Objective  To investigate the application value of amlodipine atorvastatin calcium tablet (AACT) combined with evidence-based emotional nursing mode (EENM) in elderly patients with hypertension complicated by coronary heart disease (HTN-CHD).

Methods  HTN-CHD patients admitted to the department of cardiology of The Second Affiliated Hospital of Wenzhou Medical University from June 2021 to June 2023 were selected retrospectively as study subjects. According to the intervention methods, the HTN-CHD patients were divided into the AACT group and the EENM group. Patients in the AACT group were given AACT combined with the usual care intervention, and the EENM group was given EENM on the basis of the AACT group. The changes of psychological status (SDS, SAS, and SPBS), adherence (medication compliance, daily exercise behavior, poor management behavior, and dietary management behavior) and blood pressure [(systolic blood pressure, SBP) and diastolic blood pressure (DBP)] were compared between two groups. The incidence of cardiovascular events in the two groups at 6 months was observed and compared.

Results  A total of 118 HTN-CHD patients (55 in AACT group and 63 in EENM group) were included in this study. Before the intervention, there was no significant statistical difference in the SDS, SAS, SPBS, medication compliance, daily exercise, poor management, diet management scores, SBP and DBP between AACT and EENM groups (P>0.05). After the intervention, SDS, SAS, SPBP scores, SBP and DBP of the HTN-CHD patients significantly decreased in both AACT and EENM groups compared with before (P<0.05). However, the medication compliance behavior score, daily exercise behavior score, bad management behavior score and diet management behavior score increased significantly compared with before (P<0.05); SDS, SAS, SPBS scores, SBP and DBP of  the patients in EENM group decreased more than those in the AACT group (P<0.05), however, the increase of medication compliance, daily exercise, poor management and diet management behavior scores of the EENM group was higher than that in the AACT group (P< 0.05). Furthermore, the incidence of cardiovascular events was lower in the EENM group than in the AACT group (P<0.05).

Conclusion  EENM combined with AACT intervention is beneficial to improve the compliance with HTN-CHD patients, improve the psychological status and blood pressure values, and reduce the incidence of cardiovascular events.

1.Pan WL, Ren YK, Yang F, et al. Triglyceride glucose index is associated with obstructive coronary artery disease in hypertensive patients[J]. Cardiovasc Diabetol, 2023, 22(1): 9. DOI: 10.1186/s12933-023-01739-1.

2.Wang ZW, Chen Z, Zhang LF, et al. Status of hypertension in China: results from the China hypertension survey, 2012-2015[J]. Circulation, 2018, 137(22): 2344-2356. DOI: 10.1161/CIRCULATIONAHA.117.032380.

3.庄惊奇, 徐颖, 祁超静, 等. 脑立清胶囊联合吲达帕胺治疗高血压合并冠心病的效果及对PPAR-γ、MCP-1、ADMA水平的影响[J]. 临床医学研究与实践, 2023, 8(32): 124-127. [Zhuang JQ, Xu Y, Qi CJ, et al. The effect of naoliqing capsule combined with indapamide in the treatment of hypertension combined with coronary heart disease and its effect on PPAR-γ, the impact of MCP-1and ADMA levels[J]. Clinical Medical Research and Practice, 2023, 8(32): 124-127.] DOI: 10.19347/j. cnki.2096-1413.202332031.

4.石雪丽, 赵光宇, 刘敬敏. 氨氯地平阿托伐他汀对高血压合并冠心病患者心血管活性肽、炎症因子及血管内皮功能的影响[J]. 中国循证心血管医学杂志, 2021, 13(4): 438-442. [Shi XL, Zhao GY, Liu JM. The effects of amlodipine atorvastatin on cardiovascular active peptides, inflammatory factors, and endothelial function in hypertensive patients with coronary heart disease[J]. Chinese Journal of Evidence Based Cardiovascular Medicine, 2021, 13(4): 438-442.] DOI: 10.3969/j. issn.1674-4055.2021.04.13.

5.Hu CY, Zhang Y, Lin L, et al. Gestational hyperglycemia and the risk of cardiovascular diseases among elderly Chinese women: findings from the REACTION study[J]. J Diabetes, 2021, 13(12): 949-959. DOI: 10.1111/1753-0407.13222.

6.Zhen J, Wang J, Wang YL, et al. Fear of recurrence in elderly patients with coronary heart disease: the current situation and influencing factors according to a questionnaire analysis[J]. BMC Cardiovasc Disord, 2022, 22(1): 419. DOI: 10.1186/s12872-022-02853-w.

7.张万强, 刘冰. 氨氯地平阿托伐他汀钙片治疗高血压、冠心病合并颈动脉粥样硬化的临床效果观察[J]. 中国实用医药, 2022, 17(25): 125-127. [Zhang WQ, Liu B . Observation on the clinical effect of amlodipine atorvastatin calcium tablet in the treatment of hypertension, coronary heart disease and carotid atherosclerosis[J]. Chinese Practical Medicine, 2022, 17(25): 125-127.] DOI: 10.14163/j. cnki.11-5547/r.2022.25.035.

8.鲍亚超. 高血压合并冠心病患者行氨氯地平阿托伐他汀钙片治疗的效果观察[J]. 中国现代药物应用, 2023, 17(17): 119-121.[Bao YC. Observation of the therapeutic effect of amlodipine atorvastatin calcium tablets on patients with hypertension and coronary heart disease[J]. Modern Drug Applications in China, 2023, 17(17): 119-121.] DOI: 10.14164/j. cnki. cn11-5581/r.2023.17.032.

9.王瑞华, 闫镛. 中医情志护理对2型糖尿病患者血糖波动影响的临床分析[J]. 中国药物与临床, 2021, 21(20): 3482-3484 .[Wang RH, Yan Y. Clinical analysis of the influence of emotional nursing of traditional Chinese medicine on blood glucose fluctuation in patients with type2diabetes[J]. Chinese Journal of Medicine and Clinical Sciences, 2021, 21(20): 3482-3484.] DOI: 10.11655/zgywylc2021.20.051.

10.刘志新, 刘琼, 王静. 循证-情志护理模式对老年高血压合并冠心病病人心理状态及治疗依从性的影响 [J]. 护理研究, 2023, 37(9): 1682-1685. [Liu ZX, Liu Q, Wang J. The impact of evidence-based emotional nursing model on the psychological status and treatment compliance of elderly patients with hypertension and coronary heart disease[J]. Nursing Research, 2023, 37(9): 1682-1685.] DOI: 10.12102/j. issn.1009-6493.2023.09.035.

11.史叶菊. 循证-情志护理模式对老年高血压冠心病患者心理状态及治疗依从性的影响[J]. 心血管病防治知识, 2020, 10(23): 43-45. [Shi YJ. The impact of evidence-based emotional nursing model on the psychological status and treatment compliance of elderly patients with hypertension and coronary heart disease[J]. Knowledge of Cardiovascular Disease Prevention and Treatment, 2020, 10(23): 43-45.] DOI: 10.3969/j.issn.1672-3015(x).2020.23.015.

12.《中国高血压防治指南》修订委员会. 中国高血压防治指南2018年修订版[J]. 心脑血管病防治, 2019, 19(1): 1-44. DOI: 10.3969/j.issn.1009-816X. 2019.01.001.

13.葛均波, 徐永健, 主编. 内科学. 第8版[M]. 北京: 人民卫生出版社, 2013: 1.

14.李丽, 张秀秀, 巴蕊. ABC-X模型在改善结肠癌负性情绪和生活质量中的应用效果分析[J]. 实用中医内科杂志, 2022, 36(3): 141-143. [Li L, Zhang XX, Ba R. Analysis of the application effect of ABC-X model in improving negative emotions and quality of life in colon cancer[J]. Journal of Practical Traditional Chinese Medicine Internal Medicine, 2022, 36(3): 141-143.] DOI: 10.13729/j. issn.1671-7813. Z20211421.

15.徐丽, 沈飞燕, 邱华辉, 等. 情志护理改善颅内肿瘤患者负面情绪及依从性的效果[J]. 中华现代护理杂志, 2021, 27(33): 4572-4575. [Xu L, Shen FY, Qiu HH, et al. The effect of emotional nursing on improving negative emotions and compliance in patients with intracranial tumors[J]. Chinese Journal of Modern Nursing, 2021, 27(33): 4572-4575.] DOI: 10.3760/cma.j.cn115682-20210323-01265.

16.曹爽, 丁建伟, 李炳, 等. 慢性束缚应激诱导自发性高血压大鼠出现抑郁焦虑样行为[J]. 实验动物与比较医学, 2014, 34(2): 93-97. [Cao S, Ding JW, Li B, et al. Chronic restraint stress induces depression and anxiety like behavior in spontaneously hypertensive rats[J]. Experimental Animals and Comparative Medicine, 2014, 34(2): 93-97.] DOI: 10.3969/j. issn.1674-5817.2014.02.003.

17.赵秋娥, 卢振产, 沈轶倩, 等. 循证护理对急性脑梗死并发高血压患者神经功能及自我护理能力的影响[J]. 中华全科医学, 2020, 18(11): 1966-1969. [Zhao QE, Lu ZC, Shen YQ, et al. The effect of evidence-based nursing on the neurological function and self-care ability of patients with acute cerebral infarction complicated by hypertension[J]. Chinese General Medicine, 2020, 18(11): 1966-1969.] DOI: 10.16766/j.cnki.issn.1674-4152.001665.