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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >A Study of Antihypertensive Drugs and Depressive Symptoms (SADD-Sx) in patients treated with a calcium antagonist versus an atenolol hypertension Treatment Strategy in the International Verapamil SR-Trandolapril Study (INVEST).
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A Study of Antihypertensive Drugs and Depressive Symptoms (SADD-Sx) in patients treated with a calcium antagonist versus an atenolol hypertension Treatment Strategy in the International Verapamil SR-Trandolapril Study (INVEST).

机译：国际维拉帕米SR-Trandolapril研究（INVEST）中，针对钙拮抗剂和阿替洛尔高血压治疗策略的患者进行的降压药和抑郁症状（SADD-Sx）研究。

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BACKGROUND: The International Verapamil/Trandolapril Study (INVEST) demonstrated comparable efficacy between verapamil SR and atenolol antihypertensive treatment strategies for clinical outcomes and blood pressure (BP) control in hypertensive patients with coronary artery disease (N = 22,576). Effects of these antihypertension strategies on mood-related issues are not well understood. OBJECTIVES: The objectives of this study were 1) to compare depressive symptoms by strategy and 2) to identify predictors of depressive symptoms in INVEST patients after 1 year of follow up. DESIGN, SETTING, AND PATIENTS: Depressive symptoms were assessed in a subset (N = 2317) of consecutively randomized U.S. patients enrolled between April 1, 1999, and October 31, 1999. Patients were mailed surveys after randomization and after 1 year of treatment. INTERVENTION: Patients were assigned to either a verapamil SR or atenolol strategy to achieve Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure BP goals. Trandolapril and/or hydrochlorothiazide were recommended as add-on agents. MAIN OUTCOME MEASURE: Depressive symptoms were measured by the Center for Epidemiologic Studies-Depression (CES-D) scale. RESULTS: CES-D scores improved 1.45 points (p < .001) after 1 year in patients assigned to the verapamil SR strategy, whereas a nonsignificant improvement was observed in patients assigned to the atenolol strategy (0.27 points, p = .44). Predictors of higher depressive symptoms were higher baseline CES-D score (p < .001), history of depression diagnosis (p = .03), history of stroke (p < .001), and assignment to the atenolol strategy (p < .001). CONCLUSIONS: A verapamil SR strategy is a viable alternative to beta-blocker therapy for hypertensive patients with coronary artery disease, especially those at risk of depression.
机译：背景：国际维拉帕米/ Trandolapril研究（INVEST）显示，维拉帕米SR和阿替洛尔抗高血压治疗策略在高血压冠心病患者中的临床疗效和血压（BP）控制具有可比的疗效（N = 22,576）。这些抗高血压策略对与情绪有关的问题的影响尚不清楚。目的：本研究的目的是：1）通过策略比较抑郁症状，以及2）在随访1年后确定INVEST患者抑郁症状的预测因子。设计，地点和患者：在1999年4月1日至1999年10月31日期间连续入选的美国随机分组患者中，对抑郁症状进行了评估（N = 2317）。患者在随机分组后和治疗1年后接受邮寄调查。干预：将患者分配为维拉帕米SR或阿替洛尔策略，以达到预防，检测，评估和治疗高血压BP的全国联合委员会目标。推荐将Trandolapril和/或氢氯噻嗪用作添加剂。主要观察指标：抑郁症状是由流行病学研究抑郁症中心（CES-D）量表测量的。结果：分配给维拉帕米SR策略的患者在1年后CES-D评分提高了1.45分（p <.001），而分配给阿替洛尔策略的患者则观察到无显着改善（0.27分，p = .44）。抑郁症状较高的预测因素包括基线CES-D评分较高（p <.001），抑郁症诊断史（p = .03），中风病史（p <.001）和阿替洛尔策略的归属（p <。 001）。结论：对于患有冠状动脉疾病的高血压患者，尤其是有抑郁风险的高血压患者，维拉帕米SR策略可替代β受体阻滞剂。

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