Klinik Araştırma
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Hipertansiyon Hastalarında Obezite ve Depresyonun Değerlendirilmesi

Yıl 2024, Cilt: 14 Sayı: 2, 232 - 238, 22.05.2024
https://doi.org/10.33631/sabd.1416300

Öz

Amaç: Hipertansiyon, dünyada önlenebilir ölüm nedenlerinin arasında en sık karşılaşılanların başında gelir. Anksiyete ve depresyon semptomlarının da hipertansiyon gelişimine önemli katkısı olduğu daha önce birçok çalışmada araştırılmıştır. Ancak, çalışmaların sonucunda farklılıklar gözlenmiştir. Hipertansiyona neden olan en önemli risk faktörlerinden birisi obezitedir. Biz bu çalışmamızda Düzce Üniversitesi Aile Hekimliği polikliniğine başvuran hastalarda, vücut kitle indeksi (VKİ) ve Hamilton depresyon skorunun kan basıncı üzerine olan etkisinin araştırılması amaçlandı.
Gereç ve Yöntemler: Bu kesitsel çalışmaya, Düzce Üniversitesi Aile Hekimliği polikliniğine başvuran ve obezite tanısı konan 228 hasta çalışmaya dahil edildi. Hastaların VKİ ve Hamilton depresyon skorları hesaplanarak, sistolik ve diastolik kan basınçları ile olan ilişkileri incelendi.
Bulgular: Çalışmaya dahil edilen hastaların 28‘i erkek (%12), 200‘ü kadın (%88) idi. Çalışmamızda cinsiyet, meslek durumu, öğrenim durumu ve sigara içiciliğinin HAMD depresyon puanı üzerine anlamlı etkisi olmadığı saptandı. Çalışmaya dahil edilen 228 hastanın Hamilton depresyon puanı incelendi. 182 (%79,8) hastada depresyon saptanmadı. 35 hastada (%15,3) minör depresyon saptandı. 11 hastada (%4,8) majör depresyon saptandı. Hamilton depresyon skoru artışının sistolik kan basıncında artışı üzerine istatistiksel olarak anlamlı etkisi olduğu saptandı (p=0,017).
Sonuç: Elde edilen bulgulara göre, VKİ ve Hamilton depresyon skoru artışının kan basıncı artışı ile ilişkili olabileceği saptandı. Hipertansiyon hastalarına bütünsel yaklaşımlar önemlidir. Hastaların yaşam tarzı, alışkanlıkları, mevcut kilo durumu ve psikolojik stres durumları ayrıntılı olarak incelenmelidir. Bu da bize gösteriyor ki, aile hekimliğinin hastalara biyopsikososyal olarak bütünsel yaklaşımı hipertansiyon korunması ve tedavisinde önemli bir rol oynamaktadır.

Kaynakça

  • Keil U, Kuulasmaa K. WHO MONICA project: risk factors. Int J Epidemiol. 1989; 18(3 Suppl 1): 46-55.
  • Narkiewicz K. Obesity-related hypertension: relevance of vascular responses to mental stress. J Hypertens. 2002; 20(7): 1277-8.
  • Ruthledge T, Hogan BE. A quantitative review of prospective evidence linking psychological factors with hypertension development. Psychosom Med. 2002; 64(5): 758-66.
  • Meng L, Chen D, Yang Y, Zheng Y, Hui R. Depression increases the risk of hypertension incidence: a meta-analysis of prospective cohort studies. J Hypertens. 2012; 30(5): 842-51.
  • Stamler J, Rose G, Stamler R, Elliott P, Dyer A, Marmot M. INTERSALT study findings. Public health and medical care implications. Hypertension. 1989; 14(5): 570-7.
  • Hatemi H, Yumuk VD, Turan N, Arik N. Prevalence of overweight and obesity in Turkey. Metab Syndr Relat Disord. 2003; 1(4): 285-90.
  • Brown CD, Higgins M, Donato KA, Rohde FC, Garrison R, Obarzanek E, et al. Body mass index and the prevalence of hypertension and dyslipidemia. Obes Res. 2000; 8(9): 605-19.
  • Matthews KA, Katholi CR, McCreath H, Whooley MA, Williams DR, Zhu S, et al. Blood pressure reactivity to psychological stress predicts hypertension in the cardia study. Circulation. 2004; 110(1): 74-8.
  • Kabir AA, Whelton PK, Khan MM, Gustat J, Chen W. Association of symptoms of depression and obesity with hypertension: The bogalusa heart study. Am J Hypertens. 2006; 19(6): 639-45.
  • Licht CM, de Geus EJ, Seldenrijk A, van Hout HP, Zitman FG, van Dyck R, et al. Depression is associated with decreased blood pressure, but antidepressant use increases the risk for hypertension. Hypertension. 2009; 53(4): 631-8.
  • Rutledge T, Hogan BE. A quantitative review of prospective evidence linking psychological factors with hypertension development. Psychosom Med. 2002; 64(5): 758-66.
  • Gangwisch JE, Malaspina D, Posner K, Babiss LA, Heymsfield SB, Turner JB, et al. Insomnia and sleep duration as mediators of the relationship between depression and hypertension incidence. Am J Hypertens. 2010; 23(1): 62-9.
  • Yan LL, Liu K, Matthews KA, Daviglus ML, Ferguson TF, Kiefe CI. Psychosocial factors and risk of hypertension: The coronary artery risk development in young adults (cardia) study. JAMA. 2003; 290(16): 2138-48.
  • Shinn EH, Poston WS, Kimball KT, St Jeor ST, Foreyt JP. Blood pressure and symptoms of depression and anxiety: A prospective study. Am J Hypertens. 2001; 14(7 Pt 1): 660-4.
  • Ganatra HA, Zafar SN, Qidwai W, Rozi S. Prevalence and predictors of depression among an elderly population of Pakistan. Aging Ment Health. 2008; 12(3): 349-356.
  • Chan S, Chiu H, Chien WT, Thompson DR, Lam L. Quality of life in Chinese older people with depression. Int J Geriatr Psychiatry. 2006; 21(4): 312-8.
  • Garcia-Pena C, Wagner FA, Sanchez-Garcia S, Juarez-Cedillo T, Espinel-Bermudez C, Garcia-Gonzalez JJ, et al. Depressive symptoms among older adults in Mexico city. J Gen Intern Med 2008; 23(12): 1973-80.
  • Patten SB, Williams JV, Lavorato DH, Campbell NR, Eliasziw M, Campbell TS. Major depression as a risk factor for high blood pressure: epidemiologic evidence from a national longitudinal study. Psychosom Med. 2009; 71(3): 273-9.
  • Hermann N, Jean-François C, Thomas L, Aline D, Maria M, Michael GM, et al. rajectories of depressive episodes and hypertension over 24 years: the Whitehall II prospective cohort study. Hypertension. 2011; 57(4): 710-6.
  • Andreia ZS, Monica ZS, Joao BS, Francisco LN. Hypertension and depression, Clinics. 2005; 60(3): 241-50.

Evaluation of the Obesity and Depression in Hypertensive Patients

Yıl 2024, Cilt: 14 Sayı: 2, 232 - 238, 22.05.2024
https://doi.org/10.33631/sabd.1416300

Öz

Aim: Hypertension is one of the most common preventable causes of death in the world. In previous studies, the contribution of anxiety and depression symptoms in hypertension was investigated, but results were unclear. Obesity is one of the most important risk factors that leads to hypertension. In this study, we aimed to investigate the effect of body mass index (BMI) and Hamilton depression score on blood pressure in patients who comes to the Family Medicine Unit in Duzce University.
Material and Methods: In this sectional study, 228 people diagnosed with obesity were included who admitted Duzce University family medicine unit. The relationship between BMI and Hamilton depression scores with systolic and diastolic blood pressure were studied in patients.
Results: 200 of the patients (88%) enrolled in the study were women, and 28 of them (%12) were men. In our study, there was not significant effect of gender, occupational status, educational status and smoking on Hamilton depression score. Hamilton depression scores were analyzed in 228 patients, there was no depression in 182 patient (79.8%). Minor depression was detected in 35 patient (15.3%), major depresssion was found in 11 patients (4.8%). Increasing in The Hamilton depression score had a statistically significant effect on the increase in systolic blood pressure (p=0.017).
Conclusion: According to these results, increasing BMI and Hamilton depression score were found to be associated with blood pressure increase. Holistic approaches to hypertensive patients are very important. Patient’s lifestyle, habits, current weight and psychological stress status should be examined in detail. This shows us that biopsychosocial holistic approach of family medicine unit to patient plays an important role in the prevention and treatment of hypertension.

Kaynakça

  • Keil U, Kuulasmaa K. WHO MONICA project: risk factors. Int J Epidemiol. 1989; 18(3 Suppl 1): 46-55.
  • Narkiewicz K. Obesity-related hypertension: relevance of vascular responses to mental stress. J Hypertens. 2002; 20(7): 1277-8.
  • Ruthledge T, Hogan BE. A quantitative review of prospective evidence linking psychological factors with hypertension development. Psychosom Med. 2002; 64(5): 758-66.
  • Meng L, Chen D, Yang Y, Zheng Y, Hui R. Depression increases the risk of hypertension incidence: a meta-analysis of prospective cohort studies. J Hypertens. 2012; 30(5): 842-51.
  • Stamler J, Rose G, Stamler R, Elliott P, Dyer A, Marmot M. INTERSALT study findings. Public health and medical care implications. Hypertension. 1989; 14(5): 570-7.
  • Hatemi H, Yumuk VD, Turan N, Arik N. Prevalence of overweight and obesity in Turkey. Metab Syndr Relat Disord. 2003; 1(4): 285-90.
  • Brown CD, Higgins M, Donato KA, Rohde FC, Garrison R, Obarzanek E, et al. Body mass index and the prevalence of hypertension and dyslipidemia. Obes Res. 2000; 8(9): 605-19.
  • Matthews KA, Katholi CR, McCreath H, Whooley MA, Williams DR, Zhu S, et al. Blood pressure reactivity to psychological stress predicts hypertension in the cardia study. Circulation. 2004; 110(1): 74-8.
  • Kabir AA, Whelton PK, Khan MM, Gustat J, Chen W. Association of symptoms of depression and obesity with hypertension: The bogalusa heart study. Am J Hypertens. 2006; 19(6): 639-45.
  • Licht CM, de Geus EJ, Seldenrijk A, van Hout HP, Zitman FG, van Dyck R, et al. Depression is associated with decreased blood pressure, but antidepressant use increases the risk for hypertension. Hypertension. 2009; 53(4): 631-8.
  • Rutledge T, Hogan BE. A quantitative review of prospective evidence linking psychological factors with hypertension development. Psychosom Med. 2002; 64(5): 758-66.
  • Gangwisch JE, Malaspina D, Posner K, Babiss LA, Heymsfield SB, Turner JB, et al. Insomnia and sleep duration as mediators of the relationship between depression and hypertension incidence. Am J Hypertens. 2010; 23(1): 62-9.
  • Yan LL, Liu K, Matthews KA, Daviglus ML, Ferguson TF, Kiefe CI. Psychosocial factors and risk of hypertension: The coronary artery risk development in young adults (cardia) study. JAMA. 2003; 290(16): 2138-48.
  • Shinn EH, Poston WS, Kimball KT, St Jeor ST, Foreyt JP. Blood pressure and symptoms of depression and anxiety: A prospective study. Am J Hypertens. 2001; 14(7 Pt 1): 660-4.
  • Ganatra HA, Zafar SN, Qidwai W, Rozi S. Prevalence and predictors of depression among an elderly population of Pakistan. Aging Ment Health. 2008; 12(3): 349-356.
  • Chan S, Chiu H, Chien WT, Thompson DR, Lam L. Quality of life in Chinese older people with depression. Int J Geriatr Psychiatry. 2006; 21(4): 312-8.
  • Garcia-Pena C, Wagner FA, Sanchez-Garcia S, Juarez-Cedillo T, Espinel-Bermudez C, Garcia-Gonzalez JJ, et al. Depressive symptoms among older adults in Mexico city. J Gen Intern Med 2008; 23(12): 1973-80.
  • Patten SB, Williams JV, Lavorato DH, Campbell NR, Eliasziw M, Campbell TS. Major depression as a risk factor for high blood pressure: epidemiologic evidence from a national longitudinal study. Psychosom Med. 2009; 71(3): 273-9.
  • Hermann N, Jean-François C, Thomas L, Aline D, Maria M, Michael GM, et al. rajectories of depressive episodes and hypertension over 24 years: the Whitehall II prospective cohort study. Hypertension. 2011; 57(4): 710-6.
  • Andreia ZS, Monica ZS, Joao BS, Francisco LN. Hypertension and depression, Clinics. 2005; 60(3): 241-50.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri (Diğer)
Bölüm Araştırma Makaleleri
Yazarlar

Gülşah Aktüre 0000-0002-8389-5174

Osman Kayapinar 0000-0001-6607-895X

Cem Özde 0000-0001-8846-9185

Gökhan Coşkun 0000-0002-3587-9612

Ahmet Egemen Sayın 0000-0002-4172-561X

Ensar Ekşi 0000-0003-0136-2989

Yayımlanma Tarihi 22 Mayıs 2024
Gönderilme Tarihi 12 Ocak 2024
Kabul Tarihi 3 Nisan 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 14 Sayı: 2

Kaynak Göster

Vancouver Aktüre G, Kayapinar O, Özde C, Coşkun G, Sayın AE, Ekşi E. Evaluation of the Obesity and Depression in Hypertensive Patients. SABD. 2024;14(2):232-8.