Visit-To-Visit Blood Pressure Variability and Subthreshold Depressive Symptoms in Older Adults

Sible, Isabel J.; Jang, Jung Yun; Sultzer, David L.; Nation, Daniel A.

doi:10.1016/j.jagp.2022.03.006

Cited by 15 publications

(10 citation statements)

References 40 publications

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“…The associations between BPV and emotional status, such as depressive symptoms or anxiety, are relatively consistent in prior research [21][22][23][24], although fewer studies evaluated BPV as a factor. Elderly-onset depression affects diurnal variations in BP and is associated with cerebral infarction [22].…”

Section: Introductionsupporting

confidence: 61%

Relationship between visit-to-visit blood pressure variability and depressive mood in Korean primary care patients

Lee

Sunwoo

et al. 2023

Preprint

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Background We evaluated the effect of depressive mood on long-term visit-to-visit blood pressure (BP) variability (BPV) in primary care patients in Korea.Methods The Family Cohort Study in Primary Care (FACTS) used a prospective cohort that was established to investigate the relationship between the familial environment and health in Korean primary care patients. Depressive mood was assessed as a score of 21 points or more on a Korean-type Center for Epidemiologic Studies Depression scale. BP was measured at the initial visit and first and second follow-up visits. BPV was calculated using the average of the differences between the measurements at the initial visit and first follow-up visit and at the first and second follow-up visits. High visit-to-visit BPV was defined when the average difference fell within the fourth quartile. Logistic regression analysis was used to estimate the association of high BPV with depressive mood and a range of variables.Results Of the 371 participants, 43 (11.6%) had depressive mood according to the depression score. In multivariate analysis, the odds ratio (OR) (OR: 2.26, 95% confidence interval (CI): 1.11–4.60) for high systolic BP (SBP) variability in participants with depressive mood was more than twice that in participants without depressive mood. Additionally, older age (OR: 31.91, 95% CI: 3.74–272.33 among participants aged ≥ 70 years) and use of antihypertensive medication (OR: 1.77, 95% CI: 1.02–3.05) were associated with high SBP variability.Conclusions Depressive mood was associated with high visit-to-visit SBP variability in primary care patients. Older age and use of antihypertensive medication were also associated with high SBP variability.

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Section: Introductionsupporting

confidence: 61%

Relationship between visit-to-visit blood pressure variability and depressive mood in Korean primary care patients

Lee

Sunwoo

et al. 2023

Preprint

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“…A few studies have postulated possible mechanisms of depression in each independent metabolic variability. Increased glucose variability might be related to changes in insulin sensitivity, insulin secretion, and increased oxidative stress on the endothelial function, which results in atherosclerotic change (47,48). Blood pressure variability is an independent risk of micro-macrovascular complications and can impair cerebral blood flow (49, 50).…”

Section: Discussionmentioning

confidence: 99%

Higher metabolic variability increases the risk of depressive disorder in type 2 diabetes mellitus: a longitudinal nationwide cohort study

An¹,

Jeon²

2023

Front. Psychiatry

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Background and objectivesWhile variabilities in metabolic parameters (METv) have been linked to adverse health outcomes in type 2 DM, their association with depression is yet to be studied. This research aimed to investigate the association between METv and depressive disorder in patients with type 2 DM.MethodsThe study involved a nationwide cohort of 1,119,631 type 2 DM patients who had undergone three or more serial health examinations between 2005 and 2012. At each visit, body mass index (BMI), fasting glucose (FG), systolic blood pressure (BP), and total cholesterol (TC) were measured and stratified into quartiles, with Q4 being the highest and Q1 the lowest. The risk of depressive disorder was evaluated using Cox proportional hazard regression models, which accounted for METs in the indexes, after adjusting for sex, income status, lifestyle habits, medical comorbidities, DM severity, and baseline levels of BMI, FG, BP, and TC.ResultsDuring a mean follow-up period of 6.00 ± 2.42 years, 239,477 (21.4%) cases of type 2 DM patients developed depressive disorder. The risk of developing depressive disorder was gradually increased as the number of METv increased (HR 1.18; 95% CI 1.13, 1.23 for the group with the highest METv in all parameters compared to those with the lowest METv in all parameters). In the subgroup analysis, the risk of developing depressive disorder was 43% higher in men (HR 1.43; 95% CI 1.34, 1.51), and 31% higher in those younger than 65 years of age (HR 1.31; 95% CI 1.23, 1.39) in the group with the highest number of METv compared to the group with the lowest number of METv.ConclusionIn type 2 DM, higher METv was an independent risk factor for depressive disorder. This risk is notably elevated in men and individuals under the age of 65 years.

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“…Moreover, BP responses were previously found to be correlated with baroreceptor activation of the central feedback pathway in emotional picture-perception tasks (93). Increased BP variability has been related to increased severity of subclinical depression, suggesting a link between baroreflex dysfunction and HDR (94). Thus, we speculated that individuals with high BDI scores also have reduced BRS.…”

Section: Discussionmentioning

confidence: 99%

Brain–heart dynamics during emotional processing under uncertain conditions: An index of depression risk

Chan

Machizawa

Mizuochi

et al. 2021

Preprint

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Recent studies highlight interoception as the key to processing healthy emotion and pathophysiology of affective disorders such as major depressive disorder (MDD). It has been reported that interoceptive responses are impaired in MDD and in healthy individuals with a high depressive risk (HDR). However, it is unclear how individual differences in HDR relate to neurophysiological underpinnings for interoceptive and emotional reactions under different degrees of certainty. We examined whether HDR mediates the relationship between a neuro-physiological marker for interoception, heartbeat-evoked potential (HEP), and an index for cardiac reactivity, heart rate (HR) or heart rate variability (HRV). In a concurrent EEG-ECG experiment, 26 healthy participants underwent an emotion-evoking picture evaluation task. One of three differential auditory tones associated with a level of certainty preceded display of a pleasant or unpleasant picture. The results showed attenuated HRV activity for certain cues in HDR individuals. Neural and physiological reactions to uncertain, unpleasant pictures were enhanced by the depressive risk. These results suggest reduced responses in prediction processing and enlarged precision-weighted prediction error for unpleasant pictures. Finally, HDR significantly mediated the HEP and HR relationship for unexpected unpleasant stimuli. Our study thus provides evidence that interoceptive predictive coding in the cardiac domain is altered by HDR, and suggests that investigating the heart-brain interaction related to predictive coding will offer insights into how to estimate the level of depressive risk.

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Visit-To-Visit Blood Pressure Variability and Subthreshold Depressive Symptoms in Older Adults

Cited by 15 publications

References 40 publications

Relationship between visit-to-visit blood pressure variability and depressive mood in Korean primary care patients

Relationship between visit-to-visit blood pressure variability and depressive mood in Korean primary care patients

Higher metabolic variability increases the risk of depressive disorder in type 2 diabetes mellitus: a longitudinal nationwide cohort study

Brain–heart dynamics during emotional processing under uncertain conditions: An index of depression risk

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