Blood pressure values and depression in hypertensive individuals at high cardiovascular risk

BMC Cardiovascular Disorders

Miguel-Angel Muñoz⁴  José Vicente Sorlí⁶  Josep Basora⁹  Xavier Pintó⁹  Lluis Serra-Majem⁹  Fernando Arós⁹  Montse Fitó¹  José Manuel Santos¹  Miquel Fiol⁵  Enrique Gómez-Gracia²  Dolores Corella⁶  Jordi Salas-Salvadó⁷  Miguel Angel Martínez-González^1,10  Ramón Estruch⁸  Cilia Mejia-Lancheros³ 

[1] Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición(CIBERobn), Instituto de Salud Carlos III, Madrid, Spain;The Department of Preventive Medicine, University of Malaga, Malaga, Spain;Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain;Catalan Institute of Health, Institut d’Investigació en Atenció Primària Jordi Gol, Sardenya 375,Entlo, 08025 Barcelona, Spain;Institute of Health Sciences (IUNICS), University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain;The Department of Preventive Medicine, University of Valencia, Valencia, Spain;Human Nutrition Department, Hospital Universitari Sant Joan, Institut d’Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain;The Department of Internal Medicine of Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain;The PREDIMED Study (Prevención con Dieta Mediterránea) Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain;Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain

关键词: Blood pressure;    Depression;    Hypertension;   

Others  :  1088463
DOI  :  10.1186/1471-2261-14-109

 received in 2014-04-09, accepted in 2014-08-20,  发布年份 2014

【 摘 要 】

Background

Hypertension and depression are both important risk factors for cardiovascular diseases. Nevertheless, the association of blood pressure on and depression has not been completely established. This study aims to analyze whether depression may influence the control of blood pressure in hypertensive individuals at high cardiovascular risk.

Methods

Cross-sectional study, embedded within the PREDIMED clinical trial, of 5954 hypertensive patients with high cardiovascular risk factor profiles. The relationship between blood pressure control and depression was analyzed. A multivariate analysis (logistic and log-linear regression), adjusting for potential confounders (socio-demographic factors, body mass index, lifestyle, diabetes, dyslipidemia, and antihypertensive treatment), was performed.

Results

Depressive patients, with and without antidepressant treatment, had better blood pressure control (OR: 1.28, CI 95%: 1.06-1.55, and OR: 1.30, CI 95%: 1.03-1.65, respectively) than non-depressive ones. Regarding blood pressure levels, systolic blood pressure values (mmHg) were found to be lower in both treated and untreated depressive patients (Log coefficient Beta: -1.59, 95% CI: -0.50 to -2.69 and Log coefficient Beta: -3.49, 95% CI: -2.10 to -4.87, respectively).

Conclusions

Among hypertensive patients at high cardiovascular risk, the control of blood pressure was better in those diagnosed with depression.

Trial registration

Unique identifier: ISRCTN35739639.

【 授权许可】

   
2014 Mejia-Lancheros et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Global Health Observatory (GHO), World Health Organization: Raised blood pressure: Situation and trends. [http://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/en/ webcite]
• [2]Institute for Health Metrics and Evaluation: The Global Burden of Disease:Generating Evidence, Guiding Policy. Seattle: WA, IHM; 2013.
• [3]Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren WM, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvänne M, Scholte Op Reimer WJ, Vrints C, Wood D, Zamorano JL, Zannad F, Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice; European Association for Cardiovascular Prevention and Rehabilitation: European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2012, 33:1635-1701.
• [4]Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Magid D, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER, Moy CS, Mussolino ME, et al.: Heart disease and stroke statistics-2013 update: a report from the American Heart Association. Circulation 2013, 127:e6-e245.
• [5]Hemingway H, Marmot M: Evidence based cardiology: psychosocial factors in the aetiology and prognosis of coronary heart disease. Systematic review of prospective cohort studies. BMJ 1999, 318:1460-1467.
• [6]Rozanski A, Blumenthal JA, Davidson KW, Saab PG, Kubzansky L: The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: the emerging field of behavioral cardiology. J Am Coll Cardiol 2005, 45:637-651.
• [7]Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L, INTERHEART Study Investigators: Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. Lancet 2004, 364:937-952.
• [8]World Health Organization: Depression. Fact sheet N 369[http://www.who.int/mediacentre/factsheets/fs369/en/ webcite]
• [9]Rutledge T, Hogan BE: A quantitative review of prospective evidence linking psychological factors with hypertension development. Psychosom Med 2002, 64:758-766.
• [10]Elderon L, Whooley MA: Depression and cardiovascular disease. Prog Cardiovasc Dis 2013, 55:511-523.
• [11]Scalco AZ, Scalco MZ, Azul JB, Lotufo NF: Hypertension and depression. Clinics (Sao Paulo) 2005, 60:241-250.
• [12]Delaney JA, Oddson BE, Kramer H, Shea S, Psaty BM, McClelland RL: Baseline depressive symptoms are not associated with clinically important levels of incident hypertension during two years of follow-up: the multi-ethnic study of atherosclerosis. Hypertension 2010, 55:408-414.
• [13]Licht CM, de Geus EJ, Seldenrijk A, van Hout HP, Zitman FG, van Dyck R, Penninx BW: Depression is associated with decreased blood pressure, but antidepressant use increases the risk for hypertension. Hypertension 2009, 53:631-638.
• [14]Martínez-González MÁ, Corella D, Salas-Salvadó J, Ros E, Covas MI, Fiol M, Wärnberg J, Arós F, Ruíz-Gutiérrez V, Lamuela-Raventós RM, Lapetra J, Muñoz MÁ, Martínez JA, Sáez G, Serra-Majem L, Pintó X, Mitjavila MT, Tur JA, Portillo MP, Estruch R, PREDIMED Study Investigators: Cohort profile: design and methods of the PREDIMED study. Int J Epidemiol 2012, 41:377-385.
• [15]Estruch R, Ros E, Salas-Salvado J, Covas MI, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, Lamuela-Raventos RM, Serra-Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Martínez-González MA, PREDIMED Study Investigators: Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 2013, 368:1279-1290.
• [16]Martinez-Gonzalez MA, Fernandez-Jarne E, Serrano-Martinez M, Wright M, Gomez-Gracia E: Development of a short dietary intake questionnaire for the quantitative estimation of adherence to a cardioprotective Mediterranean diet. Eur J Clin Nutr 2004, 58:1550-1552.
• [17]Elosua R, Marrugat J, Molina L, Pons S, Pujol E: Validation of the Minnesota Leisure Time Physical Activity Questionnaire in Spanish men. The MARATHOM Investigators. Am J Epidemiol 1994, 139:1197-1209.
• [18]Elosua R, Garcia M, Aguilar A, Molina L, Covas MI, Marrugat J: Validation of the Minnesota Leisure Time Physical Activity Questionnaire In Spanish Women. Investigators of the MARATDON Group. Med Sci Sports Exerc 2000, 32:1431-1437.
• [19]Shinagawa M, Otsuka K, Murakami S, Kubo Y, Cornelissen G, Matsubayashi K, Yano S, Mitsutake G, Yasaka K, Halberg F: Seven-day (24-h) ambulatory blood pressure monitoring, self-reported depression and quality of life scores. Blood Press Monit 2002, 7:69-76.
• [20]Nabi H, Chastang JF, Lefèvre T, Dugravot A, Melchior M, Marmot MG, Shipley MJ, Kivimäki M, Singh-Manoux A: Trajectories of depressive episodes and hypertension over 24 years: the Whitehall II prospective cohort study. Hypertension 2011, 57:710-716.
• [21]Kabir AA, Whelton PK, Khan MM, Gustat J, Chen W: Association of symptoms of depression and obesity with hypertension: the Bogalusa Heart Study. Am J Hypertens 2006, 19:639-645.
• [22]Meng L, Chen D, Yang Y, Zheng Y, Hui R: Depression increases the risk of hypertension incidence: a meta-analysis of prospective cohort studies. J Hypertens 2012, 30:842-851.
• [23]Dawood T, Lambert EA, Barton DA, Laude D, Elghozi JL, Esler MD, Haikerwal D, Kaye DM, Hotchkin EJ, Lambert GW: Specific serotonin reuptake inhibition in major depressive disorder adversely affects novel markers of cardiac risk. Hypertens Res 2007, 30:285-293.
• [24]Kim BS, Bae JN, Cho MJ: Depressive symptoms in elderly adults with hypotension: different associations with positive and negative affect. J Affect Disord 2010, 127:359-364.
• [25]Joynt KE, Whellan DJ, O’Connor CM: Depression and cardiovascular disease: mechanisms of interaction. Biol Psychiatry 2003, 54:248-261.
• [26]Huffman JC, Celano CM, Beach SR, Motiwala SR, Januzzi JL: Depression and cardiac disease: epidemiology, mechanisms, and diagnosis. Cardiovasc Psychiatry Neurol 2013, 2013:695925.
• [27]Pozuelo L, Tesar G, Zhang J, Penn M, Franco K, Jiang W: Depression and heart disease: what do we know, and where are we headed? Cleve Clin J Med 2009, 76:59-70.
• [28]Grippo AJ, Johnson AK: Stress, depression and cardiovascular dysregulation: a review of neurobiological mechanisms and the integration of research from preclinical disease models. Stress 2009, 12:1-21.
• [29]Perlmuter LC, Sarda G, Casavant V, O’Hara K, Hindes M, Knott PT, Mosnaim AD: A review of orthostatic blood pressure regulation and its association with mood and cognition. Clin Auton Res 2012, 22:99.
• [30]Hildrum B, Ulla R, Holmen J: Anxiety and depression lower blood pressure: 22-year follow–up of the population based HUNT study. Norway. BMC Public Health 2011, 11:601. BioMed Central Full Text
• [31]Lenoir H, Lacombe JM, Dufouil C, Ducimetière P, Hanon O, Ritchie K, Dartigues JF, Alpérovitch A, Tzourio C: Relationship between blood pressure and depression in the elderly. The Three-City Study. J Hypertens 2008, 26:1765-1772.
• [32]Stroup-Benham CA, Markides KS, Black SA, Goodwin JS: Relationship between low blood pressure and depressive symptomatology in older people. J Am Geriatr Soc 2000, 48:250-255.
• [33]Barrett-Connor E, Palinkas LA: Low blood pressure and depression in older men: a population based study. BMJ 1994, 308:446-449.
• [34]Dickey RA, Janick JJ: Lifestyle modifications in the prevention and treatment of hypertension. Endocr Pract 2001, 7:392-399.
• [35]Januzzi JL Jr, Stern TA, Pasternak RC, DeSanctis RW: The influence of anxiety and depression on outcomes of patients with coronary artery disease. Arch Intern Med 2000, 160:1913-1921.
• [36]Hill KD, Wee R: Psychotropic drug-induced falls in older people: a review of interventions aimed at reducing the problem. Drugs Aging 2012, 29:15-30.
• [37]Tyberghein M, Philips JC, Krzesinski JM, Scheen AJ: Orthostatic hypotension: definition, symptoms, assessment and pathophysiology. Rev Med Liege 2013, 68:65-73.