Association of depressive symptoms and hypertension prevalence, awareness, treatment and control among USA adults

Fang, Jing; Zhang, Zefeng; Greenlund, Kurt J.

doi:10.1097/hjh.0000000000003163

Cited by 5 publications

(5 citation statements)

References 40 publications

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“…Our study found a strong connection between depression and a heightened risk of hypertension, which increased alongside the severity of depression. These results support previous findings, reinforcing the notion that depression contributes to the likelihood of developing hypertension [ 17 ]. Plausible explanations for this association may be traced to the dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis and heightened sympathetic activation observed in individuals manifesting depressive symptoms [ 49 ].…”

Section: Discussionsupporting

confidence: 92%

“…In addition to inherent biological or genetic factors, factors such as job stress, financial limitations, stress from racial discrimination, depression, and anxiety can all play crucial roles in the development of cardiovascular diseases [ 47 ]. Psychological stress has been linked to an augmented susceptibility to hypertension, with research elucidating an elevated hypertension risk among individuals afflicted with depression [ 17 , 42 , 48 ]. Our study found a strong connection between depression and a heightened risk of hypertension, which increased alongside the severity of depression.…”

Section: Discussionmentioning

confidence: 99%

“…This may be attributed to the pronounced BP fluctuations in individuals with psychiatric disorders, leading to increased cardiovascular risk [ 16 ]. Research has demonstrated a higher incidence of hypertension among patients with depression [ 17 – 19 ]. Furthermore, a systematic review has revealed a bidirectional relationship between sleep disorders and depression [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

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Interaction effects between sleep-related disorders and depression on hypertension among adults: a cross-sectional study

Liu,

Ye,

Chen

et al. 2024

BMC Psychiatry

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Background Hypertension, sleep disorders, and depression represent notable public health issues, and their interconnected nature has long been acknowledged. The objective of this study is to explore the interplay between sleep disorders and depression in the context of hypertension. Methods This cross-sectional study involved 42,143 participants aged 18 and above from the NHANES database across seven survey cycles between 2005 and 2018. After excluding those with missing data on depression, sleep disorders, and hypertension, as well as incomplete main variables, 33,383 participants remained. We used weighted logistic regression to examine the relationship between sleep disorders, depression, and hypertension. Additionally, we assessed the interaction between sleep disorders and depression on hypertension using both multiplicative and additive approaches to quantify their combined effect. Results Compared to individuals without sleep disorders, those with sleep disorders have an increased risk of hypertension (OR = 1.51, 95% CI: 1.37–1.67). Furthermore, individuals with depression experience a significantly higher risk of hypertension compared to those with sleep disorders alone (OR = 2.34, 95% CI: 1.95–2.80). Our study reveals a positive interaction between sleep disorders and depression in relation to hypertension risk (OR = 1.07, 95% CI: 1.02–1.13). In addition, we observed the quantitative additive interaction indicators (RERI = 0.73, 95% CI: 0.56 ~ 0.92; API = 0.31, 95% CI: 0.11 ~ 0.46; SI = 2.19, 95% CI: 1.08–3.46) influencing hypertension risk. Furthermore, our research also identified that individuals with less than 7 h of sleep, a sleep latency period between 5 and 30 min, or a latency period exceeding 30 min experience a significantly increased risk of hypertension. Conclusions Our research uncovered separate links between sleep disorders, depression, and hypertension prevalence. Moreover, we identified an interaction between depression and sleep disorders in hypertension prevalence. Enhancing mental well-being and tackling sleep disorders could help prevent and manage hypertension. Yet, more investigation is required to establish causation and clarify mechanisms.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Interaction effects between sleep-related disorders and depression on hypertension among adults: a cross-sectional study

Liu,

Ye,

Chen

et al. 2024

BMC Psychiatry

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“…Our 10-year longitudinal study affirms that depressive symptoms significantly magnify the impact of hypertension, diabetes, and arthritis on reducing the life expectancy of middle-aged and older people, and this impact becomes apparent within a decade. Depressive symptoms diminish middle-aged and older individuals’ emotional regulation ( 117 ) and resilience to stress ( 118 ), heightening the challenge of managing mood and blood pressure for those with hypertension ( 119 ). Patients with depressive symptoms often exhibit an imbalance in the autonomic nervous system, particularly an overactivation of the sympathetic nervous system ( 120 ).…”

Section: Discussionmentioning

confidence: 99%

Depressive symptoms and all-cause mortality among middle-aged and older people in China and associations with chronic diseases

Zhu,

Wang,

et al. 2024

Front. Public Health

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IntroductionIt remains unclear whether depressive symptoms are associated with increased all-cause mortality and to what extent depressive symptoms are associated with chronic disease and all-cause mortality. The study aims to explore the relationship between depressive symptoms and all-cause mortality, and how depressive symptoms may, in turn, affect all-cause mortality among Chinese middle-aged and older people through chronic diseases.MethodsData were collected from the China Health and Retirement Longitudinal Study (CHARLS). This cohort study involved 13,855 individuals from Wave 1 (2011) to Wave 6 (2020) of the CHARLS, which is a nationally representative survey that collects information from Chinese residents ages 45 and older to explore intrinsic mechanisms between depressive symptoms and all-cause mortality. The Center for Epidemiological Studies Depression Scale (CES-D-10) was validated through the CHARLS. Covariates included socioeconomic variables, living habits, and self-reported history of chronic diseases. Kaplan–Meier curves depicted mortality rates by depressive symptom levels, with Cox proportional hazards regression models estimating the hazard ratios (HRs) of all-cause mortality.ResultsOut of the total 13,855 participants included, the median (Q1, Q3) age was 58.00 (51.00, 63.00) years. Adjusted for all covariates, middle-aged and older adults with depressive symptoms had a higher all-cause mortality rate (HR = 1.20 [95% CI, 1.09–1.33]). An increased rate was observed for 55–64 years old (HR = 1.23 [95% CI, 1.03–1.47]) and more than 65 years old (HR = 1.32 [95% CI, 1.18–1.49]), agricultural Hukou (HR = 1.44, [95% CI, 1.30–1.59]), and nonagricultural workload (HR = 1.81 [95% CI, 1.61–2.03]). Depressive symptoms increased the risks of all-cause mortality among patients with hypertension (HR = 1.19 [95% CI, 1.00–1.40]), diabetes (HR = 1.41[95% CI, 1.02–1.95]), and arthritis (HR = 1.29 [95% CI, 1.09–1.51]).ConclusionDepressive symptoms raise all-cause mortality risk, particularly in those aged 55 and above, rural household registration (agricultural Hukou), nonagricultural workers, and middle-aged and older people with hypertension, diabetes, and arthritis. Our findings through the longitudinal data collected in this study offer valuable insights for interventions targeting depression, such as early detection, integrated chronic disease care management, and healthy lifestyles; and community support for depressive symptoms may help to reduce mortality in middle-aged and older people.

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“…Dose–response association was observed for hypertension awareness and treatment – the percentage increased more among those with greater depressive symptom and were highest among those with moderate severe or severe depressive symptoms. Greater depressive symptoms were associated with great hypertension awareness and treatment but not with control [4].…”

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confidence: 87%