Relationships between depression and anxiety symptoms scores and blood pressure in young adults

Associations of Anxiety Symptoms With 6-Year Blood Pressure Changes and Incident Hypertension: Results From the Hispanic Community Health Study/Study of Latinos

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.

Effects of elevated emotional symptoms on metabolic disease development: a 10-year follow-up study

Background

In recent decades, the relationship between emotional disorders (i.e., depression and anxiety) and alterations in physiological functions (i.e., inflammation or metabolism) have been well supported. However, studies on a symptom-based approach have provided mixed results. Our study aims to gain insight into how subclinical statuses, featured by elevated depressive and/or anxious symptoms, may influence immunometabolic alterations in the concurrent relationship; and the development of metabolic diseases at 10-year follow-up: diabetes, hypertension and hypercholesterolemia.

Methods

Data from 758 Greek adults [394 men (aged 41 ± 10 years) and 364 women (aged 37 ± 12 years)] were used. Four groups were created according to the levels of depressive and anxiety symptoms: (1) control group (CG), (2) depressive group (DG), (3) anxiety group (AG) and (4) depressive and anxiety group (DAG). Multi-indicator multi-causes (MIMIC) modeling was used to estimate metabolic function and inflammatory response scores, on a wide selection of blood biomarkers. Finally, a binary logistic regression was carried out to study the influence of symptoms on the development of the aforementioned metabolic diseases on a 10-year follow-up.

Results

Group membership was not associated with metabolic function score. Conversely, DAG membership was related with higher inflammatory response score (B = 0.20, CI95 = 0.01, 0.40), with respect to the CG (p < 0.05). Both age and sex were significant variables in the calculation of both scores. Regarding disease at 10-year follow-up effect, risk of developing diabetes, hypertension and hypercholesterolemia was associated with age and socioeconomic status. Moreover, DG membership was significant for diabetes risk (OR = 2.08, CI95 = 1.00, 4.22) and DAG for hypercholesterolemia (OR = 1.68, CI95 = 1.16, 2.43).

Limitations

Data on anti-inflammatory drugs and psychopharmacological medication were not collected in this study.

Conclusions

Elevated symptoms of depression and anxiety accounts for inflammatory alterations at concurrent relationship and a higher risk of 10-year follow-up metabolic diseases.

Associations between depressive, anxiety, stress symptoms and elevated blood pressure: Findings from the CHCN-BTH cohort study and a two-sample Mendelian randomization analysis

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.

Prevalence and correlates of suicide attempts in young patients with first-episode and drug-naïve major depressive disorder: A large cross-sectional study

BACKGROUND

Few studies in China have reported factors influencing suicide attempt in young first-episode drug-free (FEDN) MDD patients. This study aimed to investigate the incidence and potential relevant factors of suicide attempt among young Chinese patients with FEDN MDD to prevent suicidal behavior in this population.

METHODS

We recruited 1076 FEDN MDD outpatients aged 18-45 years. Patients' mental states were measured by the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Positive and Negative Syndrome Scale (PANSS) positive subscale, and Clinical Global Impression Severity Scale (CGIS). Fasting blood glucose, lipid levels, and thyroid function parameters were also measured.

RESULTS

The prevalence of suicide attempt for FEDN MDD patients was 18.31 %. Compared to patients without suicide attempt, patients with suicide attempt had an older age of onset, higher HAMA, HAMD, PANSS-positive subscale and CGI-S scores, higher blood pressure, fasting blood glucose, thyroid peroxidases antibody (A-TPO), anti-thyroglobulin (A-TG), thyroid stimulating hormone (TSH), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC), but lower high-density lipoprotein cholesterol (HDLC) (all p < 0.05). Logistic regression analysis showed that duration of illness, hypertension, PANSS-positive subscale, HAMA and CGI-S scores, and A-TPO, LDL-C, TC, and HDL-C were associated with suicide attempt in patients with MDD.

LIMITATIONS

The main limitations are cross-sectional design and inability to control selection bias.

CONCLUSIONS

This study suggests that young patients with FEDN MDD have a high rate of suicide attempts. Several clinical and metabolic indicators related to lipids and thyroid function may be involved in suicide attempts in FEDN MDD patients.

Gender differences in the association between anxiety symptoms and thyroid hormones in young patients with first-episode and drug naïve major depressive disorder

Objective

Gender differences are prevalent in major depressive disorder (MDD), but the gender differences in the relationship between comorbid anxiety and thyroid hormones in young first-episode and drug-naive (FEND) MDD patients are unknown.

Methods

A total of 1,289 young outpatients with FEDN MDD were recruited. Demographic and clinical data were collected for each patient. The patient's blood glucose, blood pressure, thyroid hormone, and thyroid antibody levels were measured. The Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) were used to assess patients' depression, anxiety, and positive symptoms, respectively.

Results

The prevalence of comorbid anxiety disorders was 80.4 and 79.4% in male and female MDD patients, respectively. Patients with anxiety had higher HAMD and PANSS scores, higher serum thyroid stimulating hormone (TSH), anti-thyroglobulin antibody (A-TG), and thyroid peroxidase antibody (A-TPO) levels, higher blood glucose and blood pressure levels, and more patients with psychotic symptoms and suicide attempts. Male patients were younger and had a younger age of onset. Logistic regression analysis showed that HAMD score and comorbid suicide attempts were significant predictors of anxiety symptoms in both males and females, whereas A-TG predicted anxiety symptoms in female patients only. Limitations: No causal relationship could be drawn due to the cross-sectional design.

Conclusion

This study showed gender differences in factors associated with anxiety symptoms in patients with MDD. Some factors were associated with anxiety symptoms in both male and female patients, while A-TG was only associated with anxiety symptoms in female patients.

Prevalence and Patterns of Prenatal Alcohol Exposure in Australian Cohort and Cross-Sectional Studies: A Systematic Review of Data Collection Approaches

This study sought to determine data collection approaches in Australian cohort studies and explore the potential impact on reported prenatal alcohol exposure (PAE) prevalence and patterns. Inclusion criteria were that studies related to a general Australian antenatal population where PAE was assessed and reported. Studies were excluded if they were not peer reviewed, examined the prevalence of PAE in pregnancies complicated by alcohol-use disorders, or were published in a language other than English. A systematic search of five electronic databases (PubMed, Embase, CINAHL, Web of Science, and Scopus) was conducted. Risk of bias was assessed using the Effective Public Health Practice Project quality assessment tool. Results were synthesised using MetaXL. Data from 16 separate birth cohorts (n = 78 articles) were included. Included cohorts were either general cohorts that included alcohol as a variable or alcohol-focused cohorts that were designed with a primary focus on PAE. PAE prevalence was estimated as 48% (95% CI: 38 to 57%). When subgroup analysis was performed, estimates of PAE prevalence when self-administered surveys and interviews were used for data collection were 53% (95% CI: 41% to 64%) and 43% (95% CI: 28% to 59%), respectively. Use of trained assessors was an influencing factor of the prevalence estimates when data were collected via interview. Alcohol-focused studies reported higher prevalence of PAE, regardless of method of survey administration. Where interviewer training is not possible, self-administered questionnaires will likely provide the most reliable PAE estimates. No funding sources are relevant to mention. Review was registered with PROSPERO (CRD42020204853).

Anxiety disorders and age-related changes in physiology

BACKGROUND

Anxiety disorders are leading contributors to the global disease burden, highly prevalent across the lifespan and associated with substantially increased morbidity and early mortality.

AIMS

The aim of this study was to examine age-related changes across a wide range of physiological measures in middle-aged and older adults with a lifetime history of anxiety disorders compared with healthy controls.

METHOD

The UK Biobank study recruited >500 000 adults, aged 37-73, between 2006 and 2010. We used generalised additive models to estimate non-linear associations between age and hand-grip strength, cardiovascular function, body composition, lung function and heel bone mineral density in a case group and in a control group.

RESULTS

The main data-set included 332 078 adults (mean age 56.37 years; 52.65% females). In both sexes, individuals with anxiety disorders had a lower hand-grip strength and lower blood pressure, whereas their pulse rate and body composition measures were higher than in the healthy control group. Case-control group differences were larger when considering individuals with chronic and/or severe anxiety disorders, and differences in body composition were modulated by depression comorbidity status. Differences in age-related physiological changes between females in the anxiety disorder case group and healthy controls were most evident for blood pressure, pulse rate and body composition, whereas this was the case in males for hand-grip strength, blood pressure and body composition. Most differences in physiological measures between the case and control groups decreased with increasing age.

CONCLUSIONS

Findings in individuals with a lifetime history of anxiety disorders differed from a healthy control group across multiple physiological measures, with some evidence of case-control group differences by age. The differences observed varied by chronicity/severity and depression comorbidity.

Influence of Initial Severity of Depression on the Effectiveness of a Multimodal Therapy on Depressive Score, Heart Rate Variability, and Hemodynamic Parameters

Depression is a major cause of disability among populations worldwide. Apart from primary symptoms, depressed patients often have a higher cardiovascular risk profile. Multimodal therapy concepts, including exercise, have emerged as promising approaches that not only improve depressive symptoms but also have a positive impact on cardiovascular risk profile. However, controversies have arisen concerning the influence of baseline severity on the effects of therapy concepts for this demographic. This study assessed whether pretreatment severity moderates psychological and physiological treatment outcomes of a multimodal therapy. A total of 16 patients diagnosed with mild depression (MD) and 14 patients diagnosed with severe depression (SD) took part in a 3-month outpatient multimodal treatment therapy. Before and after the treatment, depression score (Beck Depression Inventory (BDI)), peripheral systolic (pSBP) and diastolic (pDBP) blood pressure, central systolic (cSBP) and diastolic (cDBP) blood pressure, pulse wave velocity (PWV), heart rate (HR), and parasympathetic parameters of heart rate variability (RMSSD) were assessed. Significant time effects were detected for BDI (−20.0 ± 11.6, p > 0.001, η2 = 0.871), pSBP (−4.7 ± 6.8 mmHg, p < 0.001, η2 = 0.322), pDBP (−3.5 ± 6.9 mmHg, p = 0.01, η2 = 0.209), cSBP (−4.8 ± 6.5 mmHg, p < 0.001, η2 = 0.355), cDBP (−3.6 ± 6.8 mmHg, p = 0.008, η2 = 0.226), PWV (−0.13 ± 0.23 m/s, p = 0.008, η2 = 0.229), HR (4.3 ± 8.8 min−1, p = 0.015, η2 = 0.193), RMSSD (−12.2 ± 23.9 ms, p = 0.017, η2 = 0.251), and and SDNN (10.5 ± 17.8 ms, p = 0.005, η2 = 0.330). Significant time × group interaction could be revealed for BDI (p < 0.001, η2 = 0.543), with patients suffering from SD showing stronger reductions. Pretreatment severity of depression has an impact on the effectiveness of a multimodal therapy regarding psychological but not physiological outcomes.

Anxiety is associated with higher blood pressure rise induced by cuff inflation

SUBJECTS

To assess whether anxiety is associated with a higher rise of blood pressure induced by cuff inflation.

METHODS

At first, intro-aortic blood pressure was continuously record before cuff inflation as baseline value in 234 patients underwent coronary angiography, then the cuff was inflated to 200 mmHg and the intro-aortic blood pressure was record again as cuff inflation blood pressure. According to anxiety score, the patients were divided into anxiety group, subanxiety group, and nonanxiety group. The difference between the baseline blood pressure and the cuff inflation blood pressure was calculated as cuff inflation-induced blood pressure elevation. When the difference ≥10 mmHg, cuff inflation-induced blood pressure elevation was diagnosed.

RESULTS

The cuff inflation systolic blood pressure (134.9 ± 22.4 versus 131.6 ± 22.3  mmHg, P < 0.01) and diastolic blood pressure (80.5 ± 11.9 versus 78.4 ± 11.6 mmHg, P < 0.01) were significantly higher than the baseline values, thus the mean cuff inflation-induced blood pressure elevation on systolic blood pressure was 3.3 ± 4.7 mmHg and that on diastolic blood pressure was 2.1 ± 4.9 mmHg. The anxiety subgroup had significantly higher percentage increase-systolic blood pressure and percentage increase-diastolic blood pressure levels (4.5 ± 3.1% and 5.6 ± 6.3%) than the nonanxiety subgroup (1.9 ± 3.3% and 2.0 ± 6.5%), meanwhile these values in the subanxiety subgroup were higher (3.2 ± 4.1% and 3.4 ± 5.7%) than the nonanxiety subgroup.

CONCLUSION

Cuff inflation can induce a transient rise of intro-aortic blood pressure. Anxiety is associated with higher cuff inflation-induced blood pressure elevation.

Esansiyel Hipertansiyon Tanılı Hastaların Üstbilişsel Süreçlerinin İncelenmesi: Vaka-Kontrol Çalışması

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

Depression and hypertension awareness, treatment, and control in a multiethnic population in the Netherlands: HELIUS study

Individuals belonging to ethnic minority groups are more susceptible to depression and comorbid hypertension than European host populations. Yet, data on how depression is related to hypertension in ethnic groups in Europe are lacking. Therefore, we studied the association between significant depressed mood (SDM) and hypertension prevalence, awareness, treatment, and control among ethnic groups. Data from the HELIUS study included 22,165 adults (aged 18-70) from six ethnic backgrounds in the Netherlands. Logistic regression analysis was used to explore the association between SDM and hypertension prevalence, awareness, treatment, and control with adjustment for age, sex, and for sensitivity analysis purposes also for anti-depressants. After adjustment for age and sex, Dutch with SDM had an increased odds of hypertension (OR 95% CI 1.67; 1.08-2.59). Among Turkish, SDM was associated with higher odds of hypertension awareness (2.09; 1.41-3.09), treatment (1.92; 1.27-2.90) and control (1.72; 1.04-2.83). Among Moroccans, SMD was associated with an increased odds of hypertension awareness (1.91; 1.14-3.21) but decreased odds of hypertension control (0.42; 0.20-0.89). Additional adjustment for anti-depressant medications did not change the results. There were no associations between SDM and hypertension, awareness, treatment and control in South-Asian Surinamese, African Surinamese and Ghanaian participants. The results underline significant differences in the association between SDM and hypertension awareness, treatment and control between ethnic groups. Our findings emphasize the necessity to further study ethnicity-related factors that may influence the association between SDM and hypertension to promote hypertension control especially, among Moroccans with SDM.

Associations between depressive symptom profiles and immunometabolic characteristics in individuals with depression and their siblings

OBJECTIVES

The present study examined associations between immunometabolic characteristics (IMCs) and depressive symptom profiles (DSPs) in probands with lifetime diagnoses of depression and/or anxiety disorders and their siblings.

METHODS

Data were from the Netherlands Study of Depression and Anxiety, comprising 256 probands with lifetime diagnoses of depression and/or anxiety and their 380 siblings. Measured IMCs included blood pressure, waist circumference, and levels of glucose, triglycerides, HDL cholesterol, CRP, TNF-α and IL-6. DSPs included mood, cognitive, somatic and atypical-like profiles. We cross-sectionally examined whether DSPs were associated with IMCs within probands and within siblings, and whether DSPs were associated with IMCs between probands and siblings.

RESULTS

Within probands and within siblings, higher BMI and waist circumference were associated with higher somatic and atypical-like profiles. Other IMCs (IL-6, glucose and HDL cholesterol) were significantly related to DSPs either within probands or within siblings. DSPs and IMCs were not associated between probands and siblings.

CONCLUSIONS

The results suggest that there is a familial component for each trait, but no common familial factors for the association between DSPs and IMCs. Alternative mechanisms, such as direct causal effects or non-shared environmental risk factors, may better fit these results.

Sex differences in the associations between blood pressure and anxiety and depression scores in a middle-aged and elderly population: The Irish Longitudinal Study on Ageing (TILDA)

BACKGROUND

Anxiety and depression are considered risk factors for cardiovascular diseases (CVDs), but their relationship to blood pressure (BP) is still uncertain. Lifestyle factors and age-related comorbidities may confound these relationships. Our study aimed to evaluate the associations between BP and anxiety and depression scores in a population aged ≥49 years.

METHODS

Data on 8504 participants from The Irish Longitudinal Study on Ageing (TILDA) were analyzed for associations between BP and anxiety and depression questionnaire scores, accounting for relevant confounding factors.

RESULTS

Multivariable analyses showed negative associations between systolic BP and anxiety and depression scores, independent of age, body mass index (BMI), marital status, education level, smoking status, alcohol consumption, level of physical activity, self-reported CVDs (≥2) and antihypertensive medication use in men (coefficient=-0.112, P=0.013; coefficient=-0.051, P=0.026) but not in women (coefficient=-0.001, P=0.855; coefficient=-0.005, P=0.556). Diastolic BP was not associated with anxiety or depression scores in either men (coefficient=-0.018, P=0.223; coefficient=-0.001, P=0.924) or women (coefficient=-0.007, P=0.338; coefficient=-0.015, P=0.293) after adjusting for these same confounding factors. After a follow-up of 4 years, lower BP in subjects not using antihypertensive medications was significantly associated with more anxiety and depression events.

LIMITATION

Time-varying confounding factors may have interfered with our results.

CONCLUSION

Our results show that systolic BP in a middle-aged and elderly population is negatively associated with anxiety and depression scores in men but not women after adjustment for a range of lifestyle factors. These results contrast with the predisposition of anxious or depressed participants to CVDs in later life when decades of unhealthy lifestyles have persisted.

Cardiac vagal control mediates the relation between past depression and blood pressure several years later among young adults

Depression has been associated with high blood pressure (BP). However, the mechanisms of the relation between depression and high BP are unclear. We therefore examined whether impaired cardiac vagal control, indexed as low levels of resting respiratory sinus arrhythmia (RSA), serves as a route from depression to high BP. The sample included 125 subjects with histories of depression (probands), 123 never depressed siblings of probands (high-risk siblings), and 156 controls. Resting RSA was assessed at Time 1 (T1) along with BP when subjects were adolescents (M_age  = 16.3 years); systolic and diastolic BP (SBP and DBP) were measured again at Time 2 (T2) when subjects were young adults (M_age  = 22.3 years). Linear mixed-effects models were used to examine the group differences in resting RSA and T2 BP outcomes and to test for RSA mediation of the relation between depression (history or being at high risk) and BP. Resting RSA was lower among probands than controls but was similar among high-risk siblings and controls, while the subject groups did not differ in T2 SBP or DBP. Controlling for T1 BP, depression history indirectly affected T2 DBP (but not SBP) through resting RSA. The findings suggest that, although the direct detrimental effects of depression on BP are not yet evident in young adulthood, among those with depression histories, impaired cardiac vagal control appears to serve as a mechanism of elevated DBP.

Hypertension prevalence in patients attending tertiary pain management services, a registry-based Australian cohort study

Persistent pain and hypertension often co-occur, and share several biological and lifestyle risk factors. The present study aimed to provide insight into the prevalence of, and factors associated with, hypertension in the largest cohort of patients seeking treatment in 43 tertiary pain clinics in Australia. Adults aged > = 18 years registered to the electronic Persistent Pain Outcomes Collaboration registry between 2013 and 2018 were included if they had persistent non-cancer pain (N = 43,789). Risk Ratios (RRs) compared prevalence of self-reported hypertension with the general and primary care Australian populations, and logistic regression examined factors associated with hypertension. One in four (23.9%) patients had hypertension, which was higher than the Australian adult population (2014–15: RR = 5.86, 95%CI: 5.66, 6.06; 2017–18: RR = 9.40, 95%CI: 9.01, 9.80), and in primary care patients (2011–13: RR = 1.17, 95%CI: 1.15, 1.20). Adjusting for covariates, patients with higher odds of hypertension were older, lived in regions with higher socioeconomic disadvantage, had higher levels of BMI, were born outside the Oceania/Australasia region, and had comorbid arthritis, diabetes, or severe-extremely severe anxiety symptoms. Female patients and those with depression symptoms had lower adjusted odds. Unadjusted analyses showed an association between widespread pain, pain duration, pain severity and interference, and lower pain self-efficacy with hypertension; however, only pain severity remained significant in adjusted analyses. Hypertension was more prevalent in people with persistent pain than in the general community, was associated with more severe pain, and commonly co-occurred with pain-related impairments. Routine hypertension screening and treatment targeting shared mechanisms of hypertension and pain may improve treatment outcomes in the pain clinic setting.

Metabolomic evidence for the therapeutic effect of gentiopicroside in a corticosterone-induced model of depression

BACKGROUND

Depression is a disease that seriously threatens the quality of human life. To explore the effect of gentiopicroside on depression, this study investigated the therapeutic effect of gentiopicroside on corticosterone-induced depressionin vivo and in vitro by using metabolomic methods.

METHODS

A total of 36 rats were randomly assigned to three groups: a normal group, model group (depression), and treatment group (depression + gentiopicroside). Corticosterone was administrated to induce depression-like model rats. Morris water maze test was used to validated the behavior performance. The hippocampus of rats was obtained for metabolomic detection. Metabolites that were differentially expressed between the groups were extracted for Heatmap, Go, and pathway enrichment analyses. Finally, neuronal cells were cultured and examined to validated the effect of gentiopicroside.

RESULTS

Corticosterone injured rats learning capacity, and decreased the levels of 5-HT, and reversed by gentiopicroside delivery. Metabolites obtained from the hippocampus of rats in the three groups were subjected to a principal component analysis (PCA). Go and pathway enrichment analyses revealed the involvement of sphingolipid metabolism et al. Gentiopicroside could inhibit apoptosis caused by corticosterone, and also decrease neuronal cell proliferation and BDNF levels in vitro. Arachidonic acid (ARA) reversed the protective effect of gentiopicroside on neuronal cells.

CONCLUSION

These findings suggest that gentiopicroside reduces apoptosis and increases the proliferation of hippocampus cells in depressed animals by regulating metabolites. Moreover, our study provides a new basis for the clinical treatment of depression and demonstrates the potential efficacy of gentiopicroside in this area of pathology.

MEMRI reveals altered activity in brain regions associated with anxiety, locomotion, and cardiovascular reactivity on the elevated plus maze in the WKY vs SHR rats

Individuals with anxiety/depression often have exaggerated cardiovascular responses to stressful stimuli and a comorbidity with hypertension. Alternatively, individuals with hypertension can be more anxious. In the present study cardiovascular changes were evaluated during behavioral testing of anxious behavior on the elevated plus maze (EPM) in the spontaneously hypertensive rat (SHR), a rodent model of neurogenic hypertension, and compared to the response of the more anxious, but normotensive, Wistar-Kyoto rat (WKY). Manganese-enhanced magnetic resonance imaging (MEMRI) was used to identify regional differences in baseline brain activity. Parallel to indicators of elevated behavioral anxiety on the EPM, WKYs had a greater increase in blood pressure but not heart rate when compared to the SHR while on the EPM. Associated with differences in anxiety-related behavior and autonomic responses, we observed increased baseline activity in the amygdala, central gray, habenula and interpeduncular nucleus with MEMRI of the WKY compared to the SHR. Conversely, elevated baseline brain activity was found in regions associated with blood pressure control and system arousal, including the hypothalamus, locus coeruleus and pedunculopontine tegmental nucleus, in the SHR vs WKY, in-line with increased resting blood pressure and increased mobility in this strain. Lastly, reduced activity in hippocampal regions was identified in the SHR compared to the WKY and may be associated with cognitive impairment previously reported in the SHR. Thus, autonomic reactivity may be a true measure of stress in rodent models of anxiety and MEMRI presents a powerful technique to uncover novel brain mechanisms of blood pressure control.

Music therapy intervention in cardiac autonomic modulation, anxiety, and depression in mothers of preterms: randomized controlled trial

Background

Mothers of preterm infants often have symptoms of anxiety and depression, recognized as risk factors for the development of cardiovascular diseases and associated with low rates of heart rate variability (HRV). This study aimed to evaluate the influence of music therapy intervention on the autonomic control of heart rate, anxiety, and depression in mothers.

Methods

Prospective randomized clinical trial including 21 mothers of preterms admitted to the Neonatal Intensive Care Unit of a tertiary hospital, recruited from August 2015 to September 2017, and divided into control group (CG; n = 11) and music therapy group (MTG; n = 10). Participants underwent anxiety and depression evaluation, as well as measurements of the intervals between consecutive heartbeats or RR intervals for the analysis of HRV at the first and the last weeks of hospitalization of their preterms. Music therapy sessions lasting 30–45 min were individually delivered weekly using receptive techniques. The mean and standard deviation of variables were obtained and the normality of data was analyzed using the Kolmogorov-Smirnov test. The paired sample t-test or Wilcoxon test were employed to calculate the differences between variables before and after music therapy intervention. The correlations anxiety versus heart variables and depression versus heart variables were established using Spearman correlation test. Fisher’s exact test was used to verify the differences between categorical variables. A significance level of p < 0.05 was established. Statistical analysis were performed using the Statistical Package for the Social Sciences, version 20.

Results

Participants in MTG had an average of seven sessions of music therapy, and showed improvement in anxiety and depression scores and autonomic indexes of the time domain (p < 0.05). Significant correlations were found between depression and parasympathetic modulation using linear (r = − 0.687; p = 0.028) and nonlinear analyses (r = − 0.689; p = 0.027) in MTG.

Conclusion

Music therapy had a significant and positive impact on anxiety and depression, acting on prevention of cardiovascular diseases, major threats to modern society.

Trial registration

Brazilian Registry of Clinical Trials (no. RBR-3x7gz8). Retrospectively registered on November 17, 2017.