Abstract P225: Depressive Symptoms Are Not Associated With Clinically Important Levels Of Home Blood Pressure In The Electronic Framingham Heart Study

Abstract

Introduction: Depressive symptoms are common and share many biopsychosocial mechanisms with hypertension, but cross-sectional studies on their association have produced inconsistent results. The emergence of digital home blood pressure (BP) measurements may provide additional insight into the relationship. Hypothesis: We hypothesized that depressive symptoms would be modestly associated with higher home BP and hypertension prevalence in participants of the electronic Framingham Heart Study (eFHS). Methods: FHS participants who attended research exam 3 (2016-2019) were invited to enroll in eFHS. They downloaded a smartphone app and were provided a digital BP cuff to measure their weekly BP for up to 1 year. Participants who had at least 3 home BPs were included. Depressive symptoms were measured at the exam using the Center for Epidemiological Studies Depression Scale (CES-D) scored 0-60. We used linear mixed regression models to test the association of CES-D score (independent) with home SBP and DBP (dependent) and a logistic regression model to evaluate the association of depressive symptoms (defined as CES-D ≥16) with prevalent hypertension, adjusting for age, sex, cohort, lifestyle factors, diabetes, and CVD. Results: The study sample included 855 eFHS participants (mean age 53 years, 59% women, 9% multi-ethnic). The prevalence of depressive symptoms was 7% (CES-D score mean±SD, 5.7±6.6). The mean SBP and DBP were 119 and 76 mmHg; the prevalence of hypertension was 48%. CES-D score was modestly associated with home BP; a 1 SD higher CES-D corresponded with 0.9 and 0.6 mmHg higher mean SBP and DBP respectively (Table). Depressive symptoms were not significantly associated with home BP or hypertension prevalence (OR=3.16, 95% CI, 0.96-10.43). Antidepressant use attenuated the relationship. Conclusion: CES-D score had a small positive association with digital home BP, but it was not clinically substantive. The association of depression and hypertension risk warrants more data, which may be supported by mobile health.