Depression and hypertension awareness, treatment, and control in a multiethnic population in the Netherlands: HELIUS study

Abstract

Individuals belonging to ethnic minority groups are more susceptible to depression and comorbid hypertension than European host populations. Yet, data on how depression is related to hypertension in ethnic groups in Europe are lacking. Therefore, we studied the association between significant depressed mood (SDM) and hypertension prevalence, awareness, treatment, and control among ethnic groups. Data from the HELIUS study included 22,165 adults (aged 18–70) from six ethnic backgrounds in the Netherlands. Logistic regression analysis was used to explore the association between SDM and hypertension prevalence, awareness, treatment, and control with adjustment for age, sex, and for sensitivity analysis purposes also for anti-depressants. After adjustment for age and sex, Dutch with SDM had an increased odds of hypertension (OR 95% CI 1.67; 1.08–2.59). Among Turkish, SDM was associated with higher odds of hypertension awareness (2.09; 1.41–3.09), treatment (1.92; 1.27–2.90) and control (1.72; 1.04–2.83). Among Moroccans, SMD was associated with an increased odds of hypertension awareness (1.91; 1.14–3.21) but decreased odds of hypertension control (0.42; 0.20–0.89). Additional adjustment for anti-depressant medications did not change the results. There were no associations between SDM and hypertension, awareness, treatment and control in South-Asian Surinamese, African Surinamese and Ghanaian participants. The results underline significant differences in the association between SDM and hypertension awareness, treatment and control between ethnic groups. Our findings emphasize the necessity to further study ethnicity-related factors that may influence the association between SDM and hypertension to promote hypertension control especially, among Moroccans with SDM.

Prospective association between depressive symptoms and blood-pressure related outcomes in Kosovo

“…This is in contrast to several other studies [51][52][53][54][55][56]. However, a recent cross-sectional study in the Netherlands (HELIUS study, n = 21 363) found that hypertension control among depressed people differed between ethnic groups [57]. This supports the importance to understand the association in the Kosovo context, especially given that we observed a much higher prevalence of depression among the Roma, Ashkali, and Egyptian ethnic minority group and poorer hypertension control was observed in ethnic minority groups as seen in the United States [58,59] who might have lower access to healthcare.…”

Association of Depression and Anxiety With Hypertensive Crisis: A Cross-Sectional Study From a Hospital Setting in Karachi, Pakistan

“…The underlying mechanisms between depression or anxiety and hypertensive crisis are that the stress response precipitated by depression leads to overactivity of the nervous system and the hypothalamic-pituitary-adrenal axis, promoting the sequelae of hypertension [ 26 ]. Other factors attributing to their correlation include poor adherence to antihypertensives in clinically depressed individuals, lack of physical activity, and use of antidepressant drugs [ 26 ].…”

“…The underlying mechanisms between depression or anxiety and hypertensive crisis are that the stress response precipitated by depression leads to overactivity of the nervous system and the hypothalamic-pituitary-adrenal axis, promoting the sequelae of hypertension [ 26 ]. Other factors attributing to their correlation include poor adherence to antihypertensives in clinically depressed individuals, lack of physical activity, and use of antidepressant drugs [ 26 ]. Anxiety is also known to activate the sympathetic nervous system as a stress response mechanism, leading to the release of neurotransmitters that cause tachycardia, increased inotropism, and vasoconstriction, ultimately impacting blood pressure levels [ 27 ].…”

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

“…The finding that greater depressive symptoms was associated with great hypertension awareness and treatment but not with control may be associated with several factors associated with either hypertension or depression, including healthcare system use, other coexisting conditions and adherence to treatment [37][38][39][40]. In addition, a recent report from the Netherlands showed significant differences in the association between depression and hypertension awareness, treatment and control between ethnic groups [39], suggesting that further study to assess the ethnicity-related factors affecting the association between depression status and hypertension is needed among diversity population.…”