Abstract 438: Association between Insomnia and Use of BP-lowering Drugs in hypertensive Patients: a Cross-sectional Cohort Study

Purpose: Insomnia and short sleep duration have been associated with increased prevalence, incidence and severity of hypertension. However, the relationship between insomnia and use of different antihypertensive drug classes has not been ascertained yet. Methods: 371 hypertensive patients at their first visit in a tertiary Hypertension Outpatient Unit were enrolled. Insomnia Severity Index (ISI), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAY-Y2) were administered. Insomnia was defined as ISI>8, depressive symptoms as BDI>10, trait anxiety as STAI -Y2>40. Patients with self-reported sleep apneas or snoring (n=29) or with incomplete data (n=12) were excluded. Results: Data from 330 patients were analyzed (males 51%, mean age 57±13 years, antihypertensive treatment 84%, previous CV events 9%, diabetes 7%, obesity 24%, smoking 13%, hypercholesterolemia 67%). Insomniacs (n=70, 21%) were older than non-insomniacs (60±11 vs 56±13 years, p=0.02); female gender (62 vs 46%, p=0.01), anxiety (68 vs 34%, p<0.0001) and depressive symptoms (30 vs 6%, p<0.0001) were more prevalent in insomniacs. Insomniacs were treated with higher number of antihypertensive drugs (1.8±1.0 vs 1.5±1.0, p=0.04) and more frequently with angiotensin-receptor-blockers (ARBs, 49 vs 31%, p=0.009) and diuretics (50 vs 28%, p=0.0007), whereas the use of other drug classes was similar. In a multiple logistic regression analysis, adjusted for cardiovascular and psychiatric variables, ARBs use (OR 2.4, CL95% 1.1-5.2), depressive symptoms (OR 3.2, CL95%1.2-8.7) and anxiety (OR 2.9, CL95%1.4-6.1) were associated with a higher probability of insomnia. Conclusions: This cross-sectional analysis suggests that ARBs use may be associated with insomnia in a cohort of hypertensive patients

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Abstract 63: Relation between Poor Sleep Quality and Resistant Hypertension

Hypertension ◽

10.1161/hyp.60.suppl_1.a63 ◽

2012 ◽

Vol 60 (suppl_1) ◽

Author(s):

Rosa Maria Bruno ◽

Laura Palagini ◽

Alessia Di Giulio ◽

Angelo Gemignani ◽

Stefano Taddei ◽

...

Keyword(s):

Depressive Symptoms ◽

Sleep Quality ◽

Sleep Duration ◽

Resistant Hypertension ◽

Antihypertensive Drugs ◽

Multiple Logistic Regression Analysis ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Short Sleep Duration ◽

Short Sleep

Purpose: Insomnia and short sleep duration have been associated with increased incidence of hypertension. However, the relationship between sleep loss and resistant hypertension (RH), has not been ascertained yet. Methods: 270 patients at first access to our Hypertension Outpatient Unit were enrolled. RH was defined according as office BP values >140/90 mmHg with 3 or more antihypertensive drugs, or controlled BP with 4 or more drugs, including a diuretic. Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Inventory (BDI) were assessed. Poor sleep quality was defined as PSQI>5, mild-to-severe depressive symptoms as BDI score >10. Patients with self-reported sleep apneas or snoring were excluded (n=21). Results: Complete data were available for 234 patients (males 51%, mean age 58±13 years, BMI 26±5 kg/mq, antihypertensive treatment 84%, previous CV events 12%, diabetes 8%, smoking 15%, hypercholesterolemia 60%). Mean sleep duration was 6.4±1.6 hours, with a 49% prevalence of short sleep duration (<6 hours) and similar in both sexes. Conversely, women had higher PSQI scores (5.2 vs 3.6, p=0.03) and prevalence of poor sleep quality (46% vs 30% in men, p=0.01). Women showed also higher BDI scores (4.5 vs 1.8, p=0.006) and prevalence of depressive symptoms than men (20% vs 7%, p=0.003). RH patients (15%) had higher PSQI (5.8 vs 4.1, p=0.03), a difference shown in women (6.8 vs 4.8, p=0.04) but not in men (4.7 vs 3.5, p=0.37). The association between BDI score and RH showed a similar behavior (overall 3.6 vs 2.8, p=0.02; women 5.1 vs 3.7, p=0.03; men: 2.0 vs 1.9, p=0.53). In a multiple logistic regression analysis (including age, sex, obesity, diabetes, previous CV events, sleep duration, use of hypnotic drugs) poor sleep quality was independently associated with RH (OR 2.2, CI95% 1.1-5.3). However this relationship lost significance when also depressive symptoms were included in the model (p=0.12). Conclusions: Short sleep duration is highly prevalent in hypertensive patients. This condition is accompanied by poor sleep quality and depressive symptoms in women. Poor sleep quality is associated with a 2-fold higher probability of having RH. This association could be mediated by the presence of depressive symptoms.

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Antihypertensive drug prescription trends in Shahrekord, Iran

Journal of Nephropharmacology ◽

10.34172/npj.2022.13 ◽

2021 ◽

Vol 11 (1) ◽

pp. e13-e13

Author(s):

Ahmadreza Maghsoudi ◽

Maryam Dehghani Mobarakeh ◽

Ali Momeni ◽

Alireza Nematollahi ◽

Shahin Asgari ◽

...

Keyword(s):

Blood Pressure ◽

Antihypertensive Drugs ◽

Beta Blockers ◽

Angiotensin Receptor Blockers ◽

Drug Prescription ◽

Angiotensin Receptor ◽

Cross Sectional ◽

Hypertensive Patients ◽

The Status ◽

Receptor Blockers

Introduction: Hypertension is one of the most leading causes of death worldwide. It is an important risk factor for ischemic heart disease (IHD), chronic kidney disease (CKD) and cerebrovascular diseases. Objectives: The aim of the study was evaluation of the status of blood pressure control and trends in prescribed antihypertensive medication usage among hypertensive patients in Shahrekord, Iran. Patients and Methods: In a cross-sectional descriptive study 250 hypertensive patients were enrolled. The patients were evaluated based on the status of blood pressure (BP) control and the prescription trends and efficacy of antihypertensive drugs. The data were also evaluated in subgroups of diabetics or non-diabetics, smokers or non-smokers, patients with or without CKD, patients with or without IHD. Results: A total of 250 patients (149 women and 101 men) were enrolled in this study. The mean age of participants was 66.22±13.58 years. Mean systolic and diastolic BP were 143.4±29.4 mm Hg and 85.8±12.5 mm Hg respectively. Poor controlled BP was seen in 106 patients. The more common prescribed antihypertensive drugs were angiotensin receptor blockers (46%), diuretics (33.6%) and beta-blockers (32.8%). Conclusion: The study showed that most of the patients had poor controlled BP and physicians increasingly prescribe angiotensin receptor blockers.

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Family functioning of elderly with depressive symptoms

Revista da Escola de Enfermagem da USP ◽

10.1590/s0080-623420140000300012 ◽

2014 ◽

Vol 48 (3) ◽

pp. 469-476 ◽

Cited By ~ 6

Author(s):

Rosely Almeida Souza ◽

Gislaine Desani da Costa ◽

Cintia Hitomi Yamashita ◽

Fernanda Amendola ◽

Jaqueline Correa Gaspar ◽

...

Keyword(s):

Depressive Symptoms ◽

Family Functioning ◽

Family Health ◽

Female Gender ◽

Well Being ◽

The Elderly ◽

Cross Sectional Study ◽

Cross Sectional ◽

Dysfunctional Family ◽

The Family

Objective: To classify families of elderly with depressive symptoms regarding their functioning and to ascertain the presence of an association between these symptoms, family functioning and the characteristics of the elderly. Method: This was an observational, analytical, cross-sectional study performed with 33 teams of the Family Health Strategy in Dourados, MS. The sample consisted of 374 elderly divided into two groups (with and without depressive symptoms). The instruments for data collection were a sociodemographic instrument, the GeriatricDepression Scale (15 items) and the Family Apgar. Results: An association was observed between depressive symptoms and family dysfunction, female gender, four or more people living together, and physical inactivity. Conclusion: The functional family may represent effective support for the elderly with depressive symptoms, because it offers a comfortable environment that ensures the well-being of its members. The dysfunctional family can barely provide necessary care for the elderly, which can exacerbate depressive symptoms. 

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An observational cross-sectional study to determine the effect of telmisartan on reducing microalbuminuria in diabetic hypertensive patients in tertiary care teaching hospital, Central India

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20173300 ◽

2017 ◽

Vol 6 (8) ◽

pp. 2082

Author(s):

Santenna Chenchula ◽

Rupesh Gupta ◽

Balakrishnan S. ◽

Akash Vishwe ◽

Pushparaj Gour ◽

...

Keyword(s):

Calcium Channel ◽

Calcium Channel Blockers ◽

Angiotensin Receptor Blockers ◽

Tertiary Care ◽

Channel Blockers ◽

Angiotensin Receptor ◽

Cross Sectional ◽

Hypertensive Patients ◽

Urine Albumin ◽

Receptor Blockers

Background: There are many groups of drugs to decrease microalbuminuria like angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARBs), calcium channel blockers and direct vasodilators. Among these, ACEI and ARBs are commonly used for this purpose. If side effects occur, ACEI are replaced with ARBs. Many ARBs have been studied for their effect on reducing microalbuminuria, but data on telmisartan with its additional unique properties are scarce in Indian population.Methods: This cross sectional observational study was carried out in a tertiary care centre. We first measured base line urine albumin levels in included patients, 3 months after treatment with telmisartan using ‘hemocue urine albumin analyser’. We collected and compared both baseline and after treatment data of microalbuminuria and analysed in descriptive statistics.Results: A total of 110 patients participated in this study; out of which 10 patients were excluded from the study because they were not available for follow up. As compared to baseline, urine albumin level decreased by 30.42% after 12 weeks treatment with telmisartan (P <0.001).Conclusions: Microalbuminuria is one of the leading cause of end stage renal disease and coronary heart diseases in diabetic hypertensive patients. Drugs like ACE inhibitors, Angiotensin receptor blockers, Calcium channel blockers and direct vasodilators are used to prevent these complications. In this present study, we concluded that telmisartan decreases urine albumin excretion around 30.42% from baseline after 12 weeks of treatment.

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Suicidal ideation among medical students, burnout or depression? Maybe both.

Revista Brasileira de Educação e Saúde ◽

10.18378/rebes.v11i1.8530 ◽

2021 ◽

Vol 11 (1) ◽

pp. 69-77

Author(s):

THAÍS CAMPELO BEDÊ VALE ◽

LÍVIA RODRIGUES DE ARAÚJO ◽

VITÓRIA NUNES MEDEIROS ◽

JOSÉ HÍCARO HELLANO GONÇALVES LIMA PAIVA ◽

TATIANA PASCHOALETTE RODRIGUES BACHUR ◽

...

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Medical Students ◽

Suicidal Ideation ◽

Emotional Support ◽

Female Gender ◽

Sleep Time ◽

Mental Condition ◽

Cross Sectional

Depression is a common mental condition worldwide and a major cause of debility, with the potential to impair the quality of life of affected people. Medical students are more likely to develop psychiatric disorders, with depression, anxiety, and burnout being the most common ones. The aim of this study was to investigate the prevalence of depressive symptoms in medical students and their association with burnout and aspects of life. This is an analytical cross-sectional study. Data collection was performed using four validated scales and a questionnaire in 511 medical students from the first to the fourth year from different universities. Depression was present in 49% of the students. A correlation was found between depression and female gender. Regarding the students' daily sleep time, 54.5% of the students slept only 3 to 6 hours per night. The use of psychoactive substances was reported by 29.9%. Regarding the emotional support offered by universities, about 92.8% of students with depressive symptoms reported not receiving adequate emotional support. As for quality of life, all domains were impaired among students with depression. According to the two-dimensional criterion, 37% of the students have burnout, with correlation between the presence of the syndrome and depressive symptoms. In addition, burnout proved to be an independent risk factor for suicidal ideation and self-mutilation. New methods that can help detect and address factors that trigger stress and depressive symptoms in medical students are needed to reduce the incidence of depression.

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Depressive symptoms and associated factors in medical interns at a tertiary hospital

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v25i0.1322 ◽

2019 ◽

Vol 25 ◽

Author(s):

Kaveshin Naidu ◽

John R. Torline ◽

Michelle Henry ◽

Helena B. Thornton

Keyword(s):

Depressive Symptoms ◽

Antidepressant Medication ◽

Female Gender ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Subjective Feeling ◽

Cross Sectional ◽

Symptoms Of Depression ◽

Previous Diagnosis ◽

Medical Interns

Background: It is known that medical doctors suffer from increased rates of depression with medical interns being most at risk. Despite this, little is known about the prevalence of depression in interns in South Africa.Objectives: This study aimed to assess the prevalence of depressive symptoms in interns employed at Groote Schuur Hospital, a tertiary hospital in the Western Cape.Method: The study was a cross-sectional study. All 91 interns were invited to participate in the study and consenting interns were required to complete a demographic and related questionnaire and the Beck Depression Inventory 2 (BDI-2).Results: Fifty-four (59.3%) of all invited interns participated in the study. Twenty-two interns (40.7%) reported a BDI-2 score of 14 or greater, indicating at least mild self-reported symptoms of depression. Features associated with a BDI-2 score of 14 or greater, included female gender, a previous diagnosis of depression, seeing a psychotherapist and previously being on antidepressant medication during internship. Other features also significantly associated with higher BDI-2 scores included suicidal ideation, thoughts of emigration, wanting to leave medicine and using substances to cope. The most significant associated feature of high BDI-2 scores was a subjective feeling of being ‘burnt out’.Conclusion: Interns had a higher prevalence of depressive symptoms when compared to the general population. The feeling of being ‘burnt out’ was the most significant factor associated with the severity of depressive symptoms. It is imperative that the mental health of both medical students and newly qualified doctors be prioritised, supported and monitored.

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The STAI-Y trait scale: psychometric properties and normative data from a large population-based study of elderly people

International Psychogeriatrics ◽

10.1017/s1041610212000300 ◽

2012 ◽

Vol 24 (7) ◽

pp. 1163-1171 ◽

Cited By ~ 24

Author(s):

Valérie Bergua ◽

Céline Meillon ◽

Olivier Potvin ◽

Jean Bouisson ◽

Mélanie Le Goff ◽

...

Keyword(s):

Depressive Symptoms ◽

Elderly People ◽

Trait Anxiety ◽

Normative Data ◽

Large Population ◽

Female Gender ◽

The Elderly ◽

Subjective Health ◽

Community Dwelling ◽

Research Context

ABSTRACTBackground:Whereas the State-Trait Anxiety Inventory (STAI-Y) is probably the most widely used self-reported measure of anxiety, the lack of current norms among elderly people appears to be problematic in both a clinical and research context. The objective of the present study was to provide normative data for the STAI-Y trait scale from a large elderly cohort and to identify the main sociodemographic and health-related determinants of trait anxiety.Methods:The STAI-Y trait scale was completed by 7,538 community-dwelling participants aged 65 years and over from the “Three City” epidemiological study. Trained nurses and psychologists collected information during a face-to-face interview including sociodemographic characteristics and clinical variables.Results:The scale was found to have good internal consistency (Cronbach's α = 0.89). Norms were stratified for gender and educational level differentiating persons with and without depressive symptoms. Multivariate linear regression found the STAI-Y trait score to be significantly associated with female gender, psychotropic medication use, higher depressive symptoms, higher cognitive complaints, and with an interaction between subjective health and marital status. Age was not associated with the total score.Conclusion:This study provides norms for the STAI-Y trait scale in the general elderly population which are of potential use in both a clinical and research context. The present results confirm the importance of several factors previously associated with higher trait anxiety in the elderly. However, more research is needed to better understand the clinical specificities of anxiety in the elderly and the improvement of assessment.

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Prevalence and Risk of Polypharmacy among Community-Dwelling, Elderly Kuwaiti Patients

Medical Principles and Practice ◽

10.1159/000503298 ◽

2019 ◽

Vol 29 (2) ◽

pp. 166-173 ◽

Cited By ~ 1

Author(s):

Nabil Ahmed Badawy ◽

Shokria Adely Labeeb ◽

Mawaheb Falah Alsamdan ◽

Badria Faleh Alazemi

Keyword(s):

Risk Factors ◽

Hospital Admissions ◽

Antihypertensive Drugs ◽

Female Gender ◽

Community Dwelling ◽

Older Individuals ◽

Cross Sectional ◽

Factors Associated ◽

High Prevalence ◽

Study Population

Objectives: To estimate the prevalence of polypharmacy in community-dwelling, older Kuwaiti patients, describe the number and types of drugs used, and identify risk factors associated with polypharmacy. Subjects and Methods: This was a descriptive cross-sectional questionnaire-based survey in which we interviewed 500 community-dwelling Kuwaiti adults over 65 years of age. The data collection occurred during a 4-month period from March to July 2017. Results: Fifty-two percent (n = 260) of the patients were males, with a mean age of 71.73 ± 5.32 years. The prevalence of polypharmacy (5–8 drugs) and excessive polypharmacy (>8 drugs) was 58.4% (n = 292) and 10.2% (n = 51), respectively. The risk factors associated with an increased number of medicines used were: female gender (p = 0.019), a lower level of education (p = 0.003), a high number of hospital admissions (p = 0.000), clinics visited by the patient (p =0.000), and number of comorbidities (p = 0.000). The most commonly used medications (82.6% of the study population) were blood glucose-lowering agents, excluding insulin. Other commonly used medications were antihypertensive drugs and lipid-modifying agents. Conclusion: A significant sector of the older Kuwaiti patient population has a high prevalence of polypharmacy and is thus exposed to its potential hazards. The current study highlights the need to revise the drug-dispensing policy among community-dwelling, older Kuwaiti people, as well as to initiate educational programs among healthcare practitioners concerning prescribing issues in older individuals.

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Frequency and risk factors for HIV-associated neurocognitive disorder and depression in older individuals with HIV in northeastern Brazil

International Psychogeriatrics ◽

10.1017/s1041610212000944 ◽

2012 ◽

Vol 24 (10) ◽

pp. 1648-1655 ◽

Cited By ~ 14

Author(s):

Sérgio Murilo Maciel Fernandes Filho ◽

Heloísa Ramos Lacerda de Melo

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Depressive Symptoms ◽

Functional Impairment ◽

Female Gender ◽

Northeastern Brazil ◽

Neurocognitive Disorder ◽

Older Individuals ◽

Older Population ◽

Cross Sectional

ABSTRACTBackground: The study was undertaken to describe the frequency of HIV-associated neurocognitive disorders (HAND) and depressive symptoms in an older population with human immunodeficiency virus (HIV).Methods: A cross-sectional analysis of patients aged 50 years or older infected with HIV was carried out in an outpatient setting in Brazil from March to November 2008. Patients selected were submitted to cognitive evaluation using the Mini-Mental State Examination and International HIV Dementia Scale, and also to functional and depression evaluations.Results: Among the 52 patients evaluated, the frequency of neurocognitive disorder was 36.5%, while for dementia the frequency was 13.5%. No risk factors were identified. Among the patients with cognitive impairment, 73.7% had cortical impairment. The frequency of depressive symptoms was of 34.6%. The female gender was identified as a risk factor (p = 0.018) and patients with depressive symptoms had greater functional impairment (p < 0.001).Conclusion: HAND and depressive symptoms are common in an older population. Patients with cognitive impairment achieved lower scores on the cortical assessment scales. Depressive symptoms are a stronger factor for functional impairment.

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Green tea and coffee consumption is inversely associated with depressive symptoms in a Japanese working population

Public Health Nutrition ◽

10.1017/s1368980013000360 ◽

2013 ◽

Vol 17 (3) ◽

pp. 625-633 ◽

Cited By ~ 38

Author(s):

Ngoc Minh Pham ◽

Akiko Nanri ◽

Kayo Kurotani ◽

Keisuke Kuwahara ◽

Ayami Kume ◽

...

Keyword(s):

Depressive Symptoms ◽

Green Tea ◽

Multiple Logistic Regression Analysis ◽

Depression Scale ◽

Coffee Consumption ◽

Serum Folate ◽

Caffeine Intake ◽

Lower Prevalence ◽

Caffeine Consumption ◽

Cross Sectional

AbstractObjectiveTo examine the association between the consumption of green tea, coffee and caffeine and depressive symptoms.DesignCross-sectional study. Consumption of green tea and coffee was ascertained with a validated dietary questionnaire and the amount of caffeine intake was estimated from these beverages. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Multiple logistic regression analysis was performed to compute odds ratios and 95 % confidence intervals for depressive symptoms with adjustments for potential confounders.SettingTwo workplaces in north-eastern Kyushu, Japan, in 2009.SubjectsA total of 537 men and women aged 20–68 years.ResultsHigher green tea consumption was associated with a lower prevalence of depressive symptoms. Compared with participants consuming ≤1 cup/d, those consuming ≥4 cups green tea/d had a 51 % significantly lower prevalence odds of having depressive symptoms after adjustment for potential confounders, with significant trend association (P for trend = 0·01). Further adjustment for serum folate slightly attenuated the association. Coffee consumption was also inversely associated with depressive symptoms (≥2 cups/d v. <1 cup/d: OR = 0·61; 95 % CI 0·38, 0·98). Multiple-adjusted odds for depressive symptoms comparing the highest with the lowest quartile of caffeine consumption was OR = 0·57 (95 % CI 0·30, 1·05; P for trend = 0·02).ConclusionsResults suggest that higher consumption of green tea, coffee and caffeine may confer protection against depression.

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