Abstract 327: Six months follow-up of “My Unlimited Potential”, A 12-week Worksite, Multi-Component, Lifestyle Intervention for Improving Cardiometabolic Health in High Risk Persons

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Maribeth Rouseff ◽  
Ehimen Aneni ◽  
Thinh H Tran ◽  
Josette Bou-Khalil ◽  
Joseph J Mora ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Intervention Program ◽  
Cardiovascular Health ◽  
Heart Association ◽  
South Florida ◽  
Cardiometabolic Health ◽  
Improvement Program ◽  
Meaningful Improvement

Background: With about 59% of the entire US population currently in the work force, the American Heart Association has emphasized worksite-based interventions to improve cardiovascular health among the working population. The primary aim of this study was to assess effectiveness of an ongoing multi-component, lifestyle improvement program (My Unlimited Potential [MyUP]) extending into 6 months, among employees of Baptist Health South Florida (BHSF), a large not-for-profit health care system. Methods: BHSF employees with 2 or more Cardiometabolic risk factors, such as total cholesterol ≥ 200 mg/dl, systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, hemoglobin A1C ≥ 6.5%, and body mass index (BMI) ≥ 30 were considered for the study. Behavioral interventions were focused on dietary and physical activity modifications. Results: Overall 202 (48±10 years, 78% females) employees who enrolled in the MyUP wellness program. The retention of subjects was high with 89% (n=181) at 12 weeks and 80% (n=162) at 6 months. The table and figure below demonstrate the baseline, 12 week and 6 months averages in anthropometric and laboratory profile in participants. Comparing follow-up from 3 months to that at 6 months, clinically meaningful improvement in endpoints were especially noted for BMI, BP, HDL targets, and reducing burden of systemic inflammation (figure). Conclusion: These findings suggest that an intensive behavioral modification intervention program, delivered to employees in a health care setting, results in both significant short and intermediate term benefit in weight reduction, improved blood pressure control and hbA1c, and concomitantly improves cardio-metabolic risk profile. Further follow-up is in progress to ascertain whether these benefits are sustainable over longer periods.

Abstract P124: My Unlimited Potential: Achieving Weight, Fitness And Cardio-metabolic Health Objectives Using A 12-week, Multicomponent, Behavioral Intervention

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Maribeth Rouseff ◽  
Thinh H Tran ◽  
Khurram Nasir ◽  
Josette Bou-Khalil ◽  
Joseph J Mora ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Exercise Capacity ◽  
Behavioral Intervention ◽  
Intervention Program ◽  
South Florida ◽  
Metabolic Risk ◽  
Short Term ◽  
Improvement Program

Background: With about 59% of the entire US population currently in the work force, American Heart Association has emphasized worksite-based interventions to improve cardiovascular health among the working population. The primary aim of this study was to assess the short-term (12 weeks) efficacy of an ongoing multi-component, behavioral intervention improvement program (My Unlimited Potential (myUP), among employees of Baptist Health South Florida (BHSF), a large not-for-profit health care system. Methods: BHSF employees with two or more Cardio-metabolic risk factors, such as total cholesterol ≥ 200 mg/dl, systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, hemoglobin A1C ≥ 6.5%, and body mass index (BMI) ≥ 30 were considered for the study. Behavioral interventions were focused on diet and physical activity modifications. Results: Overall 202 (48±10 years, 78% females) employees enrolled in myUP wellness program. The retention of subjects was high with 89% (n=181) of subjects following up at 12 weeks. The figure below demonstrates the baseline, follow-up and estimated mean change in anthropometric, exercise capacity on treadmill test and CM participants. BMI reduction >5% was noted in 38% of the participants. Significantly higher, clinically meaningful, endpoints, especially in attaining blood pressure goals and exercise capacity (>10 METS), during the short-term follow-up in this behavioral intervention program (figure), were achieved. Conclusion: These findings suggest that an intensive behavioral modification intervention program, delivered to employees in a health care setting, results in significant short term benefit in weight reduction, increase fitness level and concomitantly improve cardio-metabolic risk profile. Further follow-up is in progress to ascertain whether these benefits are sustainable over a longer duration.

Abstract P199: Keep Moving, Your Health Depends On It: Impact Of Improved Physical Activity And Weight Loss In A Wellness Program

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Ebenezer T Oni ◽  
Ehimen Aneni ◽  
Maribeth Rouseff ◽  
Thinh Tran ◽  
Henry Guzman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Weight Loss ◽  
Intervention Program ◽  
South Florida ◽  
Metabolic Equivalents ◽  
Baseline Weight ◽  
The Mean ◽  
The Difference

Negative impact of CVD as the leading cause of death in the US is worsened by the significant burden of obesity and associated morbidity and concerns about the growing population inactivity. The American Heart Association has emphasized worksite-based interventions to improve CV health. We evaluated the benefits of improved physical activity(PA) and weight loss(WL) among employees of the Baptist Health South Florida enrolled in a wellness intervention program. Methods: Employees with two or more Cardio-metabolic risk factors , such as total cholesterol ≥ 200 mg/dl, systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, hemoglobin A1C ≥ 6.5%, and body mass index (BMI) ≥ 30 were enrolled in an intervention program themed “My unlimited potential”. Interventions were focused on diet and PA modifications. We defined improved physical activity as the difference in the metabolic equivalents (METs) at 12 weeks follow-up and at baseline. WL (lbs) was the difference in weight at follow-up. The relationship between WL and changes in METs was explored in an ordered logistic regression. Results: Overall 203 (48±10 years, 78% females) employees were enrolled with a retention rate of 89% (n=181) at 12 weeks follow-up. At baseline the median weights was 211 lbs., and mean METs- 8.6, while at follow-up the median weight was 200 lbs, and the mean METs 11. At 12 weeks follow up 38% had significant WL (lost >5% of baseline weight). The median WL was 8.4 (IQR 4.8-13.0) lbs and the mean change in METs was 2.4±1.8. Median WL increased with increasing tertiles of METs change; tertile1- 6.5(4-11) lbs., tertile2- 9(6-13)lbs. tertile3- 11(7-15)lbs. Increased PA was related to increased WL across BMI categories adjusting for age, gender and baseline weight. Conclusion: This study points strongly toward the benefit of increasing PA among other lifestyle modification interventions in controlling weight. Although further follow-up of this population to evaluate sustainability of change is needed, our results clearly relate improved PA and health.

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.

scholarly journals IMPACT OF PHARMACIST INTERVENTION IN SCREENING AND EDUCATION ON BLOOD PRESSURE IN A RURAL AREA IN SOUTHERN INDIA

2016 ◽  
Vol 9 (9) ◽  
pp. 339
Author(s):  
Shanmuga Sundaram Rajagopal ◽  
Krishnaveni Kandasamy ◽  
Agilan Natarajan ◽  
Joyal Sebastian ◽  
Manikanta Konakalla ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Health Care ◽  
Intervention Group ◽  
Pharmacist Intervention ◽  
Health Concern ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

ABSTRACTObjective: Hypertension (HTN) expends a consequential public health concern on cardiovascular health status and health-care systems in India. Theeffectuation of the pharmaceutical care program in the health care is an extremely important need to achieve the optimum therapeutic effect. Theobjective of the study was to assess the impact of pharmacist intervention on patient’s blood pressure (BP) level, quality of life (QOL), and knowledge,attitude, and practice (KAP) of hypertensive patients.Methods: A randomized controlled pilot study was carried out for 6 months. The hypertensive patients were randomized into control and interventiongroup based on age, and both the groups were interviewed using KAP and WHO QOL-BREF questionnaires, screened BP, respectively, at baseline andeach follow-up after post counseling section to the intervention group. The effect of pharmacist intervention on QOL and KAP among control andintervention was statistically analyzed by paired t-test using SPSS version 16.Results: The total sample studied was 60, of which 20 (33.33%) were males and 40 (66.67%) were females. In our study, the QOL score for eachdomain of both intervention and control groups were almost poor (p˃0.05) at baseline and for the intervention group, a highly significant improvement(p<0.001) was observed for all domains in final follow-up. KAP score of intervention group also showed a significant improvement (p<0.001) frombaseline to final follow-up. In this study, intervention group showed a significant mean reduction of systolic BP from baseline 150.13±25.670 to finalfollow-up 145.33±12.914.Conclusion: The results of the study showed a significant improvement in the patient’s KAP toward different aspects of HTN and QOL followingpharmacist mediated counseling. Involvement of pharmacy practitioners in the management of HTN significantly improves QOL and KAPs.Keywords: Hypertension, Quality of life, Knowledge, Attitude and practice, Pharmacist intervention, Patient counseling.

scholarly journals New 2017 American College of Cardiology/American Heart Association High Blood Pressure Guideline

Hypertension ◽  
2019 ◽  
Vol 73 (1) ◽  
pp. 142-147 ◽  
Author(s):  
Armando J. Martínez-Rueda ◽  
Antonio Olivas-Martínez ◽  
Olynka Vega-Vega ◽  
Jorge I. Fonseca-Correa ◽  
Ricardo Correa-Rotter
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Mexico City ◽  
Pharmacological Treatment ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Nonpharmacological Treatment ◽  
City Population

The new American College of Cardiology/American Heart Association 2017 Hypertension Guidelines lower the threshold to define hypertension, thus increasing its prevalence. The impact on populations and health systems is poorly understood. We included data from 990 subjects aged 20 to 64 years from the SALMEX cohort (Salt in Mexico; Mexico City) and determined the prevalence of hypertension and requirement for pharmacological treatment according to both Joint National Committee on the Prevention, Detection, and Treatment of High Blood Pressure 7 and American College of Cardiology/American Heart Association 2017 guidelines. The data obtained were extrapolated to sex- and age-adjusted Mexico City population, and annual costs of medical follow-up were calculated. The new definition increased the prevalence of hypertension among SALMEX cohort from 16.2% to 37.4% (18%–39.3% after adjusting to Mexico City population). The proportion of subjects that require pharmacological and nonpharmacological treatment increased from 17.7% to 19.0% and from 17.7% to 37.4%, respectively (19.4%–21.8% for pharmacological and 19.4%–39.3% for nonpharmacological treatment, after adjusting to Mexico City population). Annual costs of medical follow-up for subjects with hypertension in Mexico City would increase an estimated $59 278 928. The requirement to initiate pharmacological treatment was similar when assessed by Framingham risk score with lipids or with body mass index compared with the Atherosclerotic Cardiovascular Disease score, with correlation κ indexes of 0.981 and 0.972, respectively. On the basis of these results, Framingham body mass index represents an attractive and potentially cost-effective alternative to assess cardiovascular risk. In conclusion, the adoption of the new guidelines in Mexican population has implications not only on its prevalence but also on medical follow-up costs. A pharmacoeconomic model is required to assess the actual financial impact.

scholarly journals The Effects of a Preconception Lifestyle Intervention on Childhood Cardiometabolic Health—Follow-Up of a Randomized Controlled Trial

Cells ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 41
Author(s):  
Stijn Mintjens ◽  
Mireille N. M. van Poppel ◽  
Henk Groen ◽  
Annemieke Hoek ◽  
Ben Willem Mol ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Lifestyle Intervention ◽  
Maternal Obesity ◽  
Controlled Trial ◽  
Cardiometabolic Health ◽  
Control Group ◽  
Z Score ◽  
Infertile Women ◽  
Z Scores

Maternal obesity is associated with adverse metabolic outcomes in her offspring, from the earliest stages of development leading to obesity and poorer cardiometabolic health in her offspring. We investigated whether an effective preconception lifestyle intervention in obese women affected cardiometabolic health of their offspring. We randomly allocated 577 infertile women with obesity to a 6-month lifestyle intervention, or to prompt infertility management. Of the 305 eligible children, despite intensive efforts, 17 in the intervention and 29 in the control group were available for follow-up at age 3–6 years. We compared the child’s Body Mass Index (BMI) Z score, waist and hip circumference, body-fat percentage, blood pressure Z scores, pulse wave velocity and serum lipids, glucose and insulin concentrations. Between the intervention and control groups, the mean (±SD) offspring BMI Z score (0.69 (±1.17) vs. 0.62 (±1.04)) and systolic and diastolic blood pressure Z scores (0.45 (±0.65) vs. 0.54 (±0.57); 0.91 (±0.66) vs. 0.96 (±0.57)) were similar, although elevated compared to the norm population. We also did not detect any differences between the groups in the other outcomes. In this study, we could not detect effects of a preconception lifestyle intervention in obese infertile women on the cardiometabolic health of their offspring. Low follow-up rates, perhaps due to the children’s age or the subject matter, combined with selection bias abating contrast in periconceptional weight between participating mothers, hampered the detection of potential effects. Future studies that account for these factors are needed to confirm whether a preconception lifestyle intervention may improve the cardiometabolic health of children of obese mothers.

Abstract T P345: Cardiovascular Health Metrics and All-cause and Cardiovascular Disease Mortality among Middle Aged Men in Korea: The Seoul Male Cohort Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Ji Young Kim ◽  
Chul Woo Rhee ◽  
Young-Jin Ko ◽  
Byung-Joo Park ◽  
Dong-Hyun Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Health Behaviors ◽  
Cardiovascular Health ◽  
Fasting Blood Glucose ◽  
Asian Population ◽  
Heart Association ◽  
Middle Aged ◽  
Ideal Cardiovascular Health ◽  
Cvd Mortality

Background: In Korea, Cerebrovascular and cardiovascular diseases (CVD) were the second leading cause of deaths in 2011. In 2010, the American Heart Association (AHA) published cardiovascular health metrics (CVHM) aimed at reducing deaths from all CVDs and stroke, and improving the cardiovascular health of the population as a whole. Despite their implications, the AHA’s metrics have not been broadly studied or previously applied to an Asian population. Objectives: This study estimated the combined association of cardiovascular health behaviors on the risk of all-cause and CVD mortality in middle-aged men in Korea. Methods: In total, 14,533 men aged 40-59 years were enrolled in 1993 and followed-up through 2011. CVHM defined the following lifestyles proposed by the AHA: smoking, physical activity, BMI, healthy diet score, total cholesterol, blood pressure, and fasting blood glucose. The CVHMs score was calculated as a single categorical variable, by assigning 1 point to each ideal healthy behavior vs. 0 points otherwise. All subjects were classified as meeting 0-7 CVHM. The principal outcome variables were all-cause and CVD mortality. The Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of cardiovascular health behavior, and CVHMs score. PARs were calculated from significant CVHMs. Results: During 266,482.8 person-years of follow-up, there were 1,314 deaths in total. Current smoking, blood pressure, and fasting blood glucose were significantly associated with all-cause and CVD mortality. The adjusted PARs for the 3 significant metrics combined were 81% (95% CI, 50-94%) and 96% (66-99%) for all-cause and CVD mortality, respectively. More ideal CVHM was significantly associated with lower risks of all-cause and CVD mortality ( p-trend<.0001 ). The adjusted HRs of the groups with 6-7 vs. 0-2 ideal CVHM were 0.49 (0.35-0.70) and 0.23 (0.10-0.57) for all-cause and CVD mortality, respectively. Conclusions: Among ideal cardiovascular health behaviors, non-smoking, normal blood pressure, and recommended fasting blood glucose levels associated with reduced risks of all-cause and total CVD mortality. There was a strong trend towards decreased all-cause and CVD mortality risk with increasing the number of ideal CVHMs.

Abstract P015: A Novel Healthy Blood Pressure Phenotype is Associated With Better Cardiovascular Health Benefits and Neuropsychological Performance in the Long Life Family Study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Megan M Marron ◽  
Robert M Boudreau ◽  
Kaare Christensen ◽  
Stephanie Cosentino ◽  
Mary Feitosa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Neuropsychological Tests ◽  
American Heart Association ◽  
Cardiovascular Health ◽  
American Heart ◽  
Family Study ◽  
Heart Association ◽  
Ideal Cardiovascular Health ◽  
Blood Pressure Phenotype ◽  
The U.S

Introduction: We assessed the hypothesis that a novel healthy blood pressure phenotype is familial and sought to identify factors associated with this phenotype in the Long Life Family Study (LLFS). Methods: The LLFS is a unique multi-center, international study that recruited families demonstrating clustering for longevity. Families were recruited from four centers; three in the U.S.: Boston, New York, and Pittsburgh and one in Denmark. The pedigrees included two generations: 1) probands and their siblings and 2) offspring of participants in the proband generation. Offspring (n=2211, ages 32-88, mean age=60.5; 43% male) were classified as having healthy blood pressure if their age- and sex-adjusted systolic blood pressure z-score was between -1.5 and -0.5 (i.e., a systolic blood pressure lower than expected for their age and sex, but not “too low”). Offspring on anti-hypertensive medications were classified as not having healthy blood pressure. Families (n=419) were defined as having healthy blood pressure if ≥2 and ≥50% of their offspring met the healthy blood pressure phenotype. Results: There were 476 (22%) offspring who met the healthy blood pressure phenotype. These offspring tended to have a better health profile than remaining offspring. When examining families, only 44 (11%) families met the criteria for healthy blood pressure. Both offspring and probands from families with healthy blood pressure performed better on neuropsychological tests that place demands on complex attention and executive function than offspring and probands from remaining families. Among families with healthy blood pressure, a higher proportion of offspring met the American Heart Association ideal cardiovascular health definition compared to remaining families (11% versus 4%, respectively, p<0.0001; not including the diet component). There was also a larger proportion of probands (n=1164, ages 71-110, mean age=90.5; 45% male) who met the American Heart Association ideal cardiovascular health definition when compared to the U.S. prevalence for ≥6 components among those ages ≥60 (1% versus 0.1%, respectively). Conclusion: In this cohort of familial longevity, few families had a novel healthy blood pressure phenotype in multiple members. Families and individuals with healthy blood pressure performed better on neuropsychological tests that represent aspects of executive function and had a higher proportion with ideal cardiovascular health than the U.S. population. In summary, a novel healthy blood pressure phenotype was rarely familial in this cohort; however, when it was, it was associated with cognitive and cardiovascular health benefits. Blood pressure may be a key pathway for family longevity.

scholarly journals Assessing nutritional quality as a ‘vital sign’ of cardiometabolic health

2019 ◽  
Vol 122 (2) ◽  
pp. 195-205
Author(s):  
Dorothée Buteau-Poulin ◽  
Paul Poirier ◽  
Jean-Pierre Després ◽  
Natalie Alméras
Keyword(s):  
Vital Sign ◽  
Nutritional Quality ◽  
Cardiovascular Health ◽  
Heart Association ◽  
Hdl Cholesterol ◽  
Activity Level ◽  
Cardiometabolic Health ◽  
Lifestyle Habits ◽  
Ideal Cardiovascular Health ◽  
Cholesterol Ratio

AbstractHigh overall nutritional quality (NQ) is an important component of ideal cardiovascular health, a concept introduced in 2010 by the American Heart Association. However, data on the independent contribution of overall NQ to the variation in the cardiometabolic risk (CMR) profile are limited. This observational study aimed to investigate the association between overall NQ and the CMR profile in 4785 participants (65⋅4 % of men, age 43⋅3 (sd 10⋅8) years) who underwent a cardiometabolic health evaluation, including lifestyle habits, anthropometric measurements, blood pressure, lipid profile and HbA1c concentrations. In addition, a submaximal exercise test was conducted to assess cardiorespiratory fitness (CRF). Using a standardised NQ questionnaire (twenty-five items food-based questionnaire), participants were classified into three subgroups: (1) low, (2) moderate or (3) high NQ and variance and multiple linear regression analyses were performed. Results showed that less than 15 % of participants presented a high NQ. A high NQ was associated with a healthier lifestyle habits and a more favourable CMR profile (lower values of waist circumference and cholesterol:HDL-cholesterol ratio, lower concentrations of non-HDL-cholesterol, TAG and HbA1c). Some of these associations were independent of age, physical activity level (PAL) and CRF. A better NQ was also associated with a lower proportion of participants presenting the hypertriacylglycerolaemic waist phenotype independently of both PAL and CRF. The present study suggests that overall NQ can be assessed with a short food-based questionnaire and should be considered in clinical practice as a new ‘vital sign’ associated with other health behaviours and cardiometabolic health.

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.

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