Association between depression and hypertension using classic and revised blood pressure thresholds.
Abstract
<h4>Background</h4>In a primary care population, the relationship between treatment
of depression and hypertension (HTN) under the recently revised American College of
Cardiology and American Heart Association HTN thresholds for diagnosing HTN is unknown.<h4>Objective</h4>To
compare the association between changes in severity of co-occurring depression and
HTN over time using the newly revised versus previous HTN guidelines.<h4>Methods</h4>In
this retrospective cohort study, outpatients ≥18 years (n = 3018) with clinically
significant depressive symptoms and elevated blood pressure at baseline were divided
into a 'revised' guideline group (baseline blood pressure ≥130/80 mmHg), a 'classic'
guideline group (≥140/90 mmHg) and a 'revised-minus-classic' group (≥130/80 and <140/90
mmHg). Depressive symptom change was assessed using the Patient Health Questionnaire-9
(PHQ-9). Correlations between changes in PHQ-9 scores and HTN levels by group over
a 6- to 18-month observation period were assessed using robust regression analysis.<h4>Results</h4>There
were demographic and clinical differences between groups. A total of 41% of study
subjects (1252/3018) had a visit during the follow-up period where additional PHQ-9
and HTN results were available. Depressive symptom change was unrelated to change
in blood pressure in the revised and revised-minus-classic groups. The classic HTN
group demonstrated a clinically insignificant change in systolic blood pressure for
each unit change in PHQ-9 score (β = 0.23, P-value =0.02).<h4>Conclusions</h4>Although
a statistically significant association between reduced HTN levels and improvement
in depressive symptoms was demonstrated under classic HTN guidelines, there was no
clinically meaningful association between treatment of depression and improved HTN
levels under either guideline.
Type
Journal articlePermalink
https://hdl.handle.net/10161/24798Published Version (Please cite this version)
10.1093/fampra/cmaa010Publication Info
DeMoss, Dustin S; Teigen, Kari J; Claassen, Cynthia A; Fisk, Mandy J; Blair, Somer
E; Bakre, Sulaimon A; ... Rush, Augustus J (2020). Association between depression and hypertension using classic and revised blood pressure
thresholds. Family practice, 37(5). pp. 616-622. 10.1093/fampra/cmaa010. Retrieved from https://hdl.handle.net/10161/24798.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Augustus John Rush
Adjunct Professor in the Department of Psychiatry and Behavioral Sciences

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