Faculty Collaboration Database

Association of depressive symptoms with all-cause and ischemic heart disease mortality in adults with self-reported hypertension. Am J Hypertens 2010 Jan;23(1):30-7

Date

11/07/2009

Pubmed ID

19893497

DOI

10.1038/ajh.2009.199

Scopus ID

2-s2.0-72449122280 (requires institutional sign-in at Scopus site)   41 Citations

Abstract

BACKGROUND: Hypertension (HTN) is a prevalent and important risk factor for both cardiovascular and all-cause mortality. Depression is often present in hypertensive patients and has also been associated with increased mortality risk. The aim of this study was to evaluate the association of depressive symptoms with all-cause mortality and ischemic heart disease (IHD) mortality among adults with self-reported HTN.

METHODS: We studied 10,025 participants in the National Health and Nutrition Epidemiologic Follow-up Study (NHANES I) who were alive and interviewed in 1982 and had complete data for the Center for Epidemiologic Studies Depression Scale (CES-D). Four groups were identified based screening status at initial interview: (i) no HTN, no depression (reference group); (ii) HTN, no depression; (iii) no HTN, depression; and (iv) both HTN and depression. Cox proportional hazards regression was used to calculate multivariate-adjusted hazard ratios (HRs) of death for each group.

RESULTS: Over an average of 8 years (83,943 person-years) of follow-up, patients with both self-reported HTN and depressive symptoms had the highest multivariate-adjusted HR for all-cause mortality at 1.39 (95% confidence interval (CI) 1.14, 1.69) as well as for IHD mortality at 1.59 (95% CI 1.08, 2.34). In post hoc analysis, nondepressed hypertensive patients had significantly lower adjusted HR for all-cause mortality compared to depressed hypertensive patients (HR 0.85; 95% CI 0.73-1.00), but the HR for IHD mortality was not significant (HR 0.87, 95% CI 0.63-1.20).

CONCLUSION: Comorbid depressive symptoms are associated with increased all-cause mortality in patients with self-reported HTN.

Author List

Axon RN, Zhao Y, Egede LE

Author

Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cohort Studies
Depression
Female
Follow-Up Studies
Humans
Hypertension
Male
Middle Aged
Multivariate Analysis
Myocardial Ischemia
Nutrition Surveys
Proportional Hazards Models