Prevalence of depression in hypertensive patients and its associated factors in India: A systematic review and meta-analysis

Abstract

BackgroundHypertension is a prevalent health challenge in India, with a bidirectional link to depression. Recognizing the prevalence of depression among hypertensive patients and associated factors are important for better health outcomes. MethodsA comprehensive search was conducted in PubMed, Embase, Scopus, and Google Scholar databases to identify relevant studies. R software was used for analysis, employing a random effects model with a 95% confidence interval. Subgroup analyses were done to explore sources of heterogeneity within the included studies. ResultsThe prevalence of depression among hypertensive patients in India was 39.8% (95% CI: 28.6; 52.1). Despite a higher prevalence observed in South region (44.7%) compared to North (26.9%), the difference was not significant (p=0.39). Studies utilizing different assessment scales and varying sample sizes yielded similar prevalence. However, a temporal trend analysis indicated a higher prevalence in studies published between 2020 and 2023 (52.6%) compared to those published between 2016 and 2019 (35.5%) (p=0.03). Major factors associated with depression included lower socioeconomic status, low education level, female gender, uncontrolled hypertension, and COVID-19 related factors. ConclusionsA significant proportion of hypertensive patients suffer from depression. Therefore, screening for depression in hypertensive patients is essential to improve hypertension management in India.