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The affective factors of depression symptoms in hypertensive patients and the protective effect of physical activity

  • Sleep Breathing Physiology and Disorders • Original Articlef
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Abstract

Objective

To investigate the potential affective factors of depressive symptoms in patients with hypertension and explore the protective effects of physical activity.

Methods

211 hypertensive patients aged over 18 years were consecutively recruited. All patients completed a self-designed questionnaire and the Hospital Anxiety and Depression Scale (HADS) to assess the coexistence of depressive symptoms, and psychiatrists were invited to diagnose depression when necessary. Full-night polysomnography was performed to detect the sleep pattern. The association between sleep structure and depressive symptoms was tested by using logistic regression analysis, and contributing factors as well as the effect of physical activity were assessed among patients with and without depressive symptoms.

Results

Of the 211 subjects, 33.6% of cases were coexistent with depressive symptoms. Female gender [OR (95%CI): 2.83 (1.44–5.57), P = 0.003) and the greater percentage of REM stage [OR (95%CI): 1.09 (1.01–1.18), P = 0.024] were the risk factors of depressive symptoms, while doing physical activity showed as the protective factor. Patients with REM stage ≥ 20% showed a higher score on HADS-D than those with REM stage < 20% [(4.9 ± 3.8) vs. (3.7 ± 3.1), P = 0.018]. Compared to individuals who never did physical activity, those who did physical activity 1–2 times per week and ≥ 3 times per week had a 52% and 62% risk reduction in depressive symptoms respectively. Patients who did physical activity had lower levels of high-sensitivity C-reactive protein (hs-CRP) compared to those who never did physical activity.

Conclusion

Female gender and a higher percentage of REM stage are risk factors for depressive symptoms in hypertension, while physical activity may benefit depressive symptoms by reducing serum levels of hs-CRP.

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Data availability

Data will be made available on reasonable request.

Abbreviations

AHI:

Apnea/hypopnea index

BMI:

Body mass index

BP:

Blood pressure

CPAP:

Continuous positive airway pressure

CVD:

Cardiovascular disease

FBG:

Fasting blood glucose

HADS:

Hospital Anxiety and Depression Scale

hs-CRP:

High-sensitivity C reaction protein

LSaO2 :

Lowest oxyhemoglobin saturation

MDD:

Major depressive disorder

NO:

Nitric oxide

OSA:

Obstructive sleep apnea

PSG:

Polysomnography

REM:

Rapid eye movement

TST:

Total sleep time

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Funding

This study was funded by the Open Project of Key Laboratory of Science and Technology Department of Xinjiang Uygur Autonomous Region (Grant number 2022D04024) and the Special scientific research project for young medical science and technology talents of Health Commission of Xinjiang Autonomous Region (Grant number wjwy-202031).

Author information

Author notes

  1. Shan Lu and Xiaoguang Yao contributed equally to this study and shared first authorship.

Authors and Affiliations

  1. Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, NO. 91 Tianchi Road, Urumqi, 830001, Xinjiang, China

    Xiaoguang Yao, Keming Zhou, Nanfang Li, Yingchun Wang, Jing Hong & Le Sun

  2. Xinjiang Hypertension Institute, Urumqi, China

    Xiaoguang Yao, Keming Zhou, Nanfang Li, Yingchun Wang, Jing Hong & Le Sun

  3. National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, China

    Xiaoguang Yao, Keming Zhou, Nanfang Li, Yingchun Wang, Jing Hong & Le Sun

  4. Key Laboratory of Xinjiang Uygur Autonomous Region “Hypertension Research Laboratory”, Urumqi, China

    Xiaoguang Yao, Keming Zhou, Nanfang Li, Yingchun Wang, Jing Hong & Le Sun

  5. Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China

    Xiaoguang Yao, Keming Zhou, Nanfang Li, Yingchun Wang, Jing Hong & Le Sun

  6. Hami Central Hospital, Hami, Xinjiang, China

    Shan Lu

Authors
  1. Xiaoguang Yao
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Corresponding author

Correspondence to Nanfang Li.

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Compliance with ethical standards

Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the People’s Hospital of Xinjiang Uygur Autonomous Region (NO.KY2021042021) and with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from all individual participants included in the study.

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Yao, X., Lu, S., Zhou, K. et al. The affective factors of depression symptoms in hypertensive patients and the protective effect of physical activity. Sleep Breath 28, 2127–2134 (2024). https://doi.org/10.1007/s11325-024-03118-w

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  • DOI: https://doi.org/10.1007/s11325-024-03118-w

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