Gender- and Age-Specific Associations of Visit-To-Visit Blood Pressure Variability with Incident Generalized Anxiety Disorder

Background: There is a bidirectional relationship between blood pressure variability (BPV) and anxiety, but few studies have examined the gender- and age-specific effects of visit-to-visit BPV on incident anxiety. We examined the predictive value of BPV for the incidence of anxiety in a family clinic cohort.Methods: Consecutive patients with a first attendance to family medicine clinics in Hong Kong between January 1, 2000, and December 31, 2002, with at least three blood pressure measurements available thereafter were included. The primary endpoint was incident anxiety as identified by ICD-9 coding.Results: This study included 48,023 (50% males) patients with a median follow-up of 224 [interquartile range (IQR): 217–229] months. Females were more likely to develop incident anxiety compared to males (incidence rate: 7 vs. 2%), as were patients of older age. Significant univariate predictors were female gender, older age, preexisting cardiovascular diseases, respiratory diseases, diabetes mellitus, hypertension, and gastrointestinal diseases, various laboratory examinations, and the number of blood pressure measurements. Higher baseline, maximum, minimum, standard deviation (SD), coefficient of variation (CV), and variability score of diastolic blood pressure significantly predicted incident anxiety, as did all systolic blood pressure measures [baseline, latest, maximum, minimum, mean, median, variance, SD, root mean square (RMS), CV, and variability score].Conclusions: The relationships between longer-term visit-to-visit BPV and incident anxiety were identified. Female and older patients with higher blood pressure and higher BPV were at the highest risks of incident anxiety.

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Perbedaan Derajat Ansietas antara Penyandang Hipertensi Belum Terkontrol dengan yang Terkontrol

e-CliniC ◽

10.35790/ecl.v7i2.26283 ◽

2019 ◽

Vol 7 (2) ◽

Author(s):

Cerelia E. C. Sugeng ◽

Emma Sy. Moeis ◽

Glady I. Rambert

Keyword(s):

Blood Pressure ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Blood Pressure Monitoring ◽

Office Blood Pressure ◽

Generalized Anxiety ◽

Pressure Monitoring ◽

Hypertensive Patients ◽

Significant Difference ◽

The Difference

Abstract: Hypertension and anxiety are among the group of the most common chronic disease worldwide, and according to numerous studies they are oftentimes associated each other. Patients suffered from chronic illnesses, such as hypertension, may have negative emotion that increases the risk of mental disorders, most commonly anxiety disorder. This study was aimed to assess the difference of anxiety degree between uncontrolled and controlled hypertensive patients. This was an observational analytical study with a cross-sectional design. Subjects were divided into two groups: controlled and uncontrolled hypertensive patients. Measurement of blood pressure parameter was performed by using office blood pressure monitoring. Anxiety parameter was classified based on the scoring of the Generalized Anxiety Disorder Scale (GAD-7). Data were analyzed by using the Mann-Whitney test. Subjects consisted of 60 hypertensive patients (35 males and 25 females), aged 30-70 years (mean 56.48 years). There were 35 controlled hypertension patients and 22 uncontrolled hypertensive patients. The results showed that the difference in anxiety degree based on GAD-7 between controlled hypertensive and uncontrolled hypertensive groups obtained a p-value of 0.000. In conclusion, there was a significant difference in anxiety degree between uncontrolled and controlled hypertensive patients. Screening for anxiety among hypertensive patients is a simple and cost-effective tool that may improve outcomes.Keywords: anxiety, uncontrolled hypertension, controlled hypertension Abstrak: Hipertensi dan ansietas merupakan kelompok penyakit kronik yang paling umum di seluruh dunia. Berdasarkan banyak penelitian kedua penyakit ini saling berhubungan satu sama lain. Penyandang hipertensi mungkin memiliki emosi negatif yang meningkatkan risiko terjadinya gangguan mental berupa ansietas. Ansietas dan dukungan sosial rendah akan menghambat proses penyembuhan terutama dalam mengontrol tekanan darah. Penelitian ini bertujuan untuk menge-tahui apakah terdapat perbedaan derajat ansietas antara penyandang hipertensi belum terkontrol dengan hipertensi terkontrol. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Subyek penelitian dibagi menjadi dua kelompok, yaitu kelompok penyandang hipertensi belum terkontrol dan hipertensi terkontrol. Pengukuran parameter tekanan darah dilakukan dengan menggunakan alat Oscillometric digital dengan cara Office Blood Pressure Monitoring (OBPM). Parameter ansietas diklasifikasikan berdasarkan skala Generalized Anxiety Disorder Scale (GAD-7). Adanya perbedaan derajat ansietas antara kedua kelompok dinilai dengan uji Mann-Whitney. Subyek penelitian terdiri dari 60 penyandang hipertensi (35 laki-laki dan 25 perempuan) berusia 30-70 tahun (rerata 56,48 tahun). Terdapat 25 penyandang hipertensi yang belum terkontrol dan 35 penyandang hipertensi terkontrol. Hasil penelitian menunjukkan bahwa terdapat perbedaan derajat ansietas berdasarkan GAD-7 antara kedua kelompok (p=0,000). Simpulan penelitian ini ialah terdapat perbedaan bermakna dalam derajat ansietas antara penyandang hipertensi yang belum terkontrol dengan yang terkontrol. Skrining ansietas pada penyandang hipertensi merupakan modalitas penting dalam penatalaksanaan penyandang hipertensi.Kata kunci: ansietas, hipertensi belum terkontrol, hipertensi terkontrol

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Perbedaan Derajat Ansietas antara Penyandang Hipertensi Belum Terkontrol dengan yang Terkontrol

e-CliniC ◽

10.35790/ecl.7.2.2019.26283 ◽

2019 ◽

Vol 7 (2) ◽

Author(s):

Cerelia E. C. Sugeng ◽

Emma Sy. Moeis ◽

Glady I. Rambert

Keyword(s):

Blood Pressure ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Blood Pressure Monitoring ◽

Office Blood Pressure ◽

Generalized Anxiety ◽

Pressure Monitoring ◽

Hypertensive Patients ◽

Significant Difference ◽

The Difference

Abstract: Hypertension and anxiety are among the group of the most common chronic disease worldwide, and according to numerous studies they are oftentimes associated each other. Patients suffered from chronic illnesses, such as hypertension, may have negative emotion that increases the risk of mental disorders, most commonly anxiety disorder. This study was aimed to assess the difference of anxiety degree between uncontrolled and controlled hypertensive patients. This was an observational analytical study with a cross-sectional design. Subjects were divided into two groups: controlled and uncontrolled hypertensive patients. Measurement of blood pressure parameter was performed by using office blood pressure monitoring. Anxiety parameter was classified based on the scoring of the Generalized Anxiety Disorder Scale (GAD-7). Data were analyzed by using the Mann-Whitney test. Subjects consisted of 60 hypertensive patients (35 males and 25 females), aged 30-70 years (mean 56.48 years). There were 35 controlled hypertension patients and 22 uncontrolled hypertensive patients. The results showed that the difference in anxiety degree based on GAD-7 between controlled hypertensive and uncontrolled hypertensive groups obtained a p-value of 0.000. In conclusion, there was a significant difference in anxiety degree between uncontrolled and controlled hypertensive patients. Screening for anxiety among hypertensive patients is a simple and cost-effective tool that may improve outcomes.Keywords: anxiety, uncontrolled hypertension, controlled hypertension Abstrak: Hipertensi dan ansietas merupakan kelompok penyakit kronik yang paling umum di seluruh dunia. Berdasarkan banyak penelitian kedua penyakit ini saling berhubungan satu sama lain. Penyandang hipertensi mungkin memiliki emosi negatif yang meningkatkan risiko terjadinya gangguan mental berupa ansietas. Ansietas dan dukungan sosial rendah akan menghambat proses penyembuhan terutama dalam mengontrol tekanan darah. Penelitian ini bertujuan untuk menge-tahui apakah terdapat perbedaan derajat ansietas antara penyandang hipertensi belum terkontrol dengan hipertensi terkontrol. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Subyek penelitian dibagi menjadi dua kelompok, yaitu kelompok penyandang hipertensi belum terkontrol dan hipertensi terkontrol. Pengukuran parameter tekanan darah dilakukan dengan menggunakan alat Oscillometric digital dengan cara Office Blood Pressure Monitoring (OBPM). Parameter ansietas diklasifikasikan berdasarkan skala Generalized Anxiety Disorder Scale (GAD-7). Adanya perbedaan derajat ansietas antara kedua kelompok dinilai dengan uji Mann-Whitney. Subyek penelitian terdiri dari 60 penyandang hipertensi (35 laki-laki dan 25 perempuan) berusia 30-70 tahun (rerata 56,48 tahun). Terdapat 25 penyandang hipertensi yang belum terkontrol dan 35 penyandang hipertensi terkontrol. Hasil penelitian menunjukkan bahwa terdapat perbedaan derajat ansietas berdasarkan GAD-7 antara kedua kelompok (p=0,000). Simpulan penelitian ini ialah terdapat perbedaan bermakna dalam derajat ansietas antara penyandang hipertensi yang belum terkontrol dengan yang terkontrol. Skrining ansietas pada penyandang hipertensi merupakan modalitas penting dalam penatalaksanaan penyandang hipertensi.Kata kunci: ansietas, hipertensi belum terkontrol, hipertensi terkontrol

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Associations between Five-Year Blood Pressure Variability and Risk of Cardiovascular Events and Mortality

10.1101/2020.12.21.20248682 ◽

2020 ◽

Author(s):

Jiandong Zhou ◽

Sharen Lee ◽

Wing Tak Wong ◽

William KK Wu ◽

Wai Kit Ming ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Blood Pressure ◽

Acute Myocardial Infarction ◽

Diastolic Blood Pressure ◽

Blood Pressure Variability ◽

Pressure Measurements ◽

Time To Death ◽

All Cause Mortality ◽

Maximum Minimum

AbstractIntroductionBlood pressure variability, in addition to blood pressure itself, has been used as a predictor for mortality. This study examined the predictive power of baseline/latest/mean/median blood pressure and blood pressure variability measures for all-cause mortality and adverse cardiovascular outcomes.MethodsThe retrospective observational study analyzed patients who presented to family medicine clinics between 1st January, 2000 and 31st December, 2001. Blood pressure measurements were obtained over a five-year period. Standard deviation (SD), root mean square (RMS), coefficient of variation (CV) and a variability score (number of >=5 mmHg blood pressure change) were used as measures of blood pressure variability. The primary outcome was all-cause mortality and the secondary outcomes were heart failure, acute myocardial infarction, and transient ischemic attack (TIA)/stroke, with follow-up until 31 December 2019.ResultsThis study included 37540 patients (n=29597 patients with >=3 blood pressure measurements). A nonlinear inverse U-shaped relationship was observed between baseline/latest/maximum/minimum/mean/median/RMS measures of diastolic blood pressure and time-to-death for all-cause mortality (P<0.001). Higher variance/SD/CV/variability score of both systolic and diastolic blood pressure was significantly associated with increased risks of all-cause mortality and heart failure, acute myocardial infarction and TIA/stroke (P<0.001). Low baseline/latest/maximum/minimum/mean/median/RMS systolic blood pressure was significantly associated with shorter time-to-death for all-cause mortality (P<0.001).ConclusionNonlinear inverse U-shaped relationships were observed between blood pressure and its variability measures and all-cause mortality. Higher blood pressure variability was associated with increased risk of all-cause mortality, heart failure, acute myocardial infarction and TIA/stroke.

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Generalized anxiety disorder and the circadian rhythm of blood pressure in patients with hypertension

International Journal of Psychiatry in Clinical Practice ◽

10.1080/13651500802136394 ◽

2008 ◽

Vol 12 (4) ◽

pp. 292-295 ◽

Cited By ~ 11

Author(s):

Long-Le Ma ◽

De-Gui Kong ◽

Xue-Wen Qi ◽

Le-Xin Wang

Keyword(s):

Blood Pressure ◽

Circadian Rhythm ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Generalized Anxiety

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The French Version of the Revised Child Anxiety and Depression Scale (RCADS) in a Nonclinical Sample

Swiss Journal of Psychology ◽

10.1024/1421-0185/a000158 ◽

2015 ◽

Vol 74 (3) ◽

pp. 119-127 ◽

Cited By ~ 10

Author(s):

Martine Bouvard ◽

Anne Denis ◽

Jean-Luc Roulin

Keyword(s):

Factor Analysis ◽

Anxiety Disorder ◽

Confirmatory Factor Analysis ◽

Generalized Anxiety Disorder ◽

Child Anxiety ◽

Depression Scale ◽

Anxiety And Depression ◽

Generalized Anxiety ◽

French Version ◽

Confirmatory Factor

This article investigates the psychometric properties of the Revised Child Anxiety and Depression Scale (RCADS). A group of 704 adolescents completed the questionnaires in their classrooms. This study examines potential confirmatory factor analysis factor models of the RCADS as well as the relationships between the RCADS and the Screen for Child Anxiety Related Emotional Disorders-Revised (SCARED-R). A subsample of 595 adolescents also completed an anxiety questionnaire (Fear Survey Schedule for Children-Revised, FSSC-R) and a depression questionnaire (Center for Epidemiological Studies Depression Scale, CES-D). Confirmatory factor analysis of the RCADS suggests that the 6-factor model reasonably fits the data. All subscales were positively intercorrelated, with rs varying between .48 (generalized anxiety disorder-major depression disorder) and .65 (generalized anxiety disorder-social phobia/obsessive-compulsive disorder). The RCADS total score and all the RCADS scales were found to have good internal consistency (> .70). The correlations between the RCADS subscales and their SCARED-R counterparts are generally substantial. Convergent validity was found with the FSSC-R and the CES-D. The study included normal adolescents aged 10 to 19. Therefore, the findings cannot be extended to children under 10, nor to a clinical population. Altogether, the French version of the RCADS showed reasonable psychometric properties.

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Psychometric Properties of the Spontaneous and Deliberate Mind Wandering Scales

European Journal of Psychological Assessment ◽

10.1027/1015-5759/a000470 ◽

2019 ◽

Vol 35 (6) ◽

pp. 878-890 ◽

Cited By ~ 4

Author(s):

David Marcusson-Clavertz ◽

Oscar N. E. Kjell

Keyword(s):

Anxiety Disorder ◽

Psychometric Properties ◽

Generalized Anxiety Disorder ◽

Social Desirability ◽

Cognitive Task ◽

Experience Sampling ◽

Well Being ◽

Mind Wandering ◽

Generalized Anxiety ◽

Psychological Variables

Abstract. Thinking about task-unrelated matters (mind wandering) is related to cognition and well-being. However, the relations between mind wandering and other psychological variables may depend on whether the former commence spontaneously or deliberately. The current two studies investigated the psychometric properties of the Spontaneous and Deliberate Mind Wandering Scales (SDMWS; Carriere, Seli, & Smilek, 2013 ). Study 1 evaluated the stability of the scales over 2 weeks ( N = 284 at Time 1), whereas Study 2 ( N = 323) evaluated their relations to Generalized anxiety disorder symptoms, Openness, Social desirability, and experience-sampling reports of intentional and unintentional mind wandering during an online cognitive task. The results indicated that the SDMWS were better fitted with a two-factor than a one-factor solution, although the fit was improved with the exclusion of one item. The scales exhibited strong measurement invariance across gender and time, and moderately high test-retest reliability. Spontaneous mind wandering predicted Generalized anxiety disorder and experience-sampling reports of unintentional mind wandering, whereas Deliberate mind wandering predicted Openness and experience-sampling reports of intentional mind wandering. Furthermore, Spontaneous mind wandering showed a negative association with social desirability of weak-to-medium strength. In sum, the scales generally showed favorable psychometric properties.

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