Gender Differences in Vascular Stiffness Indicators and Daily Blood Pressure Profile in Patients with Arterial Hypertension and Depressive Disorders

Abstract

Aim      To study gender-related characteristics of vascular wall stiffness (VWS), central blood pressure (CBP), and BP diurnal profile in patients with arterial hypertension (AH) and depression.Material and methods  This prospective, noninterventional study enrolled 161 patients, including 98 patients with AH and depression (50 (51 %) men and 48 (49 %) women) and 63 patients with AH without depression (32 (50.8 %) men and 31 (49.2 %) women. The 24-h BP monitoring (24-h BPM) with a BPLab Vasotens hardware system was performed for all patients. The following indexes were evaluated: mean diurnal, mean daytime, and mean nighttime systolic and diastolic BP (SBP and DBP); daytime and nighttime SBP and DBP time index; SBP and DBP variability; and suite of metrics characterizing VWS and CBP. Depression was diagnosed with the Hospital Anxiety and Depression Scale (HADS) and the Zung Self-Rating Depression Scale. Statistical analyses were performed using the STATISTICA 12 software.Results In the patient group with AH and depression, practically all indexes of 24-h BPM were higher for men than for women (р<0.05). Most 24-h BPM parameters did not differ in groups of men and women without depression. Independent of gender, 24-h BPM parameters were significantly higher in patients with both AH and depression than in AH patients without depression. Adverse changes in major indexes of VWS and CBP, were more pronounced in men than in women with AH and depression (р<0.05). Adverse changes in most VWS and CBP indexes were more statistically significant for men with AH and depression than for men without depression.Conclusion      The presence of depression in men and women with AH was associated with significant pathological changes in both BP diurnal profile and CBP and VWS parameters. Furthermore, adverse changes in indexes were more pronounced for men with depression than for women. The study results should be taken into account in administration of antihypertensive and psychocorrective drug therapy to personalize the treatment and provide not only optimization of diurnal BP profile but also vasoprotection.