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Lee J, Wang X, Liu C, Pathiravasan CH, Benjamin EJ, McManus DD, Murabito JM. Depressive symptoms are not associated with clinically important levels of digital home blood pressure in the electronic Framingham Heart Study. CARDIOVASCULAR DIGITAL HEALTH JOURNAL 2024; 5:50-58. [PMID: 38765623 PMCID: PMC11096660 DOI: 10.1016/j.cvdhj.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
Background Depressive symptoms are common and share many biopsychosocial mechanisms with hypertension. Association studies between depressive symptoms and blood pressure (BP) have been inconsistent. Home BP monitoring may provide insight. Objective To investigate the association between depressive symptoms and digital home BP. Methods Electronic Framingham Heart Study (eFHS) participants were invited to obtain a smartphone app and digital BP cuff at research exam 3 (2016-2019). Participants with ≥3 weeks of home BP measurements within 1 year were included. Depressive symptoms were measured using the Center for Epidemiological Studies Depression Scale (CES-D). Multivariable linear mixed models were used to test the associations of continuous CES-D score and dichotomous depressive symptoms (CES-D ≥16) (independent) with home BP (dependent), adjusting for age, sex, cohort, number of weeks since baseline, lifestyle factors, diabetes, and cardiovascular disease. Results Among 883 participants (mean age 54 years, 59% women, 91% White), the median CES-D score was 4. Depressive symptom prevalence was 7.6%. Mean systolic and diastolic BP at exam 3 were 119 and 76 mm Hg; hypertension prevalence was 48%. A 1 SD higher CES-D score was associated with 0.9 (95% CI: 0.18-1.56, P = .01) and 0.6 (95% CI: 0.06-1.07, P = .03) mm Hg higher home systolic BP and diastolic BP, respectively. Dichotomous depressive symptoms were not significantly associated with home BP (P > .2). Conclusion Depressive symptoms were not associated with clinically substantive levels of home BP. The association between depression and cardiovascular disease risk factors warrants more data, which may be supported by mobile health measures.
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Affiliation(s)
- Jasmine Lee
- Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
| | - Xuzhi Wang
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Chunyu Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts
| | | | - Emelia J. Benjamin
- Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - David D. McManus
- University of Massachusetts Chan Medical School, Boston, Massachusetts
| | - Joanne M. Murabito
- Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts
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2
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An L, Ma L, Xu N, Yu B. Life satisfaction, depressive symptoms, and blood pressure in the middle-aged and older Chinese population. J Psychosom Res 2023; 170:111367. [PMID: 37196586 DOI: 10.1016/j.jpsychores.2023.111367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Both life satisfaction and depressive symptoms have been proven to be related to blood pressure (BP) separately. This longitudinal study aimed to examine whether these two distinct but related psychological constructs are independent predictors of BP in the middle-aged and older Chinese population. METHODS This study used two waves of data from the China Health and Retirement Longitudinal Study (CHARLS) and the analysis were restricted to those respondents aged 45 and older without hypertension and other cardiometabolic conditions [n = 4055, mean age (SD) = 56.7 (8.3); male, 50.1%]. Multiple linear regression models were used to evaluate the associations between baseline life satisfaction, depressive symptoms, and systolic (SBP) and diastolic blood pressure (DBP) at follow-up. RESULTS Life satisfaction was positively associated with SBP (β = 0.03, p = .03), while depressive symptoms were negatively associated with both SBP (β = -0.04, p = .003) and DBP (β = -0.04, p = .004) at follow-up. The associations for life satisfaction became insignificant when all the covariates including depressive symptoms were taken into account. In contrast, the associations for depressive symptoms remained even after controlling for all the covariates including life satisfaction (SBP: β = -0.04, p = .02; DBP: β = -0.04, p = .01). CONCLUSION The results implied that depressive symptoms, rather than life satisfaction, independently predicted BP changes in the Chinese population after four years. These findings expand our knowledge about the association patterns of depressive symptoms and life satisfaction with BP.
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Affiliation(s)
- Li An
- School of Education, Tianjin University, Tianjin, China; Institute of Applied Psychology, Tianjin University, Tianjin, China; Laboratory of Suicidology, Tianjin Municipal Education Commission, Tianjin, China
| | - Ling Ma
- School of Education, Tianjin University, Tianjin, China; Institute of Applied Psychology, Tianjin University, Tianjin, China
| | - Nan Xu
- School of Education, Tianjin University, Tianjin, China; Institute of Applied Psychology, Tianjin University, Tianjin, China
| | - Bin Yu
- Institute of Applied Psychology, Tianjin University, Tianjin, China; Laboratory of Suicidology, Tianjin Municipal Education Commission, Tianjin, China; Academy of Medical Engineering and Translational Medicine, Tianjin University, China.
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3
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Schaare HL, Blöchl M, Kumral D, Uhlig M, Lemcke L, Valk SL, Villringer A. Associations between mental health, blood pressure and the development of hypertension. Nat Commun 2023; 14:1953. [PMID: 37029103 PMCID: PMC10082210 DOI: 10.1038/s41467-023-37579-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/18/2023] [Indexed: 04/09/2023] Open
Abstract
Multiple studies have reported a link between mental health and high blood pressure with mixed or even contradictory findings. Here, we resolve those contradictions and further dissect the cross-sectional and longitudinal relationship between mental health, systolic blood pressure, and hypertension using extensive psychological, medical and neuroimaging data from the UK Biobank. We show that higher systolic blood pressure is associated with fewer depressive symptoms, greater well-being, and lower emotion-related brain activity. Interestingly, impending hypertension is associated with poorer mental health years before HTN is diagnosed. In addition, a stronger baseline association between systolic blood pressure and better mental health was observed in individuals who develop hypertension until follow-up. Overall, our findings offer insights on the complex relationship between mental health, blood pressure, and hypertension, suggesting that-via baroreceptor mechanisms and reinforcement learning-the association of higher blood pressure with better mental health may ultimately contribute to the development of hypertension.
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Affiliation(s)
- H Lina Schaare
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Otto-Hahn-Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany.
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | - Maria Blöchl
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute for Psychology, Leipzig University, Leipzig, Germany
| | - Deniz Kumral
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Psychology, Neuropsychology, University of Freiburg, Freiburg, Germany
- Institute of Psychology, Clinical Psychology and Psychotherapy Unit, University of Freiburg, Freiburg, Germany
| | - Marie Uhlig
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Lorenz Lemcke
- Nuclear Magnetic Resonance Unit, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Sofie L Valk
- Otto-Hahn-Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- MindBrainBody Institute, Berlin School of Mind and Brain, Berlin, Germany
- Clinic of Cognitive Neurology, Leipzig University, Leipzig, Germany
- Charité University Medicine Berlin, Berlin, Germany
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4
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Depression and cardiovascular disease are not linked by high blood pressure: findings from the SAPALDIA cohort. Sci Rep 2022; 12:5516. [PMID: 35365701 PMCID: PMC8975826 DOI: 10.1038/s41598-022-09396-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 03/15/2022] [Indexed: 11/22/2022] Open
Abstract
Depression and cardiovascular disease (CVD) are main contributors to the global disease burden and are linked. Pathophysiological pathways through increased blood pressure (BP) are a common focus in studies aiming to explain the relationship. However, studies to date have not differentiated between the predictive effect of depression on the course of BP versus hypertension diagnosis. Hence, we aimed to elucidate this relationship by incorporating these novel aspects in the context of a cohort study. We included initially normotensive participants (n = 3214) from the second (2001–2003), third (2009–2011), and fourth (2016–2018) waves of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA). We defined depression based on physician diagnosis, depression treatment and/or SF-36 Mental Health score < 50. The prospective association between depression and BP change was quantified using multivariable censored regression models, and logistic regression for the association between depression and incident hypertension diagnosis. All models used clustered robust standard errors to account for repeat measurements. The age-related increase in systolic BP was slightly lower among people with depression at baseline (β = − 2.08 mmHg/10 years, 95% CI − 4.09 to − 0.07) compared to non-depressed. A similar trend was observed with diastolic BP (β = − 0.88 mmHg/10 years, 95% CI − 2.15 to 0.39), albeit weaker and not statistically significant. Depression predicted the incidence of hypertension diagnosis (OR 1.86, 95% CI 1.33 to 2.60). Our findings do not support the hypothesis that depression leads to CVD by increasing BP. Future research on the role of depression in the pathway to hypertension and CVD is warranted in larger cohorts, taking into account healthcare utilization as well as medication for depression and hypertension.
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Mandell LN, Parrish MS, Rodriguez VJ, Alcaide ML, Weiss SM, Peltzer K, Jones DL. Blood Pressure, Depression, and Suicidal Ideation Among Pregnant Women with HIV. AIDS Behav 2022; 26:1289-1298. [PMID: 34651247 DOI: 10.1007/s10461-021-03486-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 01/20/2023]
Abstract
Although prior research has examined associations between blood pressure (BP), depression, and suicidal ideation, few studies have examined this in high-risk populations such as pregnant women with HIV (WHIV). The current study examined the association of BP with depression and suicidal ideation among pregnant WHIV (n = 217) in rural South Africa. BP data (measured ≤ 1 month before the study visit) was extracted from medical records. Depressive symptomatology and suicidal ideation were assessed using the Edinburgh Postnatal Depression Scale. Diastolic BP was positively associated with both suicidal ideation and depressive symptomatology, even after controlling for demographic variables, gestational age, and intimate partner violence. These findings suggest that WHIV with elevated BP may be at greater risk for antenatal depression and suicidal ideation. Future research should utilize longitudinal designs to examine potential mechanisms and the directionality of the relationship, as well as other contributing factors.
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Affiliation(s)
- Lissa N Mandell
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Ave., Suite 404A, Miami, FL, 33136, USA
| | - Manasi S Parrish
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Ave., Suite 404A, Miami, FL, 33136, USA
| | - Violeta J Rodriguez
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Ave., Suite 404A, Miami, FL, 33136, USA
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Maria L Alcaide
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Stephen M Weiss
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Ave., Suite 404A, Miami, FL, 33136, USA
| | - Karl Peltzer
- Department of Human and Social Capabilities, Human Sciences Research Council, Pretoria, South Africa
- Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa
- Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| | - Deborah L Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Ave., Suite 404A, Miami, FL, 33136, USA.
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Mutz J, Lewis CM. Lifetime depression and age-related changes in body composition, cardiovascular function, grip strength and lung function: sex-specific analyses in the UK Biobank. Aging (Albany NY) 2021; 13:17038-17079. [PMID: 34233295 PMCID: PMC8312429 DOI: 10.18632/aging.203275] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/19/2021] [Indexed: 12/27/2022]
Abstract
Individuals with depression, on average, die prematurely, have high levels of physical comorbidities and may experience accelerated biological ageing. A greater understanding of age-related changes in physiology could provide novel biological insights that may help inform strategies to mitigate excess mortality in depression. We used generalised additive models to examine age-related changes in 15 cardiovascular, body composition, grip strength and lung function measures, comparing males and females with a lifetime history of depression to healthy controls. The main dataset included 342,393 adults (mean age = 55.87 years, SD = 8.09; 52.61% females). We found statistically significant case-control differences for most physiological measures. There was some evidence that age-related changes in body composition, cardiovascular function, lung function and heel bone mineral density followed different trajectories in depression. These differences did not uniformly narrow or widen with age and differed by sex. For example, BMI in female cases was 1.1 kg/m2 higher at age 40 and this difference narrowed to 0.4 kg/m2 at age 70. In males, systolic blood pressure was 1 mmHg lower in depression cases at age 45 and this difference widened to 2.5 mmHg at age 65. These findings suggest that targeted screening for physiological function in middle-aged and older adults with depression is warranted to potentially mitigate excess mortality.
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Affiliation(s)
- Julian Mutz
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, Greater London SE5 8AF, United Kingdom
| | - Cathryn M. Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, Greater London SE5 8AF, United Kingdom
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King’s College London, London, Greater London SE1 9RT, United Kingdom
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7
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Vallée A, Wiernik E, Kab S, Lemogne C, Goldberg M, Zins M, Blacher J. Association of depressive symptoms and socioeconomic status in determination of blood pressure levels and hypertension: The CONSTANCES population based study. J Affect Disord 2021; 279:282-291. [PMID: 33096326 DOI: 10.1016/j.jad.2020.10.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Inconsistent association between depression and hypertension has been highlighted. The association of depression with blood pressure (BP) might depend upon socioeconomic status (SES), but evidence remains weak. OBJECTIVES This study aimed to examine how the associations between depressive symptoms and BP levels and hypertension and then, according to SES variables (education, income, occupational status). METHODS Among 66,478 volunteers of the French CONSTANCES cohort (31,093 men; mean age (standard deviation): 47.8 (12.9) years), depressive symptoms were assessed with the Center of Epidemiologic Studies Depression scale (CES-D). Overall associations between depressive symptoms and BP and hypertension were estimated using regressions and by stratifying on SES. RESULTS SES were associated with BP in both genders. CES-D score was negatively associated with systolic BP (SBP) in women (b=-0.62 95%CI [-1.03; -0.21] and in men (b=-1.03 95%CI [-1.45; -0.61]) but not with diastolic BP (DBP) in both genders. In women, the decrease in SBP and DBP was more pronounced as educational level increases (p for interaction: 0.012 and 0.013, respectively). In men, few interactions were observed between CES-D score and SES factors for BP levels. The association between CES-D score and hypertension was significant for men, OR=0.86, 95%CI [0.80; 0.93] but not for women, OR=1.03, 95%CI [0.96; 1.10]. No interactions were observed between CES-D score and SES for hypertension. CONCLUSION Gender differences were observed for considering depressive symptoms according to SES factors for BP variation and hypertension. In women, educational level was the SES factor which has the main modifying effect on this association.
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Affiliation(s)
- Alexandre Vallée
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hotel-Dieu Hospital, AP-HP; University of Paris, Paris, France
| | - Emmanuel Wiernik
- Inserm, UMS011, Population-based Epidemiological Cohorts Unit, Villejuif, France
| | - Sofiane Kab
- Inserm, UMS011, Population-based Epidemiological Cohorts Unit, Villejuif, France
| | - Cédric Lemogne
- AP-HP, Hôpitaux Universitaire Paris Ouest, Service de Psychiatrie de l'adulte et du sujet âgé, 75015, Paris, France; Inserm, U894, Centre Psychiatrie et Neurosciences, 75014, Paris, France
| | - Marcel Goldberg
- Inserm, UMS011, Population-based Epidemiological Cohorts Unit, Villejuif, France
| | - Marie Zins
- Inserm, UMS011, Population-based Epidemiological Cohorts Unit, Villejuif, France
| | - Jacques Blacher
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hotel-Dieu Hospital, AP-HP; University of Paris, Paris, France.
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8
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Huang Y, Su Y, Jiang Y, Zhu M. Sex differences in the associations between blood pressure and anxiety and depression scores in a middle-aged and elderly population: The Irish Longitudinal Study on Ageing (TILDA). J Affect Disord 2020; 274:118-125. [PMID: 32469794 DOI: 10.1016/j.jad.2020.05.133] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Anxiety and depression are considered risk factors for cardiovascular diseases (CVDs), but their relationship to blood pressure (BP) is still uncertain. Lifestyle factors and age-related comorbidities may confound these relationships. Our study aimed to evaluate the associations between BP and anxiety and depression scores in a population aged ≥49 years. METHODS Data on 8504 participants from The Irish Longitudinal Study on Ageing (TILDA) were analyzed for associations between BP and anxiety and depression questionnaire scores, accounting for relevant confounding factors. RESULTS Multivariable analyses showed negative associations between systolic BP and anxiety and depression scores, independent of age, body mass index (BMI), marital status, education level, smoking status, alcohol consumption, level of physical activity, self-reported CVDs (≥2) and antihypertensive medication use in men (coefficient=-0.112, P=0.013; coefficient=-0.051, P=0.026) but not in women (coefficient=-0.001, P=0.855; coefficient=-0.005, P=0.556). Diastolic BP was not associated with anxiety or depression scores in either men (coefficient=-0.018, P=0.223; coefficient=-0.001, P=0.924) or women (coefficient=-0.007, P=0.338; coefficient=-0.015, P=0.293) after adjusting for these same confounding factors. After a follow-up of 4 years, lower BP in subjects not using antihypertensive medications was significantly associated with more anxiety and depression events. LIMITATION Time-varying confounding factors may have interfered with our results. CONCLUSION Our results show that systolic BP in a middle-aged and elderly population is negatively associated with anxiety and depression scores in men but not women after adjustment for a range of lifestyle factors. These results contrast with the predisposition of anxious or depressed participants to CVDs in later life when decades of unhealthy lifestyles have persisted.
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Affiliation(s)
- Ying Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China
| | - Yuhao Su
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China
| | - Ying Jiang
- Department of Rehabilitation, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China
| | - Meilan Zhu
- Department of Rehabilitation, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
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Dotson VM, McClintock SM, Verhaeghen P, Kim JU, Draheim AA, Syzmkowicz SM, Gradone AM, Bogoian HR, Wit LD. Depression and Cognitive Control across the Lifespan: a Systematic Review and Meta-Analysis. Neuropsychol Rev 2020; 30:461-476. [PMID: 32385756 DOI: 10.1007/s11065-020-09436-6] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 03/15/2020] [Indexed: 12/19/2022]
Abstract
Depression has been shown to negatively impact neurocognitive functions, particularly those governed by fronto-subcortical networks, such as executive functions. Converging evidence suggests that depression-related executive dysfunction is greater at older ages, however, this has not been previously confirmed by meta-analysis. We performed a systematic review and meta-analysis, using three-level models, on peer-reviewed studies that examined depression-related differences in cognitive control in healthy community-dwelling individuals of any age. We focused on studies of cognitive control as defined by the National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) framework, which centers on goal-directed behavior, such as goal selection (updating, representations, maintenance), response selection (inhibition or suppression), and performance monitoring. In 16,806 participants aged 7 to 97 across 76 studies, both clinical depression and subthreshold depressive symptoms were associated with cognitive control deficits (Hedges' g = -0.31). This relationship was stronger in study samples with an older mean age. Within studies with a mean age of 39 years or higher, which represents the median age in our analyses, the relationship was stronger in clinical compared to subthreshold depression and in individuals taking antidepressant medication. These findings highlight the importance of clinicians screening for cognitive control dysfunction in patients with depression, particularly in later stages of adulthood.
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Affiliation(s)
- Vonetta M Dotson
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA. .,Gerontology Institute, Georgia State University, Atlanta, GA, USA.
| | - Shawn M McClintock
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Paul Verhaeghen
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Joseph U Kim
- Department of Psychiatry, University of Utah School of Medicine, Lake City, UT, USA
| | - Amanda A Draheim
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Sarah M Syzmkowicz
- Department of Neurological Services, University of Nebraska Medical Center, Omaha, NE, USA
| | - Andrew M Gradone
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Hannah R Bogoian
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Liselotte De Wit
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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10
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Goldmann E, Jacoby R, Finfer E, Appleton N, Parikh NS, Roberts ET, Boden-Albala B. Positive Health Beliefs and Blood Pressure Reduction in the DESERVE Study. J Am Heart Assoc 2020; 9:e014782. [PMID: 32340524 PMCID: PMC7428591 DOI: 10.1161/jaha.119.014782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background There is growing recognition that positive health beliefs may promote blood pressure (BP) reduction, which is critical to stroke prevention but remains a persistent challenge. Yet, studies that examine the association between positive health beliefs and BP among stroke survivors are lacking. Methods and Results Data came from the DESERVE (Discharge Educational Strategies for Reduction of Vascular Events) study, a randomized controlled trial of a skills-based behavioral intervention to reduce vascular risk in a multiethnic cohort of 552 transient ischemic attack and mild/moderate stroke patients in New York City. The exposure was perception that people can protect themselves from having a stroke (ie, prevention self-efficacy) at baseline. The association between systolic BP (SBP) reduction at 12-month follow-up and self-efficacy was examined using linear regression adjusted for key confounders, overall and stratified by age, sex, race/ethnicity, and intervention trial arm. Approximately three quarters endorsed self-efficacy. These participants had, on average, 5.6 mm Hg greater SBP reduction compared with those who did not endorse it (95% CI, 0.5-10.7 mm Hg; P=0.032). Self-efficacy was significantly associated with greater SBP reduction, particularly among female versus male, younger versus older, and Hispanic versus non-Hispanic white patients. Sensitivity analysis adjusting for baseline SBP instead of elevated BP yielded no association between self-efficacy and SBP reduction, but showed sex differences in this association (women: β=5.3; 95% CI, -0.2 to 10.8; P=0.057; men: β=-3.3; 95% CI, -9.4 to 2.9; P=0.300; interaction P=0.064). Conclusions Self-efficacy was linked with greater SBP reduction among female stroke survivors. Targeted strategies to improve health beliefs after stroke may be important for risk factor management. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT01836354.
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Affiliation(s)
- Emily Goldmann
- Department of Epidemiology School of Global Public Health New York University New York NY
| | - Rachelle Jacoby
- Department of Epidemiology School of Global Public Health New York University New York NY
| | - Erica Finfer
- Department of Epidemiology School of Global Public Health New York University New York NY
| | - Noa Appleton
- Department of Population Health New York University Langone Health New York NY
| | - Nina S Parikh
- Department of Social and Behavioral Sciences School of Global Public Health New York University New York NY
| | - Eric T Roberts
- Department of Epidemiology School of Global Public Health New York University New York NY
| | - Bernadette Boden-Albala
- Program in Public Health, Susan and Henry Samueli College of Health Sciences University of California, Irvine CA
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11
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Suchy-Dicey A, Verney SP, Nelson LA, Barbosa-Leiker C, Howard BA, Crane PK, Buchwald DS. Depression Symptoms and Cognitive Test Performance in Older American Indians: The Strong Heart Study. J Am Geriatr Soc 2020; 68:1739-1747. [PMID: 32250446 DOI: 10.1111/jgs.16434] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 02/25/2020] [Accepted: 03/04/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND American Indians have excess risk of depression, which can contribute to cerebrovascular and cognitive disability, with effects on memory, processing speed, executive function, and visuospatial ability. However, studies examining depression and cognition in American Indians are limited; this study aims to report associations of depression with general cognition, verbal fluency and memory, and processing speed. DESIGN Cohort study. SETTING The Cerebrovascular Disease and its Consequences in American Indians study was an ancillary examination of Strong Heart Study participants from 3 U.S. regions. PARTICIPANTS All eligible were included in this analysis (N=818). MEASUREMENTS Participants completed evaluations for depressive symptomology, cognition, and physical function-including Center for Epidemiologic Studies Depression (CESD), Modified Mini-Mental State Examination (3MSE), Wechsler Adult Intelligence Scale-Fourth Edition coding (WAIS), Controlled Oral Word Association (COWA), California Verbal and Learning Test, Halstead finger tapping, grip strength, and Short Physical Performance Battery (SPPB) tests. Linear mixed models were adjusted for site, age, sex, education, income, marital status, alcohol, smoking, diabetes, hypertension, obesity, cholesterol, stroke, infarct, and hemorrhage. RESULTS Symptoms of depression were common, with 20% (N=138) endorsing CES-D scores of 16+. More depressive symptoms were associated with older age, female sex, lower education, lower income, non-married status, not using alcohol, not smoking, hypertension, diabetes, and stroke. In adjusted analyses, processing speed (WAIS: β -0.13, 95%CI -0.25, -0.03), general cognition (3MSE: β -0.10, 95%CI -0.17, -0.03), verbal fluency (COWA: β -0.10, 95%CI -0.19, -0.01), and motor function (SPPB: β -0.05, 95%CI -0.07, -0.03) were significantly associated with more symptoms of depression. CONCLUSION These findings maybe informative for health disparities populations, especially those with depressive risk. Clinicians may require particular training in cultural humility. Future studies should validate use of the CES-D scale in this population; longitudinal studies may focus on causal mechanisms and potential secondary prevention, such as social support. J Am Geriatr Soc 68:1739-1747, 2020.
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Affiliation(s)
- Astrid Suchy-Dicey
- Elson S Floyd College of Medicine, Washington State University, Seattle, Washington, USA.,Institute for Education and Research to Advance Community Health, Washington State University, Seattle, Washington, USA
| | - Steven P Verney
- Psychology Clinical Neuroscience Center, University of New Mexico, Albuquerque, New Mexico, USA
| | - Lonnie A Nelson
- Institute for Education and Research to Advance Community Health, Washington State University, Seattle, Washington, USA.,College of Nursing, Washington State University, Seattle, Washington, USA
| | | | | | - Paul K Crane
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Dedra S Buchwald
- Elson S Floyd College of Medicine, Washington State University, Seattle, Washington, USA.,Institute for Education and Research to Advance Community Health, Washington State University, Seattle, Washington, USA
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12
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Abstract
Abstract. In the present investigation it is hypothesized that depressive symptoms and antidepressant therapy are associated with systolic and diastolic blood pressure. Moreover, in additional analyses, the interaction effects of age, gender, and depressive symptoms are estimated, and discussed in the context of previous findings. Data from the German Health Interview and Examination Survey for Adults (DEGS1) were analyzed ( N = 7,987) by means of multi-response Bayesian hierarchical regression models. Missing data were imputed by the method of chain equations. Independent variables included depressive symptoms, antidepressant medication, gender, age, smoking, physical activity, family history of hypertension, body mass index, and antihypertensive medication. The estimates obtained in the multi-response model revealed that depressive symptoms were negatively associated with arterial blood pressure (−0.09, 99% CI [−0.147; −0.040]). Antidepressant therapy was found to be positively associated with increased blood pressure (1.035, 99% CI [0.333; 1.990]). There were negative interaction effects of depressive symptoms and age among women only (−0.006 99% CI [−0.010; −0.001]). The results agree with previous findings reporting a negative association between depressive symptoms and blood pressure. In addition, regarding the trajectory of blood pressure across the lifespan, interaction effects of depressive symptoms and age were found among females. The results indicate a linear increase in blood pressure with increasing age which, however, tends to flatten and decrease by around age 55 in both males and females. Potential physiological mechanisms may be related to affect regulation taking place at higher levels of cognitive processing and affecting blood pressure regulation, and/or cardiovascular mechanisms related to cerebral blood flow, arterial blood pressure, and depressive symptoms which have not been sufficiently explained so far.
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Affiliation(s)
- Diego Montano
- Department of Medical Sociology, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
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13
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Jones HJ, Minarik PA, Gilliss CL, Lee KA. Depressive symptoms associated with physical health problems in midlife women: A longitudinal study. J Affect Disord 2020; 263:301-309. [PMID: 31818793 PMCID: PMC6989369 DOI: 10.1016/j.jad.2019.11.166] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/11/2019] [Accepted: 11/30/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND It is unclear if the relationship between depression and physical health problems in women is related to age, reproductive stage, obesity or socio-demographic risk factors. METHODS Longitudinal data were obtained every 6 months for 36 months in 264 midlife African American, Caucasian and Latina women who began the study as healthy regularly menstruating 40 to 50-year-olds; 75 transitioned to peri- or post-menopause by 36 months. Scores of 16 or higher on the Center for Epidemiologic Studies-Depression (CES-D) scale were used to estimate depression risk. RESULTS Depression risk was 28% at study initiation and 25% at 36 months. Significantly more women at risk for depression were unemployed, obese, or hypertensive. Women at risk were more likely to become peri- or post-menopausal during the study period. A higher percentage (38%) of overweight and obese women had CES-D scores ≥ 16 compared to normal weight women (23%; p < .001). Over half (58%) of the 73 women at higher depression risk at the initial visit reported a health problem or chronic illness at 36 months, compared to only 36% of the 191 women with CES-D scores <16 (p = .001). LIMITATIONS This was a secondary analysis of data from a relatively healthy sample of women in the decade before menopause. Chronic illness was self-reported and the CES-D is a screening tool for depressive symptoms rather than a clinical diagnostic tool. CONCLUSIONS Health care providers may be underestimating the impact of unemployment on depressive symptoms, obesity and chronic health problems in midlife women.
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Affiliation(s)
| | | | | | - Kathryn A. Lee
- School of Nursing, University of California, San Francisco
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14
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Cardiovascular risk goes up as your mood goes down: Interaction of depression and socioeconomic status in determination of cardiovascular risk in the CONSTANCES cohort. Int J Cardiol 2018; 262:99-105. [DOI: 10.1016/j.ijcard.2018.02.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 02/08/2018] [Accepted: 02/08/2018] [Indexed: 01/05/2023]
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15
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Ma T, Lu D, Zhu YS, Chu XF, Wang Y, Shi GP, Wang ZD, Yu L, Jiang XY, Wang XF. ACTN3 genotype and physical function and frailty in an elderly Chinese population: the Rugao Longevity and Ageing Study. Age Ageing 2018; 47:416-422. [PMID: 29447359 DOI: 10.1093/ageing/afy007] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Indexed: 12/23/2022] Open
Abstract
Objective To examine the associations of the actinin alpha 3 gene (ACTN3) R577X polymorphism with physical performance and frailty in an older Chinese population. Methods Data from 1,463 individuals (57.8% female) aged 70-87 years from the Rugao Longevity and Ageing Study were used. The associations between R577X and timed 5-m walk, grip strength, timed Up and Go test, and frailty index (FI) based on deficits of 23 laboratory tests (FI-Lab) were examined. Analysis of variance and linear regression models were used to evaluate the genetic effects of ACTN3 R577X on physical performance and FI-Lab. Results The XX and RX genotypes of the ACTN3 R557X polymorphism accounted for 17.1 and 46.9%, respectively. Multivariate regression analysis revealed that in men aged 70-79 years, the ACTN3 577X allele was significantly associated with physical performance (5-m walk time, regression coefficient (β) = 0.258, P = 0.006; grip strength, β = -1.062, P = 0.012; Up and Go test time β = 0.368, P = 0.019). In women aged 70-79 years, a significant association between the ACTN3 577X allele and the FI-Lab score was observed, with a regression coefficient of β = 0.019 (P = 0.003). These findings suggest an age- and gender-specific X-additive model of R577X for 5-m walk time, grip strength, Up and Go Test time, and FI-Lab score. Conclusion The ACTN3 577X allele is associated with an age- and sex-specific decrease in physical performance and an increase in frailty in an older population.
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Affiliation(s)
- Teng Ma
- Unit of epidemiology, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, Shanghai 200433, China
| | - Deyi Lu
- University of Illinois at Chicago; Chicago, IL 60601, USA
| | - Yin-Sheng Zhu
- Rugao People’s Hospital, Rugao 226500, Jiangsu, China
| | - Xue-Feng Chu
- Rugao People’s Hospital, Rugao 226500, Jiangsu, China
| | - Yong Wang
- Rugao People’s Hospital, Rugao 226500, Jiangsu, China
| | - Guo-Ping Shi
- Rugao People’s Hospital, Rugao 226500, Jiangsu, China
| | | | - Li Yu
- Jipu biological technology (Shanghai) Co., Ltd., Shanghai 200433, China
| | - Xiao-Yan Jiang
- Key Laboratory of Arrhythmias of the Ministry of Education of China, Tongji University School of Medicine, Shanghai 200092, China
- Department of Pathology and Pathophysiology, Tongji University School of Medicine, Shanghai 200092, China
- Institute of Medical Genetics, Tongji University, Shanghai 200092, China
| | - Xiao-Feng Wang
- Unit of epidemiology, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, Shanghai 200433, China
- National Clinical Research center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
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16
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Relationships between depression and anxiety symptoms scores and blood pressure in young adults. J Hypertens 2018; 35:1983-1991. [PMID: 28505062 DOI: 10.1097/hjh.0000000000001410] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Depression and anxiety are risk factors for cardiovascular disease, but their relationship to blood pressure (BP) is less clear. Age-related comorbidity and lifestyle factors may confound these relationships. This study aimed to assess the relationships among BP, depression and anxiety symptom scores and self-reported history of depression in young adults. METHOD Data on 1014 participants aged 20 years from the Western Australian Cohort (Raine) Study were analyzed for cross-sectional associations between clinic BP and Depression, Anxiety, Stress Scale questionnaire scores or a reported history of depression, accounting for relevant confounders. RESULTS Multivariable adjusted analyses showed an inverse relationship between SBP with depression (coefficient = -0.10; P = 0.012) and anxiety (after excluding two outliers with SBP > 156 mmHg, coefficient = -0.13; P = 0.018) scores, independent of sex, BMI, female hormonal contraceptive use, alcohol consumption, birth weight and maternal hypertension in pregnancy. SBP was 1.6 mmHg lower for 2 SD (16 units) increase in depression score. There was an inverse association between self-reported history of depression (15.8% of participants) and SBP (coefficient = -1.91; P = 0.023), with an interaction with increasing BMI (interaction coefficient = -0.43; P = 0.002) enhancing this difference. CONCLUSION Our findings show that SBP in young adults is inversely associated with depression and anxiety scores, independent of a range of lifestyle confounders. Despite a positive association between BMI and BP, adiposity enhanced the inverse association between self-reported history of depression and SBP. These findings contrast with the predisposition of depressed participants to cardiovascular disease in later life when decades of unhealthy lifestyle changes may dominate.
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17
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Dinoff A, Saleem M, Herrmann N, Mielke MM, Oh PI, Venkata SLV, Haughey NJ, Lanctôt KL. Plasma sphingolipids and depressive symptoms in coronary artery disease. Brain Behav 2017; 7:e00836. [PMID: 29201542 PMCID: PMC5698859 DOI: 10.1002/brb3.836] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 08/18/2017] [Accepted: 09/01/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Depression is highly prevalent in individuals with coronary artery disease (CAD) and increases the risk of future cardiac events and mortality. Sphingolipids have been implicated in the pathophysiology of both CAD and depression. This study assessed the association between plasma sphingolipid concentrations and depressive symptoms in CAD subjects. METHODS Depressive symptoms were measured using the depression subscale of the self-reported Hospital Anxiety and Depression Scale (HADS). Sphingolipid concentrations were measured from fasting plasma samples using high-performance liquid chromatography-coupled electrospray ionization tandem mass spectrometry (LC/MS/MS). Linear regression models were used to assess associations between log-transformed concentrations of plasma sphingolipids and depressive symptoms. RESULTS A total of 111 CAD patients (mean (SD) age = 63.6 ± 6.4, 84.7% male) were included. In linear regression analyses, higher plasma concentrations of ceramides C16:0 (β = 0.204, p = .026) and C18:0 (β = 0.209, p = .023) and sphingomyelin SM18:1 (β = 0.210, p = .024) were significantly associated with higher HADS depression subscale score after adjusting for covariates. CONCLUSION Sphingolipids, in particular the ceramide species C16:0 and C18:0 and the sphingomyelin species SM18:1, may be implicated in the pathophysiology of depression in CAD. The association between plasma sphingolipid concentrations and depression should be further examined in CAD patients and in other populations.
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Affiliation(s)
- Adam Dinoff
- Neuropsychopharmacology Research Group Hurvitz Brain Sciences Program Sunnybrook Research Institute Toronto ON Canada.,Department of Pharmacology and Toxicology Faculty of Medicine University of Toronto Toronto ON Canada
| | - Mahwesh Saleem
- Neuropsychopharmacology Research Group Hurvitz Brain Sciences Program Sunnybrook Research Institute Toronto ON Canada.,Department of Pharmacology and Toxicology Faculty of Medicine University of Toronto Toronto ON Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group Hurvitz Brain Sciences Program Sunnybrook Research Institute Toronto ON Canada.,Department of Psychiatry Faculty of Medicine University of Toronto Toronto ON Canada
| | - Michelle M Mielke
- Department of Neurology Mayo Clinic Rochester MN USA.,Department of Health Sciences Research Mayo Clinic Rochester MN USA
| | - Paul I Oh
- Division of Clinical Pharmacology Sunnybrook Health Sciences Centre Toronto ON Canada.,Toronto Rehabilitation Institute Rumsey Centre Cardiac Rehabilitation Toronto ON Canada
| | | | - Norman J Haughey
- Department of Neurology Johns Hopkins University School of Medicine Baltimore MD USA.,Department of Psychiatry Johns Hopkins University School of Medicine Baltimore MD USA
| | - Krista L Lanctôt
- Neuropsychopharmacology Research Group Hurvitz Brain Sciences Program Sunnybrook Research Institute Toronto ON Canada.,Department of Pharmacology and Toxicology Faculty of Medicine University of Toronto Toronto ON Canada.,Department of Psychiatry Faculty of Medicine University of Toronto Toronto ON Canada.,Toronto Rehabilitation Institute Rumsey Centre Cardiac Rehabilitation Toronto ON Canada
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18
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Meng L, Chen D, Pei F, Hui R, Zheng Y, Chen J. DNA methylation in the norepinephrine transporter gene promoter region is not associated with depression and hypertension. Clin Exp Hypertens 2017; 39:539-545. [PMID: 28737436 DOI: 10.1080/10641963.2017.1288737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study aims to detect the role of DNA methylation in norepinephrine transporter (NET) gene promoter region on the association between depression and hypertension. METHODS A total of 162 subjects were categorized into four groups based on depression scores and blood pressure. DNA was extracted from peripheral white blood cells and methylation levels of nine CpG sites in NET gene promoter region were investigated by pyrosequencing. RESULTS For each CpG site and the average value of nine CpG sites, there were no significant differences in DNA methylation of the NET gene promoter between healthy controls and patients with depression or hypertension. And there were no significant differences among groups after adjusting for age and body mass index. However, DNA methylation levels of the CpG sites adjacent to transcription start site tended to be low. In addition, CpG1.2-CpG5.2 were highly correlated with CpG4 as the first principle component, while CpG2 and the part of CpG1 and 3 were the second principle components. The total participants were clustered into three subgroups by hierarchical cluster analysis of methylated levels. CONCLUSION Our study indicates that DNA methylation levels of nine CpG sites in NET gene promoter region are not associated with depression and hypertension.
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Affiliation(s)
- Lin Meng
- a Department of General Internal Medicine , The First Hospital of Jilin University , Changchun , Jilin Province , P. R. China
| | - Dongmei Chen
- b Department of Cardiology , The First Hospital of Jilin University , Changchun , Jilin Province , P. R. China
| | - Fei Pei
- b Department of Cardiology , The First Hospital of Jilin University , Changchun , Jilin Province , P. R. China
| | - Rutai Hui
- c Sino-German Laboratory for Molecular Medicine, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing P. R. China
| | - Yang Zheng
- b Department of Cardiology , The First Hospital of Jilin University , Changchun , Jilin Province , P. R. China
| | - Jingzhou Chen
- c Sino-German Laboratory for Molecular Medicine, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing P. R. China
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19
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Abbasi SH, Kassaian SE, Sadeghian S, Karimi A, Saadat S, Peyvandi F, Jalali A, Davarpasand T, Akhondzadh S, Shahmansouri N, Lotfi-Tokaldany M, Amiri Abchouyeh M, Ayatollahzade Isfahani F, Rosendaal F. Factors Associated with Depressive Symptoms in Young Adults with Coronary Artery Disease: Tehran Heart Center's Premature Coronary Atherosclerosis Cohort (THC-PAC) Study. IRANIAN JOURNAL OF PSYCHIATRY 2016; 11:214-223. [PMID: 28050181 PMCID: PMC5206323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Depressed coronary artery disease (CAD) patients may experience a poorer prognosis than non-depressed patients. The aim of this study was to find the associated factors for depressive symptoms in young adults with CAD. Method: This was a cross-sectional study within Tehran Heart Center's Premature Coronary Atherosclerosis Cohort (THC-PAC) study. Young adult CAD patients (men ≤ 45 year-old and women ≤ 55 year-old) were visited from March 2013 to February 2014. Demographic, clinical and laboratory data were collected and all patients were asked to fill in the Beck Depression Inventory II. Informed consent was obtained from all participants. A logistic regression model was used to find multiple associated factors of depressive symptoms. Results: Seven hundred seventy patients (mean ±SD age: 45.34 ±5.75 y, men: 47.7%) were visited. The point prevalence of depressive symptoms was 46.9% in women and 30.2% in men (p < 0.001). Logistic regressions model revealed that the most important associated factors for depressive symptoms in the male premature CAD patients were opium usage (OR: 2.4, 95% CI: 1.33-4.43), major adverse cardiac events (MACE) (OR: 2.2, 95% CI: 1.17-3.93), initial coronary artery bypass grafting (CABG) treatment (OR: 2.1, 95% CI: 1.07-4.06), positive family history for CAD (OR: 1.8, 95% CI: 1.11-3.01) and cigarette smoking (OR: 1.7, 95% CI: 0.97-2.98). Hypertension showed a protective role in this group of patients (OR = 0.5, CI = 0.29-0.92). In the female patients, hypertension (OR = 1.5, CI = 0.96-2.22) and body mass index (BMI) (OR = 1.1, CI = 1.02-1.10) were associated with depressive symptoms. Conclusion: In premature CAD male patients, opium usage, MACE, initial CABG treatment, positive family history for CAD and cigarette smoking were associated with depressive symptoms; and hypertension and BMI were associated with depressive symptoms in women.
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Affiliation(s)
| | | | - Saeed Sadeghian
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbasali Karimi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Saadat
- Sina Trauma Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Flora Peyvandi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milano, Angelo Bianchi Bonomi Hemophilia and Thrombosis Centre, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Arash Jalali
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shahin Akhondzadh
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | - Frits Rosendaal
- Department of Clinical Epidemiology and Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, the Netherlands
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20
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Zambrana RE, López L, Dinwiddie GY, Ray RM, Eaton CB, Phillips LS, Wassertheil-Smoller S. Association of Baseline Depressive Symptoms with Prevalent and Incident Pre-Hypertension and Hypertension in Postmenopausal Hispanic Women: Results from the Women's Health Initiative. PLoS One 2016; 11:e0152765. [PMID: 27124184 PMCID: PMC4849764 DOI: 10.1371/journal.pone.0152765] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 03/19/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Depression and depressive symptoms are risk factors for hypertension (HTN) and cardiovascular disease (CVD). Hispanic women have higher rates of depressive symptoms compared to other racial/ethnic groups yet few studies have investigated its association with incident prehypertension and hypertension among postmenopausal Hispanic women. This study aims to assess if an association exists between baseline depression and incident hypertension at 3 years follow-up among postmenopausal Hispanic women. METHODS Prospective cohort study, Women's Health Initiative (WHI), included 4,680 Hispanic women who participated in the observational and clinical trial studies at baseline and at third-year follow-up. Baseline current depressive symptoms and past depression history were measured as well as important correlates of depression-social support, optimism, life events and caregiving. Multinomial logistic regression was used to estimate prevalent and incident prehypertension and hypertension in relation to depressive symptoms. RESULTS Prevalence of current baseline depression ranged from 26% to 28% by hypertension category and education moderated these rates. In age-adjusted models, women with depression were more likely to be hypertensive (OR = 1.25; 95% CI 1.04-1.51), although results were attenuated when adjusting for covariates. Depression at baseline in normotensive Hispanic women was associated with incident hypertension at year 3 follow-up (OR = 1.74; 95% CI 1.10-2.74) after adjustment for insurance and behavioral factors. However, further adjustment for clinical covariates attenuated the association. Analyses of psychosocial variables correlated with depression but did not alter findings. Low rates of antidepressant medication usage were also reported. CONCLUSIONS In the largest longitudinal study to date of older Hispanic women which included physiologic, behavioral and psychosocial moderators of depression, there was no association between baseline depressive symptoms and prevalent nor incident pre-hypertension and hypertension. We found low rates of antidepressant medication usage among Hispanic women suggesting a possible point for clinical intervention. TRIAL REGISTRATION Clinicaltrials.gov NCT00000611.
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Affiliation(s)
- Ruth E. Zambrana
- Department of Women’s Studies, Consortium on Race, Gender and Ethnicity, University of Maryland, College Park, Maryland, United States of America
| | - Lenny López
- Division of Hospital Medicine, University of California, San Francisco, California, United States of America
| | - Gniesha Y. Dinwiddie
- African American Studies Department, University of Maryland, College Park, Maryland, United States of America
| | - Roberta M. Ray
- Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Charles B. Eaton
- Family Medicine & Epidemiology, Alpert Medical School, Brown University, Providence, Rhode Island, United States of America
| | - Lawrence S. Phillips
- Division of Endocrinology and Metabolism, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
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Trudel-Fitzgerald C, Gilsanz P, Mittleman MA, Kubzansky LD. Dysregulated Blood Pressure: Can Regulating Emotions Help? Curr Hypertens Rep 2016; 17:92. [PMID: 26520446 DOI: 10.1007/s11906-015-0605-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Despite having identified key physiological and behavioral risk factors, the prevalence of hypertension continues to rise, affecting two thirds of American adults 60 years or older. An important condition in its own right, hypertension is also a leading risk factor for cardiovascular diseases; thus, identifying additional modifiable determinants remains a public health priority. Psychological states and negative emotions more specifically have been proposed as risk factors, but the research findings are inconsistent. Additional prospective studies have recently been published increasing the availability of longitudinal data. The aim of this literature review is to evaluate these findings focusing on those from the last 3 years. We synthesize current research on whether negative (e.g., depression, anxiety) or positive (e.g., optimism) emotion-related factors are associated with high blood pressure onset. We discuss discrepant findings and propose considering emotion regulation as a novel approach to explain inconsistencies. Finally, we provide thoughts on future research directions.
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Affiliation(s)
- Claudia Trudel-Fitzgerald
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA, 02115, USA.
| | - Paola Gilsanz
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA, 02115, USA
| | - Murray A Mittleman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02215, USA.,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA, 02115, USA
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22
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Depression in hypertension and blood pressure variability over shorter time periods. Hypertens Res 2015; 38:713-5. [PMID: 26289781 DOI: 10.1038/hr.2015.92] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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23
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Impact of depression on masked hypertension and variability in home blood pressure in treated hypertensive patients. Hypertens Res 2015; 38:751-7. [DOI: 10.1038/hr.2015.75] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/24/2015] [Accepted: 03/26/2015] [Indexed: 11/08/2022]
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Abstract
A growing body of research demonstrates that psychosocial factors play an important role in the development of hypertension. Previous reviews have identified several key factors (i.e., occupational stress) that contribute to the onset of hypertension; however, they are now outdated. In this review, we provide an updated synthesis of the literature from 2010 to April 2014. We identified 21 articles for inclusion in the review, of which there were six categories of psychosocial stressors: occupational stress, personality, mental health, housing instability, social support/isolation, and sleep quality. Sixteen of the studies reported an association between the psychosocial stressor and blood pressure. While several findings were consistent with previous literature, new findings regarding mediating and moderating factors underlying the psychosocial-hypertension association help to untangle inconsistencies reported in the literature. Moreover, sleep quality is a novel additional factor that should undergo further exploration. Areas for future research based on these findings are discussed.
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Tikhonoff V, Hardy R, Deanfield J, Friberg P, Kuh D, Muniz G, Pariante CM, Hotopf M, Richards M. Symptoms of anxiety and depression across adulthood and blood pressure in late middle age: the 1946 British birth cohort. J Hypertens 2015; 32:1590-8; discussion 1599. [PMID: 24906173 PMCID: PMC4166011 DOI: 10.1097/hjh.0000000000000244] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective: Previous studies testing the hypothesis that symptoms of anxiety and depression increase blood pressure (BP) levels show inconsistent and limited findings. We examined the association between those symptoms across adult life and BP in late middle age. Methods: Using data from 1683 participants from the MRC NSHD, we investigated associations between affective symptoms at ages 36, 43, 53 and 60–64 years and SBP and DBP at age 60–64. Multivariable linear regression was used to examine the effect on BP of affective symptoms at each age separately and as a categorical cumulative score based on the number of times an individual was classified as a ‘case’. Models were adjusted for sex, BMI, educational attainment, socio-economic position, heart rate, lifestyle factors and antihypertensive treatment. Results: In fully adjusted models, we observed lower SBP in study members with case-level symptoms at one to two time-points [−1.83 mmHg; 95% confidence interval (CI) −3.74 to 0.01] and at three to four time-points (−3.93 mmHg; 95% CI −7.19 to −0.68) compared with those never meeting case criteria suggesting a cumulative inverse impact of affective symptoms on SBP across adulthood (P value for trend 0.022). Sex and BMI had a large impact on the estimates while not other confounders. Potential mediators such as heart rate and lifestyle behaviours had a little impact on the association. SBP at age 36 and behavioural changes across adulthood, as additional covariates, had a little impact on the association. A similar but weaker trend was observed for DBP. Conclusion: A cumulative effect of symptoms of anxiety and depression across adulthood results in lower SBP in late middle age that is not explained by lifestyle factors and antihypertensive treatment. Mechanisms by which mood may impact BP should be investigated.
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Affiliation(s)
- Valérie Tikhonoff
- aMRC Unit for Lifelong Health and Ageing at University College London bNational Centre for Cardiovascular Prevention and Outcomes, Institute of Cardiovascular Science, University College London, London, UK cDepartment of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden dDepartment of Psychological Medicine, Institute of Psychiatry eInstitute of Psychiatry, King's College London, London, UK *Matthew Hotopf and Marcus Richards contributed equally to the writing of this article
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26
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Azimova K, Rude J, Mallawaarachchi I, Dwivedi A, Sarosiek J, Mukherjee D. Glucose Levels and Depression in Hispanic Patients Admitted to the Cardiovascular Intensive Care Unit. Angiology 2013; 66:57-64. [DOI: 10.1177/0003319713513318] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Depression is frequently associated with diabetes mellitus (DM) and may worsen DM-related morbidity and mortality. We determined the potential association of glucose levels with depression in Hispanic patients admitted to the Cardiovascular Intensive Care Unit. Patients were given the Center for Epidemiologic Studies—Depression scale survey within 24 hours of admission. Glycated hemoglobin and fasting blood glucose levels within 30 days of admission were extracted. The HbA1c levels remained significantly associated with both presence of depression and depression levels. Histories of DM, myocardial infarction, and percutaneous coronary intervention as well as baseline brain natriuretic peptide levels were also significantly associated with depression levels. The presence of a significant association between glucose levels and depression in Hispanic patients indicates that there is a need for optimal management of glycemic levels. This may then lead to better health outcomes in Hispanics with cardiovascular disease.
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Affiliation(s)
- Komola Azimova
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Jennifer Rude
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Indika Mallawaarachchi
- Division of Biostatistics & Epidemiology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Alok Dwivedi
- Division of Biostatistics & Epidemiology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Jerzy Sarosiek
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Debabrata Mukherjee
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
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