Baseline Depressive Symptoms Are Not Associated With Clinically Important Levels of Incident Hypertension During Two Years of Follow-Up: The Multi-Ethnic Study of Atherosclerosis

• Published in: Hypertension (Dallas, Tex. 1979) Vol. 55; no. 2; pp. 408 - 414
• Main Authors: Delaney, Joseph A.C, Oddson, Bruce E, Kramer, Holly, Shea, Steven, Psaty, Bruce M, McClelland, Robyn L
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD American Heart Association, Inc 01.02.2010; Lippincott Williams & Wilkins
• Subjects: Age Distribution; Aged; Aged, 80 and over; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Atherosclerosis - diagnosis; Atherosclerosis - epidemiology; Atherosclerosis - ethnology; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure Determination; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Cohort Studies; Comorbidity; Confidence Intervals; Depression - diagnosis; Depression - epidemiology; Depression - ethnology; Ethnic Groups - statistics & numerical data; Female; Follow-Up Studies; Humans; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - epidemiology; Hypertension - ethnology; Incidence; Linear Models; Male; Medical sciences; Middle Aged; Multivariate Analysis; Prospective Studies; Risk Assessment; Severity of Illness Index; Sex Distribution; Sickness Impact Profile; Time Factors; United States - epidemiology; United States; Vascular disease; Hypertension; imputations; Follow up study; Atherosclerosis; Cardiovascular disease; Arterial pressure; Blood pressure; Multi-Ethnic Study of Atherosclerosis; depression; censored normal regression
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/HYPERTENSIONAHA.109.139824

Previous longitudinal cohort studies have suggested an association between baseline depressive symptoms and incident hypertension. We assessed this possible association using data from the Multi-ethnic Study of Atherosclerosis, a population-based prospective cohort study of 6814 US adults from 4 different racial/ethnic groups. Baseline users of antihypertensive medications and participants lost to follow-up were excluded leaving 3914 participants. Patients with baseline depressive symptoms (n=622) were defined using a high score on the Center for Epidemiological Studies Depression Scale (≥16) or the use of an antidepressant medication. Hypertension was defined as systolic blood pressure of ≥140 mm Hg, diastolic blood pressure of ≥90 mm Hg or new use of antihypertensive medications plus physician diagnosis. Estimates were adjusted for known risk factors, including age, sex, baseline blood pressure, diabetes, and body mass index. Untreated blood pressure was estimated using an imputation approach. A total of 477 participants developed hypertension. Using relative risk regression, patients with baseline depressive symptoms did not have an increased risk of incident hypertension (relative risk1.02; 95% confidence interval [CI]0.99 to 1.05), although an association between tricyclic antidepressants and hypertension (relative risk1.20; 95% CI1.05 to 1.37) was observed in subgroup analysis. Depression, even after adjustment for covariates, was associated with small changes in systolic (+2.4 mm Hg; 95% CI0.2 to 4.7) and diastolic (+0.8 mm Hg; 95% CI−0.6 to 2.3) blood pressures. Depressive symptoms may be associated with slight increases in blood pressure in this multiethnic cohort, but it is premature to conclude much without longer studies in other populations.