The effect of anxiety depression on circadian rhythm of ambulatory blood pressure and heart rate variability in patients with hypertension

Objective:To investigate the effect of anxiety depression on circadian rhythm of ambulatory blood pressure and heart rate variability(HRV) in patients with essential hypertension(EH),and the relationship between circadian rhythm and HRV.Methods:To evaluate in 106 EH patients,to divided into EH+AD group(n=52) and EH+nonAD group(n=54) according to anxiety depression.To compare related clinic information between EH+AD group and EH+nonAD group,Holter ECG monitoring,ambulatory blood pressure and circadian rhythm of ambulatory blood pressure.Results:(1)The 24 hours average blood pressure,the average blood pressure of daytime,the average blood pressure of night in EH+AD group were all higher than EH+nonAD group(P0.01),and the average blood pressure of night was higher obviously(P0.001),the circadian rhythm of ambulatory blood pressure lost,circadian rhythm of non-dipper was increased than that of EH+nonAD group(73.08%to 31.48%,P0.01).(2)The HRV index(SDNN,SDANN,RMSSD,PNN50) in EH+AD group were lower than EH+nonAD group (P0.01).(3)The logistic regression analysis indicated that the dangerous of the loss of circadian rhythm in EH patients with AD were related with AD and SDNN decreasing(OR are 4.120,8.631,P0.01).Conclusion:AD increase circadian rhythm of non-dipper in EH patients related with the serious damage of autonomic nerves.