中国老年高血压患者焦虑和/或抑郁影响因素的Meta分析

Meta-Analysis of Factors Affecting Anxiety and/or Depression in Chinese Elderly Hypertensive Patients

摘要: 目的：本研究旨在通过Meta分析系统评估中国老年高血压患者中焦虑和/或抑郁的检出率及其影响因素，探讨性别、年龄、文化程度、经济状况、婚姻状况等社会和健康因素对老年高血压患者心理健康的影响，为临床治疗和心理干预提供依据。方法：检索中国知网、万方、维普网、PubMed、Web of Science等数据库中截至2023年1月发表的关于老年高血压患者焦虑和/或抑郁的研究。文献纳入标准为横断面研究，研究对象为年龄 ≥ 60岁、符合高血压诊断标准的患者。使用RevMan 5.4软件进行数据分析，评估各影响因素的合并效应量(OR值)和95%置信区间。异质性检验采用I²统计量，使用随机或固定效应模型进行分析，并对结果进行敏感性分析和发表偏倚评估。结果：本次Meta分析共纳入19篇文献，涵盖中国不同地区的老年高血压患者。焦虑和抑郁的检出率分别在11%至56.61%和14.94%至61.00%之间。性别、文化程度、经济状况、婚姻状况、服药依从性、睡眠质量等是焦虑和/或抑郁的显著影响因素。女性、文化程度低、经济状况差、婚姻不稳定(如丧偶或离异)患者中焦虑和抑郁的发生率较高。敏感性分析结果稳定，发表偏倚风险较低。结论：焦虑和抑郁在中国老年高血压患者中具有较高的发生率，且与多种社会和健康因素密切相关。临床医生在高血压治疗过程中应加强心理健康管理，特别是对高风险群体(如女性、经济困难者等)的心理干预。本研究为老年高血压患者的综合治疗提供了科学依据，也为未来的干预措施设计提供了参考。

Abstract: Objective: The aim of this study was to assess the detection rate of anxiety and/or depression and its influencing factors among Chinese elderly hypertensive patients by Meta-analysis system, to explore the influence of social and health factors such as gender, age, education level, economic status, marital status, and so on, on the mental health of elderly hypertensive patients, and to provide a basis for clinical treatment and psychological intervention. Methods: Studies on anxiety and/or depression in elderly hypertensive patients published up to January 2023 in the databases of CNKI, Wanfang, VIP, PubMed, and Web of Science were searched. Literature inclusion criteria were cross-sectional studies of patients aged ≥ 60 years who met diagnostic criteria for hypertension. Data were analysed using RevMan 5.4 software to assess the combined effect sizes (ORs) and 95% confidence intervals for each influential factor. Heterogeneity tests were performed using the I² statistic, analyses were performed using random or fixed-effects models, and results were subjected to sensitivity analysis and publication bias assessment. Results: A total of 19 papers were included in this Meta-analysis, covering elderly hypertensive patients from different regions of China. The detection rates of anxiety and depression ranged from 11% to 56.61% and 14.94% to 61.00%, respectively. Gender, literacy, economic status, marital status, medication adherence, and sleep quality were significant influences on anxiety and/or depression. The incidence of anxiety and depression is higher among female patients with low education levels, poor economic conditions, and unstable marriages (such as widowed or divorced). The results of the sensitivity analyses were stable with a low risk of publication bias. Conclusion: Anxiety and depression have a high prevalence in Chinese elderly hypertensive patients and are strongly associated with multiple social and health factors. Clinicians should strengthen mental health management during hypertension treatment, especially psychological interventions for high-risk groups (e.g., women, economically disadvantaged, etc.). This study provides a scientific basis for the comprehensive treatment of elderly hypertensive patients and a reference for the design of future interventions.