Page 44 - BH-3-1

Brain & Heart Depression, anxiety and blood pressure control

Laboratory data: estimated glomerular filtration rate Table 2. Diagram of data collection at baseline and follow-up
according to Cockroft or modification of diet in renal
disease equation, low-density lipoprotein, high-density Baseline Follow-up Follow-up
lipoprotein, triglyceride, total cholesterol, very low-density Time 1 – 14 days 6 months 12 months
lipoprotein, glucose levels, uric acid, liver enzymes, whole Informed consent 
blood count, and C-reactive protein. Medical history 
Ambulatory BP measurement data: Ambulatory BP Clinical examination 
measurements will be recorded during a working day Somatometric  
(Monday through Friday) using the automatic Spacelabs HADS and SF-36  
unit 90207 (Redmond, WA), set to obtain automatic questionnaire
heart rate and BP readings at 15-min intervals during the Electrocardiogram  
daytime and at 30-min intervals during the nighttime. Home blood pressure  
Only recordings with at least 70% of valid readings over Treatment compliance
the 24-h period will be included in the final analysis.  
In accordance with current practice, daytime and Ambulatory blood pressure  
measurement
nighttime will be defined using short fixed-clock time
intervals, from 7 a.m. to 11 p.m. and from 11 p.m. to 7 Cardiac ultrasonography  
a.m., respectively. Automatic editing will be used. The Laboratory examination  
24-h, daytime, and nighttime systolic and diastolic BP Abbreviations: HADS: Hospitality anxiety and depression scale; SF-36
values will be the means of the respective 24-h, daytime, questionnaire: 36-item Short form survey instrument.
and nighttime recordings after artifact editing. Systolic
dipping will be defined as the percentage of nocturnal disturbance. The rationale for this – over 30 years ago – was
70
systolic BP reduction relative to diurnal levels. Using that fatigue and insomnia may arise from physical rather
specific software, subsequent parameters of short-term than mental illness. Finally, potential confounders could
BP variability will be calculated: standard deviation, affect the relationship between psychiatric intervention
weighted standard deviation, average real variability, and hypertension outcomes. Specifically, lifestyle changes
coefficient of variation, and time rates. such as smoking cessation and weight loss may positively
affect both diseases, whereas injuries, accidents, and
3.5. Follow-up
socioeconomic status changes may adversely influence
All patients with hypertension and high HADS scores, depression and hypertension.
irrespective of randomization, will complete the
HADS and quality-of-life questionnaires and undergo 4. Conclusion
electrocardiography, ambulatory BP measurement, Arterial hypertension, anxiety, and depression are closely
and cardiac ultrasonography after the 1-year follow-up related and contribute to increased global mortality.
(Table 2). Pathophysiological analysis supports this close relationship,

3.6. Limitations suggesting not only an epidemiologically proven link but
also a strong etiological connection between these factors.
First, the sample consisted of patients from only one This study presents a protocol that will initially focus on
hypertensive unit, and they participated in the study evaluating stress/depression levels and quality of life in
voluntarily. Second, not all patients will receive psychiatric patients with hypertension and their correlation with BP
interventions. Psychiatric intervention involves drugs and/ control and target organ damage. Then, this study will
or psychotherapy and is not the same for every participant assess the effect of subsequent psychiatric intervention on
due to the aforementioned ethical reasons. Moreover, a BP control, treatment compliance, and quality of life after
cutoff score of ≥11 on the HADS has low sensitivity for a follow-up period of 1 year in patients with hypertension
detecting clinical depression in different clinical settings. and high depression/stress levels.
69
When screening for major depression, a HADS cutoff
score of ≥7 maximizes combined sensitivity and specificity. Acknowledgments
A cutoff value of ≥7 generates similar combined sensitivity
and specificity but is less sensitive and more specific. None.
Furthermore, unlike other self-report questionnaires, Funding
such as the patient health questionnaire, the HADS does
not capture the somatic symptoms of fatigue and sleep None.

Volume 3 Issue 1 (2025) 7 doi: 10.36922/bh.4923