The prevalence of depressive symptoms among older patients with hypertension in rural China

Abstract

Objective The comorbidity of depression and hypertension (HTN) is common and complicates the management of both conditions. This study investigated the prevalence of depressive symptoms among older patients with HTN in rural China and explored the relationship between the two conditions. Methods The baseline data of older patients diagnosed with HTN included in the depression/HTN in Chinese Older Adults—Collaborations for Health Study were used for the analysis. The Chinese Older Adults—Collaborations for Health Study was conducted in rural villages of Tonglu County, Zhejiang Province, China. In all, 10 389 older village residents had HTN (57.2% female, mean age 71.5 ± 8.1 years). Blood pressure was measured by using a calibrated manual sphygmomanometer and stethoscope. Depressive symptom was measured by using the Chinese version of the nine-item Patient Health Questionnaire. Results Among 10 389 patients with HTN, 12.8% had significant depressive symptoms (nine-item Patient Health Questionnaire ≥10). Rates of significant depressive symptoms were 5.3% and 32.8% among patients with controlled and uncontrolled HTN (systolic blood pressure ≥ 140 and/or diastolic blood pressure ≥ 90), respectively (χ2=8.701, p<0.001). Logistic regression analysis indicated that those in older age group (≥70 years) and with uncontrolled HTN have higher rates of significant depressive symptoms than those who are younger (age 60 to <70) and with controlled HTN. Conclusion Our findings show high rates of depressive symptoms among patients with HTN in rural China and higher rates of depressive symptoms among patients with uncontrolled HTN. These support the development and dissemination of integrative care approaches for older adults with HTN and depression in rural China.

Treatment adherence as a mediator of blood pressure control in Chinese older adults with depression

“…The results of mediation analyses supported our hypothesis that HTN control was mediated partially by treatment adherence in patients with HTN. These findings are consistent with previous work …”

“…As well, HTN and its sequelae are risk factors for depression, complicating help‐seeking, diagnosis, treatment, and prognosis . We recently reported that 13% of rural Chinese primary care patients aged 60 or more with HTN had clinically significant depressive symptoms and that the presence of depressive symptoms was associated with poor BP control—70% of those with depressive symptoms had uncontrolled HTN compared with 21% of those without …”

Prevalence of depression among hypertensive individuals in urban Trivandrum: a cross sectional study

“…A large population based study in rural China showed much lesser prevalence of depression than our study which may be due to ethnical differences. 12 A hypertensive clinic based cross sectional study conducted in South India showed a prevalence of depression as 25% among hypertensive subjects. 13 The prevalence in this study is less compared to the present study as the sample size was less and it was rather not a population based study.…”

Antihypertensive treatment and depressive symptoms in Chinese middle‐aged and older hypertensive adults: A population‐based longitudinal study

“…2,3 Among those with chronic diseases, the prevalence of depressive symptoms was as high as about 13%. 4 Hypertension is one of the most common chronic diseases in China and is estimated to have impacted nearly 52% of Chinese over 65 years old. 5 Prospective studies and meta-analyses including one of our own have shown that hypertension is a risk factor for incident depressive symptoms.…”