title: Depression and anxiety are associated with abnormal nocturnal blood pressure fall in hypertensive patients.
abstract: BACKGROUND
  Previous studies have shown that depression and anxiety were independent risk factors for hypertension. Non-dipper hypertension is associated with higher cardiovascular mortality. The aim of this study was to evaluate the anxiety and depression scores in patients with dipper and non-dipper hypertension.
  
  
  METHODS
  The study sample consisted of 153 hypertensive patients. All patients underwent 24-h blood pressure monitoring. Patients were classified into two groups according to their dipper or non-dipper hypertension status. We evaluated results of the Hospital Anxiety and Depression Scale between groups.
  
  
  RESULTS
  Seventy-eight patients (38 male, mean age: 51.6 ± 12.5 years) had dipper hypertension while 75 patients (27 male, mean age: 55.4 ± 14.1 years) had non-dipper hypertension (p = 0.141, 0.072, respectively). Clinical characteristics were similar for both groups. Patients with non-dipper hypertension had significantly higher depression and anxiety scores compared to patients with dipper hypertension. Dipper and non-dipper status significantly correlated with anxiety (p: 0.025, r: 0.181) and depression score (p: 0.001, r: 0.255). In univariate analysis, smoking, alcohol usage, presence of diabetes, hyperlipidemia, anxiety score >8 and depression score >7 were predictors of dipper versus non-dipper status. In multivariate logistic regression analyses only depression score >7 was independent predictor of dipper versus non-dipper status (odds ratio: 2.74, confidence intervals: 1.41-5.37). A depression score of 7 or higher predicted non-dipper status with a sensitivity of 62.7% and specificity of 62.8%.
  
  
  CONCLUSIONS
  Non-dipper patients have significantly higher anxiety and depression scores compared to dipper patients. Evaluation of anxiety and depression in patients with hypertension might help to detect non-dipper group and hence guide for better management.
authors.affiliation: Faculty of Medicine, Department of Cardiology, Marmara University , Istanbul , Turkey and.
authors.forename: Murat
authors.initials: M
authors.lastname: Sunbul
authors.forename: Esra Aydin
authors.initials: EA
authors.lastname: Sunbul
authors.forename: Selcen Dogru
authors.initials: SD
authors.lastname: Kosker
authors.forename: Erdal
authors.initials: E
authors.lastname: Durmus
authors.forename: Tarik
authors.initials: T
authors.lastname: Kivrak
authors.forename: Cigdem
authors.initials: C
authors.lastname: Ileri
authors.forename: Mustafa
authors.initials: M
authors.lastname: Oguz
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Sari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D001008:Anxiety Disorders / Q000150:complications / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D002940:Circadian Rhythm / Q000502:physiology; D003863:Depression / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
keywords: Anxiety; depression; dipper; hypertension; non-dipper