Association between depression and hypertension using classic and revised blood pressure thresholds

2020 ◽  
Vol 37 (5) ◽  
pp. 616-622
Author(s):  
Dustin S DeMoss ◽  
Kari J Teigen ◽  
Cynthia A Claassen ◽  
Mandy J Fisk ◽  
Somer E Blair ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Robust Regression ◽  
Heart Association ◽  
P Value ◽  
Symptom Change ◽  
Primary Care Population ◽  
Treatment Of Depression ◽  
Guideline Group

Abstract Background 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. Objective To compare the association between changes in severity of co-occurring depression and HTN over time using the newly revised versus previous HTN guidelines. Methods 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. Results 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). Conclusions 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.

scholarly journals Bidirectional association between blood pressure and depressive symptoms in young and middle-age adults: A cohort study

2020 ◽  
Vol 29 ◽  
Author(s):  
Sang Won Jeon ◽  
Yoosoo Chang ◽  
Se-Won Lim ◽  
Juhee Cho ◽  
Han-Na Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Depressive Symptoms ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Heart Association ◽  
Epidemiologic Studies ◽  
Incident Hypertension ◽  
Bidirectional Association

Abstract Aims To evaluate the bidirectional relationship between blood pressure (BP) and depressive symptoms using a large prospective cohort study. Methods Prospective cohort study was performed in 276 244 adults who participated in a regular health check-up and were followed annually or biennially for up to 5.9 years. BP levels were categorised according to the 2017 American College of Cardiology and American Heart Association hypertension guidelines. Depressive symptoms were assessed using Centre for Epidemiologic Studies-Depression (CESD) questionnaire and a cut-off score of ≥25 was regarded as case-level depressive symptoms. Results During 672 603.3 person-years of follow-up, 5222 participants developed case-level depressive symptoms. The multivariable-adjusted hazard ratios (HRs) [95% confidence interval (CI)] for incident case-level depressive symptoms comparing hypotension, elevated BP, hypertension stage 1 and hypertension stage 2 to normal BP were 1.07 (0.99–1.16), 0.93 (0.82–1.05), 0.89 (0.81–0.97) and 0.81 (0.62–1.06), respectively (p for trend <0.001). During 583 615.3 person-years of follow-up, 27 787 participants developed hypertension. The multivariable-adjusted HRs (95% CI) for incident hypertension comparing CESD 16–24 and ⩾25 to CESD < 16 were 1.05 (1.01–1.11) and 1.12 (1.03–1.20), respectively (p for trend <0.001) and in the time-dependent models, corresponding HRs (95% CI) were 1.12 (1.02–1.24) and 1.29 (1.10–1.50), respectively (p for trend <0.001). Conclusions In this large cohort study of young and middle-aged individuals, higher BP levels were independently associated with a decreased risk for developing case-level depressive symptoms and depressive symptoms were also associated with incident hypertension. Further studies are required to elucidate the mechanisms underlying the bidirectional association between BP levels and incident depression.

scholarly journals Brief Report: Preliminary evidence that co-rumination fosters adolescents’ depression risk by increasing rumination

2017 ◽  
Author(s):  
Lindsey B Stone ◽  
Brandon Gibb
Keyword(s):  
High School ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Direct Effect ◽  
Preliminary Evidence ◽  
Interpersonal Process ◽  
Symptom Change ◽  
High School Freshmen ◽  
Depression Risk ◽  
Proposed Model

Mounting research shows that the tendency to co-ruminate with peers regarding ongoing problems increases adolescents’ depression risk; however, the means by which this interpersonal process fosters risk has not been identified. This said, theorists have proposed that co-rumination increases depression risk, in part, by increasing one’s tendency to ruminate when alone. We tested this hypothesis in a study of 201 high-school freshmen who completed two assessments, six months apart. Supporting the proposed model, co-rumination predicted prospective increases in rumination and rumination predicted increases in depressive symptoms. The direct effect of co-rumination on depressive symptom change was not significant. Results indicate that co-rumination with friends may serve to increase rumination, which in turn increases depression risk.

scholarly journals The Potential Influence of Group Membership on Outcomes in Indicated Cognitive-Behavioral Adolescent Depression Prevention

2020 ◽  
Vol 17 (18) ◽  
pp. 6553
Author(s):  
Paul Rohde ◽  
Frédéric N. Brière ◽  
Eric Stice
Keyword(s):  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Adolescent Depression ◽  
Group Membership ◽  
Cognitive Behavioral ◽  
Group Level ◽  
Symptom Change ◽  
Post Intervention ◽  
Depression Prevention

Background: Adolescent depression prevention programs are typically delivered in groups in which adolescents share a common setting and interventionist, but the influence of the group is usually ignored or statistically controlled. We tested whether the primary outcomes of reductions in depressive symptoms and future onset of major depressive disorder (MDD) varied as a function of group membership. Methods: Data were available from two randomized trials in which 220 adolescents received the Blues Program indicated prevention intervention in 36 separate groups; participants were assessed at baseline, post intervention, and at 6-, 12-, and 24-month follow-ups. Results: Ten percent of participants had developed MDD 2 years post intervention. Group-level effects for MDD onset over follow-up were nonsignificant (accounted for <1% of variance; ICC = 0.004, ns). Group-level effects for depressive symptom change across the follow-up period were also nonsignificant (ICC = 0.001, ns) but group effects accounted for 16% of depressive symptom change immediately post intervention (ICC = 0.159, p < 0.05). Group-level clustering of posttest depressive symptoms was not associated with size of group or gender composition. Conclusions: Membership in specific adolescent cognitive-behavioral depression prevention groups may have an impact in terms of immediate symptom reduction but does not appear to have significant prevention effects in terms of long-term symptom change or MDD onset.

scholarly journals Left prefrontal impact links subthalamic stimulation with depressive symptoms

2019 ◽  
Author(s):  
Friederike Irmen ◽  
Andreas Horn ◽  
Philip Mosley ◽  
Alistair Perry ◽  
Jan Niklas Petry-Schmelzer ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Structural Connectivity ◽  
Electrode Placement ◽  
Validation Dataset ◽  
Symptom Change ◽  
Test Set ◽  
Before And After ◽  
The Impact ◽  
Stn Dbs

AbstractObjectiveSubthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson’s Disease (PD) not only stimulates focal target structures but also affects distributed brain networks. The impact this network modulation has on non-motor DBS effects is not well characterized. By focusing on the affective domain, we systematically investigate the impact of electrode placement and associated structural connectivity on changes in depressive symptoms following STN-DBS which have been reported to improve, worsen or remain unchanged.MethodsDepressive symptoms before and after STN-DBS surgery were documented in 116 PD patients from three DBS centers (Berlin, Queensland, Cologne). Based on individual electrode reconstructions, the volumes of tissue activated (VTA) were estimated and combined with normative connectome data to identify structural connections passing through VTAs. Berlin and Queensland cohorts formed a training and cross-validation dataset used to identify structural connectivity explaining change in depressive symptoms. The Cologne data served as test-set for which depressive symptom change was predicted.ResultsStructural connectivity was linked to depressive symptom change under STN-DBS. An optimal connectivity map trained on the Berlin cohort could predict changes in depressive symptoms in Queensland patients and vice versa. Furthermore, the joint training-set map predicted changes in depressive symptoms in the independent test-set. Worsening of depressive symptoms was associated with left prefrontal connectivity.InterpretationFibers linking the STN electrode with left prefrontal areas predicted worsening of depressive symptoms. Our results suggest that for the left STN-DBS lead, placement impacting fibers to left prefrontal areas should be avoided to maximize improvement of depressive symptoms.

scholarly journals A longitudinal analysis of the progression from normal blood pressure to stage 2 hypertension: A 12-year Korean cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eun Sun Yu ◽  
Kwan Hong ◽  
Byung Chul Chun
Keyword(s):  
Blood Pressure ◽  
Health Insurance ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Normal Blood ◽  
Normal Blood Pressure ◽  
The Mean ◽  
Stage 1

Abstract Background The study aimed to estimate the incidence of and period of progression to stage 2 hypertension from normal blood pressure. Methods We selected a total of 21,172 normotensive individuals between 2003 and 2004 from the National Health Insurance Service-Health Screening and followed them up until 2015. The criteria for blood pressure were based on the American College of Cardiology/American Heart Association 2017 guideline (normal BP: SBP < 120 and DBP < 80 mmHg, elevated BP: SBP 120–129 and DBP < 80 mmHg, stage 1 hypertension: SBP 130–139 or DBP 80–89 mmHg, stage 2 hypertension: SBP ≥140 or DBP ≥ 90 mmHg). We classified the participants into four courses (Course A: normal BP → elevated BP → stage 1 hypertension→ stage 2 hypertension, Course B: normal BP → elevated BP → stage 2 hypertension, Course C: normal BP → stage 1 hypertension → stage 2 hypertension, Course D: normal BP → stage 2 hypertension) according to their progression from normal blood pressure to stage 2 hypertension. Results During the median 12.23 years of follow-up period, 52.8% (n= 11,168) and 23.6% (n=5004) of the participants had stage 1 and stage 2 hypertension, respectively. In particular, over 60 years old had a 2.8-fold higher incidence of stage 2 hypertension than 40–49 years old. After the follow-up period, 77.5% (n=3879) of participants with stage 2 hypertension were found to be course C (n= 2378) and D (n=1501). After the follow-up period, 77.5% (n=3879) of participants with stage 2 hypertension were found to be course C (n= 2378) and D (n=1501). The mean years of progression from normal blood pressure to stage 2 hypertension were 8.7±2.6 years (course A), 6.1±2.9 years (course B), 7.5±2.8 years (course C) and 3.2±2.0 years, respectively. Conclusions This study found that the incidence of hypertension is associated with the progression at each stage. We suggest that the strategies necessary to prevent progression to stage 2 hypertension need to be set differently for each target course.

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