Abstract
BackgroundDepression and depressive symptoms are risk factors for hypertension (HTN) and cardiovascular disease (CVD). Hispanic women have higher rates of depressive symptoms compared to other racial/ethnic groups yet few studies have investigated its association with incident prehypertension and hypertension among postmenopausal Hispanic women. This study aims to assess if an association exists between baseline depression and incident hypertension at 3 years follow-up among postmenopausal Hispanic women.MethodsProspective cohort study, Women’s Health Initiative (WHI), included 4,680 Hispanic women who participated in the observational and clinical trial studies at baseline and at third-year follow-up. Baseline current depressive symptoms and past depression history were measured as well as important correlates of depression—social support, optimism, life events and caregiving. Multinomial logistic regression was used to estimate prevalent and incident prehypertension and hypertension in relation to depressive symptoms.ResultsPrevalence of current baseline depression ranged from 26% to 28% by hypertension category and education moderated these rates. In age-adjusted models, women with depression were more likely to be hypertensive (OR = 1.25; 95% CI 1.04–1.51), although results were attenuated when adjusting for covariates. Depression at baseline in normotensive Hispanic women was associated with incident hypertension at year 3 follow-up (OR = 1.74; 95% CI 1.10–2.74) after adjustment for insurance and behavioral factors. However, further adjustment for clinical covariates attenuated the association. Analyses of psychosocial variables correlated with depression but did not alter findings. Low rates of antidepressant medication usage were also reported.ConclusionsIn the largest longitudinal study to date of older Hispanic women which included physiologic, behavioral and psychosocial moderators of depression, there was no association between baseline depressive symptoms and prevalent nor incident pre-hypertension and hypertension. We found low rates of antidepressant medication usage among Hispanic women suggesting a possible point for clinical intervention.Trial RegistrationClinicaltrials.gov NCT00000611
Highlights
Investigators over the last two decades have produced an increasing body of knowledge on racial/ethnic hypertension disparities [1,2,3,4] and hypothesized that depression plays a mediating role in elevated blood pressure among adult women. [5,6,7,8,9,10] Depression and depressive symptoms are risk factors for hypertension (HTN) and cardiovascular disease (CVD)
In the largest longitudinal study to date of older Hispanic women which included physiologic, behavioral and psychosocial moderators of depression, there was no association between baseline depressive symptoms and prevalent nor incident pre-hypertension and hypertension
We found low rates of antidepressant medication usage among Hispanic women suggesting a possible point for clinical intervention
Summary
Investigators over the last two decades have produced an increasing body of knowledge on racial/ethnic hypertension disparities [1,2,3,4] and hypothesized that depression plays a mediating role in elevated blood pressure among adult women. [5,6,7,8,9,10] Depression and depressive symptoms are risk factors for hypertension (HTN) and cardiovascular disease (CVD). [16,17,18,19] A paucity of research exists that investigates the association between incident prehypertension and hypertension with depression among postmenopausal Hispanic women, and few include multiple psychosocial stressors, or use a longitudinal study design. [24] Comprehensive reviews of the role of psychosocial factors, namely low levels of social support, [25] stressful life events, low optimism, depression, and increased rates of caregiving responsibilities, [8,26,27,28,29,30,31] provide convincing evidence of their link with higher levels of systolic blood pressure. Hispanic women have higher rates of depressive symptoms compared to other racial/ethnic groups yet few studies have investigated its association with incident prehypertension and hypertension among postmenopausal Hispanic women. This study aims to assess if an association exists between baseline depression and incident hypertension at 3 years follow-up among postmenopausal Hispanic women
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