Prevalence and Predictors of Depression Amongst Hypertensive Individuals in Karachi, Pakistan

Abstract

ObjectiveWhile studies evaluating the prevalence of depression and hypertension have been extensively carried out in high income countries, there is a paucity of information assessing the prevalence of depression within hypertensive patients in low income nations. The primary objective of this study was to investigate the prevalence of undiagnosed depression in hypertensive patients within a tertiary care facility in Karachi, Pakistan. The secondary objective was to assess factors associated with undiagnosed depression in this group.MethodsA cross-sectional study was conducted at the Civil Hospital Karachi Outpatient Department from January 2017 to April 2017. The sample population was composed of 411 hypertensive patients. Interviews were conducted after taking informed consent, with data concerning basic demographic details and lifestyle habits gathered. Blood pressure was recorded and its severity was classified as per the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) guidelines. Depression was evaluated and its severity classified as per the Patient Health Questionnaire-9 (PHQ-9) scale, with a score of 10 or above set as the cut-off point. Data were entered and analyzed using the IBM Statistical Package for the Social Sciences 23.0. (IBM, NY, USA)ResultsThe prevalence of depression within 411 hypertensive patients was 40.1% (n = 165). The mean age of the sample was 45.7 ± 11.2 years, and the majority were females (72%, n = 295), unemployed (72%, n = 296), had primary or no education (67%, n = 277), and were of low socioeconomic status (78%, n = 321). The average systolic and diastolic blood pressures were 143.8 ± 21.7 and 93.3 ± 15.5 mm Hg, respectively. Factors which had a significant association with depression were gender (p = 0.009), age class (p = 0.035), educational status (p = 0.000), employment status (p = 0.003), socioeconomic status (p = 0.008), physical activity (p = 0.025), smoking (p = 0.017), and family history of hypertension (p = 0.022).ConclusionWith such a high prevalence rate of undiagnosed depression within hypertensive patients, it is pertinent to establish screening programs for early detection and community programs to raise awareness regarding long-term complications of untreated depression.

Undiagnosed Depression among Hypertensive Individuals in Gaza: A Cross-sectional Survey from Palestine

“…However, gender and smoking [21,22,24,26] found to be associated factors in previous studies, they did not reach statistical signi cant level in our study. Longer hypertension duration has been previously found to be signi cantly associated factor in an Indian study [26]; and was associated factor in our univariable analysis, although, it could not reach signi cant level in multivariable analysis.…”

“…The associated factors found by multiple linear regression in this study were: age, number of antihypertensive medication, adherent status, health-care system support, patient-doctor relationship and perceived social support. Increasing age was found to be an associated factors with increase depressive symptom in other studies [21,22,24,25], although, our results predicted a negative relationship between age and depressive status. An explanation of this could be related to the nature of aged people in Gaza, since they are more acceptance and adapted to their disease than younger adult.…”

The Association Between Depression and Self-Reported Sleep Quality Among Hypertensive Patients in a Rural Area of Central Sulawesi

“…The incidence of hypertension is higher among individuals with depressive symptoms (Ma & Li, 2017). The prevalence of depression among hypertensive patients were from 26.6 to 41.7% (Ademola et al, 2019;Mahmood et al, 2017;Prathibha, Varghese, & Jincy, 2017). Study showed that the prevalence of depression in elderly patients with hypertension living in rural areas was higher.…”

Maginitude and Associated Factors of Depression Among Hypertensive Patients Attending Treatment Follow Up in Chronic Opd at Hawassa University Comprehensive Specialized Hospital, Hawassa, Southern Ethiopia

“…In 2010, it had been estimated that a 31.1% of the global population (1.39 billion) was hypertensive [4] Patients with depression and/or anxiety represent a particularly vulnerable population as they are at higher risk for developing hypertension. In addition, patients with co-morbid hypertension and mental health disorders are a higher-risk population for cardiovascular disease related mortality [5]. Depression and hypertension combined have a far more detrimental effect on health than individually and are reported to decrease the quality of life and cause an increased risk of myocardial infarction and stroke.…”