The prevalence of hypertension comorbid of depression and anxiety disorder in Beijing and Jilin: an analysis of risk factors

Abstract

Objective To investigate the prevalence of hypertension comorbid of depression and anxiety disorder, and to explore the related psycho–social factors. Methods A total of 1 806 patients with hypertension were selected from urban and rural areas in Beijing and Jilin Province in 2011. The Chinese version of the Composite International Diagnostic Interview Version 3.0 ( CIDI–3.0) was used to diagnose depression and anxiety disorder. Four additional questionnaires obtained demographic data, and data on coping style, social support, quality of life and degree of life satisfaction. Logistic regression analysis was used to explore the related factors of hypertension comorbid of depression and anxiety. Results (1) The prevalence rate of depression and anxiety disorder among patients with hypertension in Beijing and Jilin was 6.5% (117/1 806) and 24.2% (437/1 806), respectively. (2) The prevalence of depression among patients with hypertension was significantly higher in female patients and patients without a spouse (7.6%(88/1 162) vs. 9.0%(29/324) ) than male patients and that with a spouse (4.5%(29/644) vs.5.9%(88/1 482); χ2=6.446, 3.983, both P<0.05). The prevalence of anxiety among patients with hypertension was significantly higher in patients of female gender, being 60 years of age or younger, living in rural areas, manual labor, having 9 or fewer years of education than in patients of male gender(26.6%(309/1 162) vs.19.9%(128/644)), being 60 years older(28.7%(255/890) vs.19.9%(182/916)), living in urban areas(26.9%(242/900)vs. 21.5%(195/906)), mental work(25.9%(289/1 114) vs.20.0%(83/416)) and having 9 more years of education(25.7%(333/1 296) vs. 20.4%(104/510); χ2=10.190, 18.983, 7.087, 5.907, 5.610, all P<0.05). (3) Compared with non–depression group, depression group had significantly lower scores on subjective support (24.2±4.7 vs.26.1±4.4, t=–2.508), support availability (6.2±2.1 vs.7.6±2.2, t=–3.951), total social suppot (39.5±7.5 vs. 43.1±6.7, t=–3.110), positive coping dimension (1.6±0.7 vs. 1.9±0.7, Z=–2.356), Q–LES–Q–SF (47.4±7.8 vs.61.2±4.3, t=–15.615), and had significantly higher scores on amount of negative events stimulation (38.8±59.3 vs.7.8±16.8, t=5.591), total amount of life events stimulation (47.8±64.2 vs. 20.2±33.0, Z=3.775; all P<0.05). Compared with non–anxiety group, anxiety group had significantly lower scores on subjective support (24.0±4.9 vs.25.1±4.6, t=–2.678), total social support (40.0±7.2 vs. 41.2±7.1, t=–2.063), positive coping dimension (1.5±0.6 vs.1.6±0.7, Z=–1.963), Q–LES–Q–SF (48.0±5.5 vs.53.9±5.5, t=–12.340), and had significantly higher scores on amount of negative events stimulation (27.2±50.0 vs.10.6±21.5, Z=5.993), average negative coping dimension (1.2±0.6 vs. 1.1±0.6, Z=3.775), total amount of life events stimulation (39.5±56.4 vs.23.9±36.0, Z=4.155; all P<0.05) . (4) Logistic regression analysis showed female gender, negative events had significant positive correlation to concurrent depression and anxiety in patients with hypertension (OR=1.689, 1.017, 1.431, 1.070, all P<0.05). High life satisfaction degree had significant negative correlation (OR=0.558, 0.797, both P<0.05). Conclusion The prevalence of anxiety disorder is higher than that of depression in hypertensive patients in Beijing and Jilin. Female gender, negative events are possible risk factors for concurrent depression and anxiety in patients with hypertension, and high life satisfaction degree are possible protective factor. Key words: Hypertension; Depression; Anxiety; Prevalence; Comorbidity; Factor analysis, statistical