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Rosas CE, Pirzada A, Durazo-Arvizu R, Gallo LC, Talavera GA, Elfassy T, Cai J, Llabre MM, Perreira KM, Wassertheil-Smoller S, Daviglus ML, Sanchez-Johnsen LAP. Associations of Anxiety Symptoms With 6-Year Blood Pressure Changes and Incident Hypertension: Results From the Hispanic Community Health Study/Study of Latinos. Ann Behav Med 2024; 58:488-497. [PMID: 38810223 PMCID: PMC11185088 DOI: 10.1093/abm/kaae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Despite the high burden of anxiety and hypertension in Hispanic/Latino adults, little is known about their association in this population. PURPOSE To examine the associations of anxiety symptoms with 6-year changes in blood pressure (BP) and incident hypertension in Hispanic/Latino adults. METHODS We examined data from a probability sample of 10,881 Hispanic/Latino persons aged 18-74 who attended visits 1 (V1; 2008-2011) and 2 (V2; 2014-2017) of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a prospective cohort study. Anxiety symptoms were assessed at V1 using the 10-item Spielberger Trait Anxiety Scale (M = 17.1; Range = 10-40) and dichotomized using a cut-point of 20, the highest quartile in this cohort. BP was measured at both visits using a standardized protocol. RESULTS Adults with elevated anxiety symptoms had a 1.02 mm Hg greater increase in systolic (p = .02) and a 0.75 mm Hg greater increase in diastolic BP (p = .02) over 6.1 years than those with lower symptoms, after adjusting for sociodemographic and clinical covariates. These associations differed by sex. Elevated anxiety was associated with a greater increase in systolic and diastolic BP in men only. Among persons without hypertension at V1 (N = 7,412), those with elevated anxiety symptoms at V1 had a 22% higher incidence of hypertension (p = .02) 6.1 years later. CONCLUSIONS Our findings underscore the importance of screening for and treating elevated anxiety symptoms to help prevent hypertension. Further research on the role of sex and underlying mechanisms is warranted.
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Affiliation(s)
- Carlos E Rosas
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- South Bay Latino Research Center, San Diego State University, Chula Vista, California, USA
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, Illinois, USA
- Department of Medicine, University of Illinois Chicago, Chicago, Illinois, USA
| | - Ramon Durazo-Arvizu
- Department of Neonatology, Children's Hospital Los Angeles - University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Linda C Gallo
- South Bay Latino Research Center, San Diego State University, Chula Vista, California, USA
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Gregory A Talavera
- South Bay Latino Research Center, San Diego State University, Chula Vista, California, USA
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Tali Elfassy
- Department of Medicine, Katz Family Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jianwen Cai
- Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Martha L Daviglus
- South Bay Latino Research Center, San Diego State University, Chula Vista, California, USA
- Department of Medicine, University of Illinois Chicago, Chicago, Illinois, USA
| | - Lisa A P Sanchez-Johnsen
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Department of Psychology, University of Illinois Chicago, Chicago, Illinois, USA
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Smith ML, Gelaye B, Tsai AC, Gradus JL. Mediation of the association between depression and coronary heart disease by metabolic syndrome components. Ann Epidemiol 2024; 92:1-7. [PMID: 38341050 DOI: 10.1016/j.annepidem.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/30/2024] [Accepted: 02/06/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Depression is associated with incident coronary heart disease (CHD) via a pathway that may be causal, but the mechanisms underlying this association are unclear. We assessed the extent to which metabolic syndrome (MetS) and its components (i.e., elevated waist circumference, low high-density lipoprotein [HDL] cholesterol, elevated triglycerides, elevated blood pressure, and elevated fasting plasma glucose) may mediate this association. METHODS Data were Framingham Heart Study Research Materials obtained from the National Heart, Lung, and Blood Institute (NHLBI) Biologic Specimen and Data Repository Information Coordinating Center. We used Cox proportional hazards regression to estimate adjusted hazard ratios (aHR) representing the total effect (aHRTE) of probable depression, measured via the Centers for Epidemiological Studies - Depression scale, on incident CHD over approximately 18 years. Using inverse odds ratio weighting, we decomposed this estimate into natural direct effects (aHRNDE) and natural indirect effects (aHRNIE) through potential mediators (measured approximately three years after depression). RESULTS Probable depression was associated with incident CHD (aHRTE=1.45, 95% confidence interval [CI]: 0.93, 2.25), and elevated waist circumference partially mediated this association (aHRNDE=1.34, 95% CI: 0.76-2.32; aHRNIE=1.08, 95% CI: 0.63-1.91). We did not find evidence of additional mediation by additional MetS components. CONCLUSIONS Elevated waist circumference appears to play a role in the association between depression and CHD.
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Affiliation(s)
- Meghan L Smith
- Boston University School of Public Health, Department of Epidemiology, United States.
| | - Bizu Gelaye
- Harvard TH Chan School of Public Health, Department of Epidemiology, United States; Harvard Medical School, United States
| | - Alexander C Tsai
- Harvard Medical School, United States; Massachusetts General Hospital, Center for Global Health and Mongan Institute, United States
| | - Jaimie L Gradus
- Boston University School of Public Health, Department of Epidemiology, United States; Boston University School of Medicine, Department of Psychiatry, United States
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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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4
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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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Mental and Body Health: The Association between Psychological Factors, Overweight, and Blood Pressure in Young Adults. J Clin Med 2022; 11:jcm11071999. [PMID: 35407607 PMCID: PMC8999355 DOI: 10.3390/jcm11071999] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/28/2022] [Accepted: 04/01/2022] [Indexed: 02/06/2023] Open
Abstract
Comorbidity between cardiometabolic risk factors and major mental health disorders is a public health concern. The close interconnection between the mental and physical aspects of health precludes considering each condition separately. Accordingly, this study sought to explore the interrelationships between psychological factors, overweight, and blood pressure in young adults. One hundred and forty-five young adults participated in the study and were classified according to two independent characteristics: weight condition (normal weight, overweight) and blood pressure (low blood pressure, high blood pressure). Anxiety, depression, and emotional dysregulation were assessed. The results confirmed certain associations, highlighting how cardiometabolic risk factors, such as blood pressure and body mass index, were associated in different ways with mental health, although an interaction between the variables was not reported. In particular, a relationship between body mass index and depression and between anxiety and blood pressure was detected.
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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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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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Archer G, Kuh D, Hotopf M, Stafford M, Richards M. Association Between Lifetime Affective Symptoms and Premature Mortality. JAMA Psychiatry 2020; 77:806-813. [PMID: 32267482 PMCID: PMC7142795 DOI: 10.1001/jamapsychiatry.2020.0316] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 01/30/2020] [Indexed: 11/14/2022]
Abstract
Importance Associations between affective symptoms and mortality have been evaluated, but studies have not examined timing or cumulative exposure to affective symptoms over the life course. Objectives To examine how lifetime accumulation and timing of affective symptoms are associated with mortality and identify potential explanatory factors. Design, Setting, and Participants Data were obtained from the MRC National Survey of Health and Development (1946 British birth cohort), a socially stratified, population-based sample originally consisting of 5362 singleton births in England, Wales, and Scotland during March 1946. The cohort has been followed up 24 times, most recently in 2014-2015. Eligible participants included those flagged for mortality with affective symptom data available at a minimum of 3 time points (n = 3001). Data analysis was conducted from July 2016 to January 2019. Exposures Affective symptoms were assessed at ages 13 to 15 years (teacher-rated questionnaire), 36 years (Present State Examination clinical semistructured interview), 43 years (Psychiatric Symptom Frequency questionnaire), and 53 years (General Health Questionnaire-28). Case-level affective symptoms were determined by those scoring in the top 16th percentile (ie, suggestive of a clinical diagnosis). Main Outcomes and Measures Mortality data were obtained from the UK National Health Service Central Register from age 53 to 68 years. Results Of 3001 study members (1509 [50.3%] female, 1492 [49.7%] male), 235 individuals (7.8%) died over a 15-year follow-up. After adjustment for sex, those who experienced case-level affective symptoms 1, 2, and 3 to 4 times had 76%, 87%, and 134% higher rates of premature mortality, respectively, compared with those who never experienced case-level symptoms. Case-level symptoms in adolescence only (ages 13-15 years) were associated with a 94% increased rate of mortality, which was unexplained after full adjustment for covariates (hazard ratio, 1.73; 95% CI, 1.10-2.72). Associations between participants with case-level symptoms multiple (2-4) times and mortality were predominately explained by adult health indicators and behaviors. For example, associations for those with case-level symptoms 3 to 4 times were most strongly attenuated by number of health conditions (32.1%), anxiolytic use (28.4%), lung function (24.6%), physical activity (23.9%), smoking (24.6%), antidepressant use (20.1%), diet (16.4%), pulse rate (12.7%), and adult social class (11.2%). Conclusions and Relevance Lifetime accumulation of affective symptoms may be associated with an increased rate of mortality, with explanatory pathways dependent on the duration and timing of symptoms. Future research into causal pathways and potential points of intervention should consider affective symptom history.
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Affiliation(s)
- Gemma Archer
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Mai Stafford
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom
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Comorbilidad afectiva en personas con hipertensión arterial: un estudio de caso-control en adultos dominicanos. ACTA COLOMBIANA DE PSICOLOGIA 2020. [DOI: 10.14718/acp.2020.23.1.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
En la literatura científica se encuentra un gran número de controversias y resultados dispares a la hora de explicar la relación entre la hipertensión arterial y algunas variables vinculadas a la afectividad negativa, como la depresión, la ansiedad y la ira. Teniendo esto en cuenta, en la presente investigación se planteó como objetivo principal analizar medidas de ansiedad, depresión e ira en personas adultas que padecen de hipertensión arterial (HTA). A partir de un diseño de caso-control, se contrastaron dos grupos, uno conformado por personas con HTA (n = 50) y otro de control equiparado en número de casos, edad y sexo. A nivel general, el grupo de HTA mostró mayores niveles de depresión ¾en su dimensión somática¾ y de ira-rasgo ¾en su dimensión de temperamento¾. Asimismo, las personas con HTA presentaron síntomas de irritabilidad y pérdida de energía ¾síntomas depresivo-somáticos¾, además de que tendían a enojarse con facilidad o rápidamente —sín- tomas de temperamento de ira¾. El abordaje de estos factores psicológicos comórbidos resulta de relevancia dado que en estudios precedentes ha demostrado aumentar la adherencia al tratamiento médico en pacientes que han sido diagnosticados con hipertensión o patologías similares.
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10
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Liu JH, Qian YX, Ma QH, Sun HP, Xu Y, Pan CW. Depressive symptoms and metabolic syndrome components among older Chinese adults. Diabetol Metab Syndr 2020; 12:18. [PMID: 32099584 PMCID: PMC7029582 DOI: 10.1186/s13098-020-00526-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/14/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Few studies examined associations between depressive symptoms and metabolic syndrome (MetS) among older Chinese adults. Considering that the prevalence of depressive symptoms is high in older Chinese adults, we aimed to examine associations of depressive symptoms with MetS and its components in older Chinese adults. METHODS Data from a community-based cross-sectional study of 4579 Chinese adults aged 60 years or older were analyzed. Depressive symptoms were assessed using the nine-item Patient Health Questionnaire. The presence of MetS was defined based on the Adult Treatment Panel III criteria, which include obesity, reduced blood high-density lipoprotein, high blood pressure (BP), elevated fasting plasma glucose and hypertriglyceridemia. A participant was considered as having MetS if he or she met at least three of the above-mentioned criteria. RESULTS In all participants, depressive symptoms were related to elevated fasting plasma glucose (≥ 7.0 mmol/L) (adjusted odds ratio [OR] = 1.50, 95% confidence interval [CI] [1.00-2.20]) and diabetes (adjusted OR = 1.50, 95% CI [1.01-2.20]). The associations of depressive symptoms with MetS and its components were not significant among women. However, there was a negative association between depressive symptoms and elevated systolic BP (≥ 130 mm Hg) (OR = 0.59, 95% CI [0.4-0.9]), and similar findings were observed after adjusting for lifestyle-related variables in men. CONCLUSIONS In older Chinese adults, depressive symptoms were negatively associated with elevated systolic BP in men while these findings were not found in women.
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Affiliation(s)
- Jing-Hong Liu
- School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123 China
| | - Yu-Xi Qian
- School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123 China
| | - Qing-Hua Ma
- The 3rd People’s Hospital of Xiangcheng District, Suzhou, China
| | - Hong-Peng Sun
- School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123 China
| | - Yong Xu
- School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123 China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123 China
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Chronic medical conditions and metabolic syndrome as risk factors for incidence of major depressive disorder: A longitudinal study based on 4.7 million adults in South Korea. J Affect Disord 2019; 257:486-494. [PMID: 31319340 DOI: 10.1016/j.jad.2019.07.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/28/2019] [Accepted: 07/01/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND The assessment of comorbid physical illness and metabolic or cardiovascular risk factors as potential risk factors for onset of major depressive disorder (MDD) is crucial. We aimed to investigate potential risk factors for the development of MDD among individuals with chronic medical conditions and metabolic and behavioral risk factors using a large population-based retrospective cohort from the data of the National Health Insurance Service (NHIS) in South Korea. METHODS The population-based retrospective cohort included data from 2,370,815 adults (age ≥20 years) diagnosed with MDD between January 1, 2010, and December 31, 2016 and age- and gender-matched 2,370,815 healthy controls obtained from the claims data of the NHIS. The data of the regular health checkup provided by the NHIS were also included (age ≥40 years). Logistic regression analyses were performed to investigate the potential risk factors for the incidence of MDD. RESULTS Chronic medical conditions such as Parkinson's disease (odds ratio [OR] = 7.808, 95% confidence interval [CI] = 7.517-8.11), epilepsy (OR = 6.119, 95% CI = 6.019-6.22), multiple sclerosis (OR = 5.532, 95% CI = 4.976-6.151), Huntington's disease (OR = 5.387, 95% CI = 3.258-8.909), migraine (OR = 4.374, 95% CI = 4.341-4.408), stroke (OR = 4.074, 95% CI = 4.032-4.117), and cancer; metabolic syndrome (OR = 1.049, 95% CI = 1.041-1.057) and several of its components including central obesity, elevated fasting blood glucose and triglyceride levels, and reduced high-density lipoprotein level; and cigarette smoking, frequent alcohol consumption, and low physical activity are potential risk factors for the development of MDD. CONCLUSION Our results may support previous evidence on the association between physical conditions and the incidence of MDD as reported by individual population-based studies with modest sample sizes.
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Mayer O, Bruthans J, Seidlerová J, Karnosová P, Mateřánková M, Gelžinský J, Rychecká M, Cífková R, Filipovský J. Mood disorders impaired quality of life but not the mortality or morbidity risk in stable coronary heart disease patients. Acta Cardiol 2019; 75:667-675. [PMID: 31442189 DOI: 10.1080/00015385.2019.1653568] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: It was suggested that depression and anxiety might be associated with increased cardiovascular risk in both primary and secondary prevention. In stable coronary heart disease (CHD) patients, we aimed to assess prevalence of depression and anxiety, its relations to conventional risk profile and mortality or morbidity and to quality of life (QoL). Methods: We examined 969 patients, at least 6 months after myocardial infarction or coronary revascularisation. Depression or anxiety was assessed using a standard HADS (Hospital Anxiety and Depression Scale), while QoL by SF-36 (Short-Form-36 Questions) questionnaires. Follow-up was done to assess mortality in incidence of non-fatal cardiovascular event. Results: Both mood disorders were rather frequent; borderline depression or anxiety (HADS score 8-10) had 14.8 or 10.9% of patients, respectively; moderate-to-severe depression or anxiety (HADS score ≥11) had another 8.2 or 6.7% of patients. After adjustment for potential covariates impaired QoL (SF-36 score <40) was independently associated with depressive mood [odds ratio (OR) 6.08 (95%CI: 2.92-12.7) or anxiety [OR 8.66 (95%CI: 3.77-19.89)], as well as with combination of both disorders [OR 33.58 (95%CI: 15.5-72.6)]. Conventional risk characteristics remained virtually unrelated to mood disorders (with exception of angina pectoris). We found significantly higher incidence of major cardiovascular events in patients with anxious mood and marginally significant inferior survival in patients with depression, but any cardiovascular risk disappeared if adjusted for potential covariates (conventional risk factors, natriuretic peptides, angina pectoris.) Conclusions: Mood disorders severely affected QoL of stable CHD patients, but not their global cardiovascular risk.
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Affiliation(s)
- Otto Mayer
- 2nd Department of Internal Medicine, Faculty of Medicine in Pilsen, Charles University and University Hospital, Pilsen, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Czech Republic
| | - Jan Bruthans
- 2nd Department of Internal Medicine, Faculty of Medicine in Pilsen, Charles University and University Hospital, Pilsen, Czech Republic
- Centre for Cardiovascular Prevention of the First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Jitka Seidlerová
- 2nd Department of Internal Medicine, Faculty of Medicine in Pilsen, Charles University and University Hospital, Pilsen, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Czech Republic
| | - Petra Karnosová
- 2nd Department of Internal Medicine, Faculty of Medicine in Pilsen, Charles University and University Hospital, Pilsen, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Czech Republic
| | - Markéta Mateřánková
- 2nd Department of Internal Medicine, Faculty of Medicine in Pilsen, Charles University and University Hospital, Pilsen, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Czech Republic
| | - Julius Gelžinský
- 2nd Department of Internal Medicine, Faculty of Medicine in Pilsen, Charles University and University Hospital, Pilsen, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Czech Republic
| | - Martina Rychecká
- 2nd Department of Internal Medicine, Faculty of Medicine in Pilsen, Charles University and University Hospital, Pilsen, Czech Republic
| | - Renata Cífková
- Centre for Cardiovascular Prevention of the First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Jan Filipovský
- 2nd Department of Internal Medicine, Faculty of Medicine in Pilsen, Charles University and University Hospital, Pilsen, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Czech Republic
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Zubcevic J, Watkins J, Perez PD, Colon-Perez LM, Long MT, Febo M, Hayward L. MEMRI reveals altered activity in brain regions associated with anxiety, locomotion, and cardiovascular reactivity on the elevated plus maze in the WKY vs SHR rats. Brain Imaging Behav 2019; 12:1318-1331. [PMID: 29181695 DOI: 10.1007/s11682-017-9798-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Individuals with anxiety/depression often have exaggerated cardiovascular responses to stressful stimuli and a comorbidity with hypertension. Alternatively, individuals with hypertension can be more anxious. In the present study cardiovascular changes were evaluated during behavioral testing of anxious behavior on the elevated plus maze (EPM) in the spontaneously hypertensive rat (SHR), a rodent model of neurogenic hypertension, and compared to the response of the more anxious, but normotensive, Wistar-Kyoto rat (WKY). Manganese-enhanced magnetic resonance imaging (MEMRI) was used to identify regional differences in baseline brain activity. Parallel to indicators of elevated behavioral anxiety on the EPM, WKYs had a greater increase in blood pressure but not heart rate when compared to the SHR while on the EPM. Associated with differences in anxiety-related behavior and autonomic responses, we observed increased baseline activity in the amygdala, central gray, habenula and interpeduncular nucleus with MEMRI of the WKY compared to the SHR. Conversely, elevated baseline brain activity was found in regions associated with blood pressure control and system arousal, including the hypothalamus, locus coeruleus and pedunculopontine tegmental nucleus, in the SHR vs WKY, in-line with increased resting blood pressure and increased mobility in this strain. Lastly, reduced activity in hippocampal regions was identified in the SHR compared to the WKY and may be associated with cognitive impairment previously reported in the SHR. Thus, autonomic reactivity may be a true measure of stress in rodent models of anxiety and MEMRI presents a powerful technique to uncover novel brain mechanisms of blood pressure control.
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Affiliation(s)
- Jasenka Zubcevic
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, 1333 Center Dr., BSB 3-32, Gainesville, FL, 32610-0144, USA
| | - Jacqueline Watkins
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, 1333 Center Dr., BSB 3-32, Gainesville, FL, 32610-0144, USA
| | - Pablo D Perez
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, 32610-0256, USA
| | - Luis M Colon-Perez
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, 32610-0256, USA
| | - Maureen T Long
- Department of Comparative, Diagnostic & Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610-0123, USA
| | - Marcelo Febo
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, 32610-0256, USA
| | - Linda Hayward
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, 1333 Center Dr., BSB 3-32, Gainesville, FL, 32610-0144, USA.
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14
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Foundation of algorithm of medical and psychological support of adolescents with primary arterial hypertension. Fam Med 2018. [DOI: 10.30841/2307-5112.3.2018.146348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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15
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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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Joung KI, Cho SI. Association of low blood pressure with suicidal ideation: a cross-sectional study of 10,708 adults with normal or low blood pressure in Korea. BMC Public Health 2018; 18:200. [PMID: 29490622 PMCID: PMC5831223 DOI: 10.1186/s12889-018-5106-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 01/19/2018] [Indexed: 01/13/2023] Open
Abstract
Background Whether constitutional low blood pressure (BP) causes substantive health problems has been controversial, and subjects with hypotension exhibit a range of symptoms, from mild typical conditions such as tiredness and dizziness to more specific psychological conditions and even cognitive disorders. This study investigated whether low BP is associated with suicidal ideation in the general population. Methods Four years of data from the 2010–2013 Korean National Health and Nutrition Examination Survey were used. Among the 23,163 participants, aged 19–101 years, 10,708 with normal or low BP were included in the analysis of the association between low BP and suicidal ideation. The criterion used for low BP was systolic BP (SBP) < 100 mmHg, and in comparative analyses, the criteria used for low BP were SBP < 110, < 95, and < 90 mmHg. The association of prehypertension or hypertension with suicidal ideation was also examined. Suicidal ideation was assessed by a questionnaire. Results Compared with the normotensive reference group, the odds ratios (ORs) for suicidal ideation were significantly higher in the three hypotensive groups after adjusting for sex, age, body mass index, total cholesterol level, household income, educational level, marital status, current smoking status, alcohol intake, and the interaction between sex and age (OR = 1.29, 95% confidence interval [CI], 1.08 to 1.55; OR = 1.44, 95% CI, 1.14 to 1.82; and OR = 1.71, 95% CI, 1.11 to 2.62 for SBP < 100, SBP < 95, and SBP < 90 mmHg, respectively). Adding the clinical morbidities of diabetes mellitus, stroke, myocardial infarction/angina pectoris, and depression as covariates had little effect on the strength of the associations (OR = 1.25, 95% CI, 1.04 to 1.50; OR = 1.43, 95% CI, 1.13 to 1.81; and OR = 1.74, 95% CI, 1.14 to 2.68 for SBP < 100, < 95, and < 90 mmHg, respectively). Conclusions Low SBP showed an association with suicidal ideation in the general Korean population. The association was significant for low BP, defined as a SBP < 100 mmHg, and the strength of the association increased as the criteria for low BP increased in strictness. Electronic supplementary material The online version of this article (10.1186/s12889-018-5106-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kyung-In Joung
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Sung-Il Cho
- Department of Public Health Science, Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, South Korea.
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18
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Do genetics help epidemiologists? Arterial hypertension and cardiovascular events in the light of genetic demiology. Hypertens Res 2018; 41:320-322. [DOI: 10.1038/s41440-018-0022-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 09/06/2017] [Accepted: 09/06/2017] [Indexed: 11/08/2022]
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19
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Briggs R, Kenny RA, Kennelly SP. Does baseline hypotension predict incident depression in a cohort of community-dwelling older people? Data from The Irish Longitudinal Study on Ageing (TILDA). Age Ageing 2017; 46:648-653. [PMID: 28338875 DOI: 10.1093/ageing/afx033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Indexed: 01/16/2023] Open
Abstract
Background hypotension is now recognised as a risk factor for syncope, cardiovascular events and mortality, but it may also represent a risk factor for late life depression (LLD). The aim of this study was to clarify the longitudinal relationship between hypotension and incident LLD. Methods this is a longitudinal study involving community-dwelling participants aged ≥50 years, using data from The Irish Longitudinal Study on Ageing. The Centre for Epidemiological Studies Depression Scale (CES-D) was administered at baseline and at follow-up 2 years later. Blood pressure (BP) was measured at baseline. Participants with a CES-D score ≥16 at baseline and those taking antidepressants were excluded and considered to have a current diagnosis of depression. A score of ≥16 at follow-up was used to define incident depression. Results about 4,525 participants were included and 200 participants had diagnosis of incident LLD. The incident depression group had lower systolic BP at baseline than the non-depressed group (132.8 ± 1.43 mm Hg vs. 136.0 ± 0.30 mm HG, P = 0.025). Logistic regression showed those with systolic BP <130 mm HG had an unadjusted odds ratio of 1.31 (1.01-1.68) for incident depression. This persisted after adjustment for confounding factors. Conclusion systolic BP <130 mm Hg increased the likelihood of incident depression in a cohort of community-dwelling older adults. These findings are important because systolic hypotension may represent a potentially modifiable risk factor for LLD. They are also relevant in the context of BP treatment targets for older people.
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Affiliation(s)
- Robert Briggs
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin 2, Ireland
- Department of Medical Gerontology, Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin 8, Ireland
- Department of Age-Related Health Care, Tallaght Hospital, Dublin 24, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin 2, Ireland
- Department of Medical Gerontology, Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin 8, Ireland
| | - Sean P Kennelly
- Department of Age-Related Health Care, Tallaght Hospital, Dublin 24, Ireland
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Rihmer Z, Gonda X, Döme P. Is Mania the Hypertension of the Mood? Discussion of A Hypothesis. Curr Neuropharmacol 2017; 15:424-433. [PMID: 28503115 PMCID: PMC5405605 DOI: 10.2174/1570159x14666160902145635] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 04/28/2016] [Accepted: 05/24/2016] [Indexed: 01/17/2023] Open
Abstract
Beyond both being biphasic/bidirectional disorders (hypo)mania and essential hypertension share a surprising number of similarities and an overlap between their genetics, biological background, underlying personality and temperamental factors, precipitating factors, comorbidity and response to treatment, indicating a possibly partially shared biological background. Based on theoretical knowledge, similarities related to characteristics, manifestation and course, and the results of pharmacological studies related to the effects and side effects of pharmacotherapies used in the treatment of these two distinct disorders, the authors outline a hypothesis discussing the similar origins of these two phenomena and thus mania being the hypertension of mood in memory of Athanasios Koukopoulos, one of the greatest researchers and theoreticists of mania of all time.
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Affiliation(s)
- Zoltán Rihmer
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Budapest, Hungary, and Laboratory of Suicide Research and Prevention, National Institute for Psychiatry and Addictions, Budapest, Hungary
| | - Xénia Gonda
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Budapest, Hungary, and Laboratory of Suicide Research and Prevention, National Institute for Psychiatry and Addictions, Budapest, Hungary
| | - Péter Döme
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Budapest, Hungary, and Laboratory of Suicide Research and Prevention, National Institute for Psychiatry and Addictions, Budapest, Hungary
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21
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Briggs R, Kenny RA, Kennelly SP. Systematic Review: The Association between Late Life Depression and Hypotension. J Am Med Dir Assoc 2016; 17:1076-1088. [DOI: 10.1016/j.jamda.2016.06.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 06/28/2016] [Indexed: 12/17/2022]
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Jani BD, Cavanagh J, Barry SJE, Der G, Sattar N, Mair FS. Relationship Between Blood Pressure Values, Depressive Symptoms, and Cardiovascular Outcomes in Patients With Cardiometabolic Disease. J Clin Hypertens (Greenwich) 2016; 18:1027-1035. [PMID: 27040355 PMCID: PMC5096031 DOI: 10.1111/jch.12813] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 01/26/2016] [Accepted: 01/27/2016] [Indexed: 01/28/2023]
Abstract
The authors studied the joint effect of blood pressure (BP) and depression on the risk of major adverse cardiovascular outcome in patients with existing cardiometabolic disease. A cohort of 35,537 patients with coronary heart disease, diabetes, or stroke underwent depression screening and BP measurement recorded concurrently. The authors used Cox's proportional hazards to calculate risk of major adverse cardiovascular event (MACE; myocardial infarction/heart failure/stroke or cardiovascular death) over 4 years associated with baseline BP and depression. A total of 11% (3939) had experienced a MACE within 4 years. Patients with very high systolic BP (160-240 mm Hg; hazard ratio, 1.28) and depression (hazard ratio, 1.22) at baseline had significantly higher adjusted risk. Depression had a significant interaction with systolic BP in risk prediction (P=.03). Patients with a combination of high systolic BP and depression at baseline had 83% higher adjusted risk of MACE, as compared with patients with reference systolic BP without depression. Patients with cardiometabolic disease and comorbid depression may benefit from closer monitoring of systolic BP.
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Affiliation(s)
- Bhautesh Dinesh Jani
- General Practice and Primary Care, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Jonathan Cavanagh
- Mental Health and Wellbeing, Sackler Institute, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Sarah J E Barry
- Robertson Centre for Biostatistics, Institute of Health and Well Being, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Geoff Der
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- Metabolic Medicine, BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Frances S Mair
- General Practice and Primary Care, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
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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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Tikhonoff V, Hardy R, Deanfield J, Friberg P, Muniz G, Kuh D, Pariante CM, Hotopf M, Richards M. The relationship between affective symptoms and hypertension-role of the labelling effect: the 1946 British birth cohort. Open Heart 2016; 3:e000341. [PMID: 26835144 PMCID: PMC4716449 DOI: 10.1136/openhrt-2015-000341] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/19/2015] [Accepted: 12/03/2015] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES To investigate the association between repeated measures of affective symptoms collected over 2 decades and hypertension (clinically ascertained or self-report); to test whether, among people with hypertension, affective symptoms are associated with awareness of hypertension, and to evaluate the longitudinal effects of the label of hypertension on affective symptoms. METHODS Multivariable logistic regression, accounting for confounders and mediators, were used to test the aforementioned associations in 1683 participants from a national British cohort. RESULTS Weak evidence of a cumulative impact of affective symptoms across adulthood on self-reported hypertension at age 60-64 years was observed (OR 1.40 (95% CI 1.10 to 1.78) and 1.19 (0.79 to 1.80) for symptoms at 1-2 time points and at 3-4 time points vs no symptoms, respectively). Study members with affective symptoms in recent times were more likely to have self-reported hypertension at age 60-64 years than those without symptoms (OR 1.47 (1.10 to 1.96)). Similar results were observed for awareness of hypertension (OR 2.00 (1.30 to 3.06)). Conversely, no associations were found with clinically ascertained hypertension. The act of labelling someone as hypertensive at age 53 years was associated with affective symptoms at age 60-64 years, independently of antihypertensive treatment and affective symptoms at the time of the diagnosis (OR 2.40 (1.32 to 4.36)). CONCLUSIONS Our findings suggest that elevated risk of hypertension in participants with affective symptoms might be explained by awareness of hypertension and by exposure to medical attention, though not by a direct effect of affective symptoms on blood pressure. Conversely, long-term psychological consequences of the label of hypertension are observed.
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Affiliation(s)
- Valérie Tikhonoff
- MRC Unit for Lifelong Health, Ageing at UCL, London, UK
- Department of Medicine, University of Padova, Padova, Italy
| | - Rebecca Hardy
- MRC Unit for Lifelong Health, Ageing at UCL, London, UK
| | - John Deanfield
- National Centre for Cardiovascular Prevention and Outcomes, Institute of Cardiovascular Science, University College London, London, UK
| | - Peter Friberg
- Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden
| | | | - Diana Kuh
- MRC Unit for Lifelong Health, Ageing at UCL, London, UK
| | - Carmine M Pariante
- Department of Psychological Medicine, King's College London Institute of Psychiatry, London, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, King's College London Institute of Psychiatry, London, UK
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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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