title: Anxiety, depression and autonomic nervous system dysfunction in hypertension.
abstract: OBJECTIVE
  This study examined the relationship between autonomic nervous system dysfunction, anxiety and depression in untreated hypertension.
  
  
  METHODS
  86 newly diagnosed hypertensive patients and 98 healthy volunteers were included in the study. The psychological parameters were assessed with Spielberger State-Trait Anxiety Inventory and Beck Depression Inventory by a skilled psychologist. Autonomic parameters were examined during tilt table examination (10min lying position, 10min passive tilt). Heart rate variability (HRV) was calculated by autoregressive methods. Baroreflex sensitivity (BRS) was calculated by non-invasive sequence method from the recorded beat to beat blood pressure values and RR intervals.
  
  
  RESULTS
  Significantly higher state (42.6±9.3 vs. 39.6±10.7 p=0.05) and trait (40.1±8.9 vs. 35.1±8.6, p<0.0001) anxiety scores were found in the hypertension group. There was no statistically significant difference in the depression level. LF-RRI (Low Frequency-RR interval) of HRV in passive tilt (377.3±430.6 vs. 494.1±547, p=0.049) and mean BRS slope (11.4±5.5 vs. 13.2±6.4, p=0.07) in lying position were lower in hypertensives. Trait anxiety score correlates significantly with sympatho/vagal balance (LF/HF-RRI) in passive tilt position (Spearman R=-0.286, p=0.01).
  
  
  CONCLUSIONS
  Anxiety could play a more important role than depression in the development of hypertension. Altered autonomic control of the heart could be one of the pathophysiological links between hypertension and psychological factors.
authors.affiliation: Department of Neurology, Mureş County Clinical Emergency Hospital, Târgu-Mureş, Romania. bzoltan2003@yahoo.com
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Bajkó
authors.forename: Csilla-Cecília
authors.initials: CC
authors.lastname: Szekeres
authors.forename: Katalin Réka
authors.initials: KR
authors.lastname: Kovács
authors.forename: Krisztina
authors.initials: K
authors.lastname: Csapó
authors.forename: Sándor
authors.initials: S
authors.lastname: Molnár
authors.forename: Pál
authors.initials: P
authors.lastname: Soltész
authors.forename: Erika
authors.initials: E
authors.lastname: Nyitrai
authors.forename: Mária Tünde
authors.initials: MT
authors.lastname: Magyar
authors.forename: László
authors.initials: L
authors.lastname: Oláh
authors.forename: Dániel
authors.initials: D
authors.lastname: Bereczki
authors.forename: László
authors.initials: L
authors.lastname: Csiba
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D001341:Autonomic Nervous System / Q000503:physiopathology*; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D018667:Tilt-Table Test / Q000379:methods