Prevalence of Anxiety and Depression Symptoms and Their Association with Sleep Quality in Patients with Hypertension
- Authors: Kazachenko A.A.1, Kuchmin A.N.1, Golova E.P.1, Tanich A.V.1, Borisov I.M.1, Muzikin M.I.1,2,3, Burletova V.A.1, Budkovaia M.А.2, Tytiuk S.Y.1
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Affiliations:
- Kirov Military Medical Academy
- St.-Petersburg Scientific Research Institute of Ear, Throat, Nose and Speech
- St. Petersburg Medical and Social Institute
- Issue: Vol 32, No 2 (2025)
- Pages: 135-144
- Section: ORIGINAL STUDY ARTICLES
- URL: https://journals.rcsi.science/1728-0869/article/view/314576
- DOI: https://doi.org/10.17816/humeco643517
- EDN: https://elibrary.ru/TRPOGP
- ID: 314576
Cite item
Abstract
BACKGROUND: In recent years, substantial evidence has accumulated regarding the negative impact of psychoemotional stress, sleep disorders, and anxiety and depressive disorders on the course of arterial hypertension, as reflected in national guidelines. However, in real-world clinical practice, these aspects are often assessed subjectively and rarely incorporated into the diagnosis; as a result, they frequently receive insufficient attention and are not addressed properly.
AIM: To assess the prevalence of subclinical and clinically significant anxiety and depression symptoms, as well as their association with sleep quality in patients with hypertension.
METHODS: A single-center, observational, cross-sectional study was conducted. The study included patients admitted for follow-up inpatient examination and treatment at the Department of Propaedeutics of Internal Diseases, S.M. Kirov Military Medical Academy, from 2021 to 2024. During their first days in the hospital, patients completed validated questionnaires assessing psychoemotional status, sleep disorders, and risk of obstructive sleep apnea. The questionnaires included the Hospital Anxiety and Depression Scale, the Insomnia Severity Index, the STOP-BANG Risk Score for Obstructive Sleep Apnea, and the Epworth Sleepiness Scale.
RESULTS: A total of 348 patients were surveyed, with a mean age of 49.5 ± 20.6 years. The majority of participants were male (83.3%), whereas females comprised 16.7%. Symptoms of subclinical and clinically significant anxiety and depression were reported in 112 patients (32.2%) and 132 patients (37.9%), respectively. A high risk of obstructive sleep apnea was identified in 228 patients (65.5%), whereas 282 patients (81.1%) had moderate sleep disorders. The severity of anxiety and depression moderately correlated with sleep quality (ρ = 0.51 and 0.50, respectively; p < 0.001) and daytime sleepiness (r = 0.43 and 0.57, respectively; p < 0.001). Individuals with moderate sleep disorders were 12.88 times more likely to have depression symptoms (95% CI: 4.6–36.4) and 9.62 times more likely to have anxiety symptoms (95% CI: 3.40–27.20); these differences were significant. Moreover, there were significant differences in anxiety and depression severity in patients with exertional angina and a high risk of obstructive sleep apnea, regardless of sex. In female patients, significant differences in anxiety severity were reported (p < 0.05).
CONCLUSION: The findings show that patients with hypertension have a high prevalence of cardiovascular risk factors, including psychoemotional disorders, sleep disorders, and obstructive sleep apnea, emphasizing the importance of comprehensive history taking and using specialized questionnaires in routine clinical practice.
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##article.viewOnOriginalSite##About the authors
Alexander A. Kazachenko
Kirov Military Medical Academy
Author for correspondence.
Email: kazachenko.alex@gmail.com
ORCID iD: 0000-0002-4578-7893
SPIN-code: 4346-6785
MD, Cand. Sci. (Medicine), Associate Professor
Russian Federation, Saint PetersburgAlexey N. Kuchmin
Kirov Military Medical Academy
Email: kuchmin63@mail.ru
ORCID iD: 0000-0003-2888-9625
SPIN-code: 7787-1364
MD, Dr. Sci. (Medicine), Professor
Russian Federation, Saint PetersburgElena P. Golova
Kirov Military Medical Academy
Email: galova.elena@gmail.com
ORCID iD: 0000-0001-7820-0481
SPIN-code: 7306-8096
Russian Federation, Saint Petersburg
Anna V. Tanich
Kirov Military Medical Academy
Email: anya-tanich@yandex.ru
ORCID iD: 0009-0006-3349-1813
SPIN-code: 4059-6128
Russian Federation, Saint Petersburg
Igor M. Borisov
Kirov Military Medical Academy
Email: askbo@mail.ru
ORCID iD: 0000-0001-5075-9515
SPIN-code: 8139-5706
MD, Cand. Sci. (Medicine)
Russian Federation, Saint PetersburgMaxim I. Muzikin
Kirov Military Medical Academy; St.-Petersburg Scientific Research Institute of Ear, Throat, Nose and Speech; St. Petersburg Medical and Social Institute
Email: MuzikinM@gmail.com
ORCID iD: 0000-0003-1941-7909
SPIN-code: 7169-1489
MD, Dr. Sci. (Medicine), Associate Professor
Russian Federation, Saint Petersburg; Saint Petersburg; Saint PetersburgViktoriia A. Burletova
Kirov Military Medical Academy
Email: burletova2000@mail.ru
ORCID iD: 0009-0005-5300-5141
SPIN-code: 8199-9956
Russian Federation, Saint Petersburg
Marina А. Budkovaia
St.-Petersburg Scientific Research Institute of Ear, Throat, Nose and Speech
Email: marina-laptijova@yandex.ru
ORCID iD: 0000-0003-0219-1413
SPIN-code: 4116-3635
MD, Cand. Sci. (Medicine)
Russian Federation, Saint PetersburgSergei Yu. Tytiuk
Kirov Military Medical Academy
Email: sergei_tytyuk@mail.ru
ORCID iD: 0000-0002-7380-9332
SPIN-code: 2475-4340
MD, Cand. Sci. (Medicine)
Russian Federation, Saint PetersburgReferences
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