baseline characteristics and additional surgical procedures (ΔMAP, P < 0.001, R2 = 0.276; ΔHR, P < 0.001, R2 = 0.152). VR did not increase the incidence of adverse events (P = 0.677). In conclusion, the VR technique was effective in controlling BP and HR within an acceptable range and can help manage BP and HR during tooth extraction for patients with hypertension (Chinese Clinical Trial Registry: ChiCTR2100042132).
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Affiliation(s)
- Z Qin
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of General Dentistry, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - C Zhou
- Department of Emergency, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Y Zhu
- Clinical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Y Wang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of General Dentistry, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - H Cao
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of General Dentistry, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - W Li
- Department of Critical Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Z Huang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of General Dentistry, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Polypharmacy in the Management of Arterial Hypertension-Friend or Foe? MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57121288. [PMID: 34946233 PMCID: PMC8705955 DOI: 10.3390/medicina57121288] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 02/06/2023]
Abstract
Background and Objectives: Polypharmacy is associated with drug-drug or food-drug interactions that may pose treatment difficulties. The objective of the study was to investigate the use of polypharmacy in hypertensive patients hospitalized in the Internal Medicine Clinic of a European referral hospital. Materials and Methods: We conducted a retrospective chart review study on patients identified by a database search of discharge diagnoses to assess the use of polypharmacy and identify potential drug-drug and food-drug interactions. Results: In total, 166 hypertensive patients (68.46 ± 12.70 years, range 42-94 years) were compared to 83 normotensive subjects (67.82 ± 14.47 years, range 22-94 years) who were hospitalized in the clinic during the same period. Polypharmacy was more common in hypertensive versus normotensive subjects (p = 0.007). There were no differences in terms of age, as well as major (0.44 ± 0.77 versus 0.37 ± 0.73 interactions/patient, p = 0.52) and minor (1.25 ± 1.50 versus 1.08 ± 1.84 interactions/patient, p = 0.46) drug-drug interactions between patients with and without hypertension. The mean number of drug-drug interactions (6.55 ± 5.82 versus 4.93 ± 5.59 interactions/patient, p = 0.03), moderate drug-drug interactions (4.94 ± 4.75 versus 3.54 ± 4.17, p = 0.02) and food-drug interactions (2.64 ± 1.29 versus 2.02 ± 1.73, p = 0.00) was higher in patients with hypertension versus their counterparts. Conclusions: The present study reinforces that polypharmacy is a serious concern in hypertensive patients, as reflected by the high number of potentially harmful drug-drug or food-drug interactions. We recorded higher numbers of comorbidities, prescribed drugs, and moderate drug-drug/food-drug interactions in hypertensive versus normotensive patients. A strategy to evaluate the number of discharge medications and reduce drug-drug interactions is essential for the safety of hypertensive patients.
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