The effect of depression on morning blood pressure surge in maintenance hemodialysis patients with hypertension

Abstract

Objective To investigate the effect of depression on morning blood pressure surge (MBPS)in maintenance hemodialysis(MHD)patients with hypertension. Methods 67 MHD patients with hypertension were included in this study.All clinical data were collected, and ambulatory blood pressure monitor was used to monitor patient's blood pressure in 24 hours.Self-rating depression scale(SDS) was used to survey 67 MHD patients, and multivariable logistic regression was conducted to determine independent risk factors for morning hypertension in MHD patients with hypertension. Results There were 14 depression patients in non-morning hypertension group(35.0%), 18 depression patients in morning hypertension group(66.7%), and the difference was significant(χ2=6.479, P=0.011). In addition correlation analysis showed that age(r=0.027, P=0.044), 24 h systolic pressure(r=0.284, P=0.020), 24 h diastolic pressure(r=0.278, P=0.023), fasting blood-glucose (r=0.293, P=0.039), low-density lipoprotein cholesterol (r=0.345, P=0.016), and the standard score of SDS(r=0. 276, P=0.024) were significantly correlated with MBPS .Furthermore, multivariable logistic regression showed that the standard score of SDS(OR=1.101, 95%CI=1.018-1.191, P=0.016), 24 h diastolic pressure (OR=1.070, 95%CI=1.007-1.136, P=0.028)and fasting blood-glucose (OR=2.127, 95%CI=1.118-4.049, P=0.022)were independent risk factors for morning hypertension in MHD patients with hypertension(OR=1.101, 95%CI: 1.018-1.191, P=0.016). Conclusion Depression, 24 h diastolic pressure and fasting blood-glucose can increase the risk of morning blood pressure surge in patients with MHD hypertension. Key words: Depression; Maintenance hemodialysis; Morning blood pressure surge