Editor: My mother is 58 years old and has high blood pressure for many years. Recently 1 year, my mood has obviously become anxious, especially worried about whether I will have a cerebral infarction or not. I'm not in the mood to do anything at home. I often suffer from insomnia at night and my blood pressure is more unstable. Excuse me, is this another disease similar to anxiety or depression? Is this related to hypertension?

Zhejiang Tian ××

Tian Reader: Hello!

Your mother's condition is not uncommon in clinic. Clinical practice and many studies show that hypertension, emotional anxiety and depression are interrelated.

Hypertension is easily accompanied by emotional anxiety and depression.

Although there are many antihypertensive drugs available for treatment, they are still difficult to cure in the end, and various complications may occur with the progress of the disease. Anxiety and depression are one of the most common psychological complications.

Statistics show that the incidence of hypertension complicated with anxiety and depression is 45.09% and 6.33% respectively, and the prevalence of hypertension complicated with anxiety and depression in the elderly is 28.3%. The prevalence of pregnancy-induced hypertension complicated with anxiety and depression is also higher than that of normal pregnant women. According to foreign data, the prevalence rate of hypertension with anxiety and depression is 15%-50%, and women are significantly higher than men, with a ratio of about 3: 5.

Patients with hypertension may be anxious because they pay too much attention to and worry about their illness, or they may be anxious because they are afraid of possible stroke, and even have fear of death or hypochondria. People with long course of disease and pessimistic personality are prone to depression, coupled with the lack of understanding of their own illness and knowledge of hypertension prevention and treatment, and the negative psychology of poor prognosis, which can lead to severe depression. Clinically, some people call this kind of hypertension with anxiety and depression as anxiety and depression hypertension.

Anxiety and depression are one of the risk factors of hypertension

After 7 ~ 16 years' follow-up of 2992 cases with normal blood pressure, it was found that the risk of hypertension in people with high depression score was twice as high as that in people without depression. The risk of severe depression in patients with hypertension is 3-5 times that of normal people. In another study, 2 149 male patients with cardiovascular diseases were followed up for 10-20 years, and it was found that 42% patients with hypertension were in a state of high anxiety. It is suggested that anxiety and depression may be independent risk factors of hypertension.

Emotional anxiety can lead to a transient increase in blood pressure by increasing cardiac output and vascular resistance, and the average values of systolic blood pressure and diastolic blood pressure increase, so that the increased blood pressure tends to be stable and hypertension is formed over time. Anxiety can not only raise the blood pressure of people without hypertension, but also keep the blood pressure of patients with hypertension at a high level, which affects the efficacy of antihypertensive drugs. Anger is also closely related to high blood pressure. The average diastolic blood pressure increased in small anger, and the average systolic blood pressure and diastolic blood pressure increased in great anger.

The relationship between depression and hypertension is generally considered to have the same risk factor, namely stress. In addition to genetic and other biological factors, depression can also be induced by bad life events (psychological stress). Hypertension is also a psychosomatic disease, which can also be caused by some social and psychological factors (psychological stress). Some people with depression. Some people think that depression has nothing to do with hypertension, because patients with depression lack motivation and vitality, are depressed, talk less and exercise less, and their blood pressure and other physiological indicators drop. However, most studies show that hypertension and depression are mutual risk factors, and the incidence and severity of depression in hypertensive patients are significantly higher than that in non-hypertensive patients.

Pay attention to the related side effects of antihypertensive drugs and antidepressants.

The use of some antihypertensive drugs may cause emotional depression and anxiety, which should be paid attention to. For example, the antihypertensive drug reserpine can make about 65,438+0/4 patients feel depressed, while antihypertensive drugs such as Naylor, mecamylamine and methyldopa can cause different degrees of emotional anxiety and depression.

For hypertensive patients with anxiety or depression symptoms, some anti-anxiety and anti-depression drugs can be used at the same time. However, it should be noted that some of these drugs, such as some tricyclic drugs and monoamine oxidase inhibitors, have a complicated relationship with blood pressure, which sometimes causes postural hypotension or blood pressure increase during use, so they should be used with caution and observed. Among the new antidepressants used in recent years, some varieties such as venlafaxine can also raise blood pressure. It is reported that it can raise the blood pressure of 24% normotensive people and 54% hypertensive patients, so it should be used with caution in clinical practice.

Patients with anxiety-depression hypertension should use some anti-anxiety and anti-depression drugs, which can not only improve anxiety and depression, but also help to control hypertension. For patients with essential hypertension who have no anxiety symptoms, it is also argued that comprehensive psychotherapy with small doses of anti-anxiety drugs will achieve better results than simple antihypertensive drugs.