Depression and hypertension awareness, treatment, and control in a multiethnic population in the Netherlands: HELIUS study

Florence Fernald,Ron Peters,Anja Lok,Charles Agyemang,Bert-Jan Van Den Born,Marieke Snijder

doi:10.1007/s11739-021-02717-9

Florence Fernald, Ron Peters + Show 4 more

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https://doi.org/10.1007/s11739-021-02717-9

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Abstract

Individuals belonging to ethnic minority groups are more susceptible to depression and comorbid hypertension than European host populations. Yet, data on how depression is related to hypertension in ethnic groups in Europe are lacking. Therefore, we studied the association between significant depressed mood (SDM) and hypertension prevalence, awareness, treatment, and control among ethnic groups. Data from the HELIUS study included 22,165 adults (aged 18–70) from six ethnic backgrounds in the Netherlands. Logistic regression analysis was used to explore the association between SDM and hypertension prevalence, awareness, treatment, and control with adjustment for age, sex, and for sensitivity analysis purposes also for anti-depressants. After adjustment for age and sex, Dutch with SDM had an increased odds of hypertension (OR 95% CI 1.67; 1.08–2.59). Among Turkish, SDM was associated with higher odds of hypertension awareness (2.09; 1.41–3.09), treatment (1.92; 1.27–2.90) and control (1.72; 1.04–2.83). Among Moroccans, SMD was associated with an increased odds of hypertension awareness (1.91; 1.14–3.21) but decreased odds of hypertension control (0.42; 0.20–0.89). Additional adjustment for anti-depressant medications did not change the results. There were no associations between SDM and hypertension, awareness, treatment and control in South-Asian Surinamese, African Surinamese and Ghanaian participants. The results underline significant differences in the association between SDM and hypertension awareness, treatment and control between ethnic groups. Our findings emphasize the necessity to further study ethnicity-related factors that may influence the association between SDM and hypertension to promote hypertension control especially, among Moroccans with SDM.

Highlights

It is well described that depression is a common risk factor for hypertension [1, 2] and consequent risk of cardiovascular disease (CVD) [3]
We studied associations between significant depressed mood (SDM) and prevalence, awareness, treatment, and control of hypertension across ethnic groups
Our study shows that Turkish people with SDM were more likely to be aware of, treated and controlled for their hypertension compared with their Turkish counterparts without SDM

Summary

Introduction

It is well described that depression is a common risk factor for hypertension [1, 2] and consequent risk of cardiovascular disease (CVD) [3]. Stress experienced by individuals with depression has the potential to cause dysregulation in overactivation of the nervous system and hyperactivity of hypothalamic–pituitary–adrenal axis, thereby increasing the risk of hypertension [4]. Depression and hypertension share common disease pathways, possibly negatively affecting one another [2]. Unhealthy lifestyle behaviors (e.g., physical inactivity) are more common among depressed individuals [6] and are another reason for hypertension [7]. Evidence shows that use of anti-depressants like tricyclic

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