Decreasing Blood Pressure Over Time is the Strongest Predictor of Depressive Symptoms in Octogenarian Men

Siennicki-Lantz, Arkadiusz; André-Petersson, Lena; Elmståhl, Sölve

doi:10.1016/j.jagp.2012.11.007

Cited by 12 publications

(11 citation statements)

References 35 publications

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“…Systolic blood pressure was over 10 mmHg lower (151.8 ± 21.5vs. 162.5 ± 24.4 ; p = .03 ) in the case group compared to the controls, as previously reported [5], while frequency of hypertension was significantly lower at age 68, and slightly lower at age 82 (Table 1). Somatic symptoms differed between the groups, with significantly higher frequency of: fatigue, nausea, freezing, leg edema, in the case group, and slightly higher, if non-significant, of abdominal pain or dyspnea.…”

Section: Resultssupporting

confidence: 86%

“…It could mean that CBF changes in a large part of the brain in early depression could be at least in some subjects caused by a high blood pressure. This result is surprising, since we previously have shown that a grade of depression in this cohort is related to the blood pressure decline from age 68 to age 82, especially in those who were hypertensive at age 68, thereafter reached an inflection point in blood pressure trajectories, followed by a pressure decline until age 82 [5]. We explained it with a possible heart failure, frailty or dysautonomia.…”

Section: Discussionmentioning

confidence: 67%

“…The possible mechanism for these changes could be vascular or degenerative, or an accumulation of both factors [4]. Study results suggesting vascular impact in the elderly depression presented higher frequency of hypertension earlier in life, in those who later developed depression (72% vs 52%), and a very clear blood pressure decline in the preceding years [5]. Brain atrophy observed in younger elderly with hypertension and subsequent blood pressure decline predict poorer somatic health, cognition and shorter survival [6].…”

Section: Introductionmentioning

confidence: 99%

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Depressive symptoms, atherosclerotic burden and cerebral blood flow disturbances in a cohort of octogenarian men from a general population

Siennicki-Lantz

André-Petersson²,

Wollmer³

et al. 2013

BMC Psychiatry

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BackgroundThe aim of this study was to examine in elderly men a relationship between depressive symptoms, peripheral vascular disease and cerebral blood flow (CBF).MethodsPopulation-based cohort study started with an examination of 809 men at age 55, followed by the first (age 68ys) and second follow up (age 82ys). 128 survivors were examined at age 82 with 99mTc-HMPAO-SPECT to estimate CBF, Zung-Self-Rating-Depression Scale (ZSDS), and Ankle-Brachial Index (ABI). Analysis was performed on men free from stroke and dementia which defined the final study population to 120 subjects.ResultsZSDS in the whole cohort ranged from 0.26 to 0.71 (reference 0.25-1.0). As the frequency of depressive symptoms was low, the case group (n = 31) was defined by ZSDS index above 75th percentile (≥0.48), comprising 9 subjects with mild depression (ZSDS 0.55-0.71) and 22 subjects at 88th percentile and above of the normal range (ZSDS index 0.48-0.54). Cases were more often current smokers at age 68 (44% vs. 24%; p = .02) and had lower systolic blood presure (SBP), lower social and physical activity, and suffered from fatigue, nausea, freezing and leg edema at age 82. Within the case group, ZSDS-index correlated negatively with CBF in subcortical area (r = -.42*), left and right thalamus (r = -.40*, r = -.46**), and right basal nuclei (r = -.35*). ZSDS-index correlated also with ABI at age 82 (right leg r = -.40*; left leg r = -.37*), and with Δ between ABI at age 82 and 68 (right r = -.36*; left r = -.46**). Despite decreasing SBP from age 68 to 82, adjusted multiple regression analysis showed in the case group that higher SBP determined CBF changes in the frontal and parietal areas, independently of ZSDS index, Δ ABI, and smoking.ConclusionIn this population-based cohort of octogenarian men free from stroke or dementia, a proportion of subjects with depressive symptoms was low. Still, men with borderline or mild depression scores had lower social and physical activity, persistent smoking habit, worse peripheral circulation in legs, and cerebral perfusion changes in basal nuclei, thalamus and subcortical white matter. Regional CBF decline could be partly mediated by higher SBP.

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Section: Resultssupporting

confidence: 86%

Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

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Depressive symptoms, atherosclerotic burden and cerebral blood flow disturbances in a cohort of octogenarian men from a general population

Siennicki-Lantz

André-Petersson²,

Wollmer³

et al. 2013

BMC Psychiatry

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“…However, in contrast to the other components, results for SBP and HDL‐C were unexpected, whereby greater depressive and anxiety symptom severity were associated with lower SBP and higher HDL‐C. Although a relationship between depression and hypertension is often observed,39, 40 a negative association between psychopathology and SBP has been reported previously in NESDA and other cohorts 41, 42, 43, 44. The effect does not seem to be driven by medication use.…”

Section: Discussionmentioning

confidence: 53%

“…Although a relationship between depression and hypertension is often observed, [39,40] a negative association between psychopathology and SBP has been reported previously in NESDA and other cohorts. [41][42][43][44] The effect does not seem to be driven by medication use. Lowered blood pressure in psychopathology may be a consequence of shared risk factors, such as levels of neuropeptide Y, which is associated with suppressed parasympathetic activity and stress, depression and anxiety.…”

Section: Table 2 Associations Of Psychopathology Diagnosis Symptomsmentioning

confidence: 88%

Bidirectional Prospective Associations of Metabolic Syndrome Components With Depression, Anxiety, and Antidepressant Use

et al. 2016

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BackgroundMetabolic syndrome components—waist circumference, high‐density lipoprotein cholesterol (HDL‐C), triglycerides, systolic blood pressure and fasting glucose—are cross‐sectionally associated with depression and anxiety with differing strength. Few studies examine the relationships over time or whether antidepressants have independent effects.MethodsParticipants were from the Netherlands Study of Depression and Anxiety (NESDA; N = 2,776; 18–65 years; 66% female). At baseline, 2‐ and 6‐year follow‐up, participants completed diagnostic interviews, depression and anxiety symptom inventories, antidepressant use assessment, and measurements of the five metabolic syndrome components. Data were analyzed for the consistency of associations between psychopathology indicators and metabolic syndrome components across the three assessment waves, and whether psychopathology or antidepressant use at one assessment predicts metabolic dysregulation at the next and vice versa.ResultsConsistently across waves, psychopathology was associated with generally poorer values of metabolic syndrome components, particularly waist circumference and triglycerides. Stronger associations were observed for psychopathology symptom severity than diagnosis. Antidepressant use was independently associated with higher waist circumference, triglycerides and number of metabolic syndrome abnormalities, and lower HDL‐C. Symptom severity and antidepressant use were associated with subsequently increased number of abnormalities, waist circumference, and glucose after 2 but not 4 years. Conversely, there was little evidence that metabolic syndrome components were associated with subsequent psychopathology outcomes.ConclusionsSymptom severity and antidepressant use were independently associated with metabolic dysregulation consistently over time and also had negative consequences for short‐term metabolic health. This is of concern given the chronicity of depression and anxiety and prevalence of antidepressant treatment.

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Increase in blood pressure precedes clinical depression in elderly primary care patients

Gao

Hendrie

Yang

et al. 2013

Int J Geriat Psychiatry

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Decreasing Blood Pressure Over Time is the Strongest Predictor of Depressive Symptoms in Octogenarian Men

Cited by 12 publications

References 35 publications

Depressive symptoms, atherosclerotic burden and cerebral blood flow disturbances in a cohort of octogenarian men from a general population

Depressive symptoms, atherosclerotic burden and cerebral blood flow disturbances in a cohort of octogenarian men from a general population

Bidirectional Prospective Associations of Metabolic Syndrome Components With Depression, Anxiety, and Antidepressant Use

Increase in blood pressure precedes clinical depression in elderly primary care patients

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