Depressive symptoms are not associated with clinically important levels of digital home blood pressure in the electronic Framingham Heart Study

Abstract

BACKGROUNDDepressive symptoms are common and share many biopsychosocial mechanisms with hypertension. Association studies between depressive symptoms and blood pressure (BP) have been inconsistent. Home BP monitoring may provide insight. OBJECTIVETo investigate the association between depressive symptoms and digital home BP METHODSElectronic Framingham Heart Study (eFHS) participants were invited to obtain a smartphone app and digital BP cuff at research exam 3 (2016-2019). Participants with ≥3 weeks of home BP measurements within one year were included. Depressive symptoms were measured using the Center for Epidemiological Studies Depression Scale (CES-D). Multivariable linear mixed models were used to test the associations of continuous CES-D score and dichotomous depressive symptoms (CES-D ≥16) (independent) with home BP (dependent), adjusting for age, sex, cohort, number of weeks since baseline, lifestyle factors, diabetes, and CVD. RESULTSAmong 883 participants (mean age 54 years, 59% women, 91% White), the median CES-D score was 4. Depressive symptoms prevalence was 7.6%. Mean SBP and DBP at exam 3 were 119 and 76 mmHg; hypertension prevalence was 48%. A 1 SD higher CES-D score was associated with 0.9 (95% CI: 0.18 to 1.56, p=0.01) and 0.6 (95% CI: 0.06 to 1.07, p=0.03) mmHg higher home SBP and DBP respectively. Dichotomous depressive symptoms were not significantly associated with home BP(p>0.2). CONCLUSIONDepressive symptoms were not associated with clinically substantive levels of home BP. The association between depression and CVD risk factors warrants more data, which may be supported by mobile health measures.