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Tassew WC, Nigate GK, Assefa GW, Zeleke AM, Ferede YA. Systematic review and meta-analysis on the prevalence and associated factors of depression among hypertensive patients in Ethiopia. PLoS One 2024; 19:e0304043. [PMID: 38917087 PMCID: PMC11198805 DOI: 10.1371/journal.pone.0304043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 05/04/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Identifying individuals at increased risk for depression allows for earlier intervention and treatment, ultimately leading to better outcomes and potentially preventing severe symptoms. However, to date, no systematic reviews or meta-analyses have estimated the prevalence of depression among hypertensive patients. Thus, this review was initiated to determine the prevalence and factors associated with depression among patients with hypertension in Ethiopia. METHODS Multiple databases, such as PubMed, African Journals Online, the Cochrane Library, and Google Scholar, were used to ensure wider coverage of relevant studies. The data extracted from Microsoft Excel were imported into STATA version 11 (Stata Corp LLC, TX, USA) for further analysis. The pooled prevalence of depression was estimated using a random effects model. To evaluate statistical heterogeneity, the Cochrane Q test and I2 statistic were used. RESULTS The random effect model indicated that the pooled prevalence of depression in 12 studies conducted in Ethiopia was 32.43% (95% CI: 25.18, 39.67%). Being female (POR = 2.41; 95% CI: 1.89, 3.07, I2 = 17.7%, P = 0.302), having comorbid illnesses (POR = 3.80; 95% CI: 2.09, 6.90, I2 = 81%, P = 0.005), having poor blood pressure control (POR = 3.58; 95% CI: 2.51, 5.12, I2 = 0.0%, P = 0.716), having a family history of depression (POR = 3.43; 95% CI: 1.98, 5.96, I2 = 62.6%, P = 0.069), being single (POR = 2.30; 95% CI: 1.35, 3.99, I2 = 48.0%, P = 0.146) and having poor social support (POR = 4.24; 95% CI: 1.29, 13.98, I2 = 95.8%, P<0.001) were positively associated with depression among hypertensive patients. CONCLUSION Overall, the results of our review showed that depression affects a significant number of Ethiopians who have hypertension. Being female, being single, having comorbidities, having poor blood pressure control, having a family history of depression, and having poor social support were factors associated with depression among patients with hypertension. For those who are depressed, improving the psycho-behavioral treatment linkage with the psychiatric unit can result in improved clinical outcomes. TRIAL REGISTRATION Prospero Registration number: CRD42024498447. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024498447.
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Affiliation(s)
- Worku Chekol Tassew
- Department of Medical Nursing, Teda Health Science College, Gondar, Ethiopia
| | | | - Getaw Wubie Assefa
- Department of CTID &HIV Medicine, Teda Health Science College, Gondar, Ethiopia
| | | | - Yeshiwas Ayal Ferede
- Department of Reproductive Health, Teda Health Science College, Gondar, Ethiopia
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Madavanakadu Devassy S, Baby John S, Scaria L. Cognitive factors associated with hypertension and diabetes control among diagnosed and treated patients; findings from a community cohort in India. Prev Med Rep 2023; 36:102495. [PMID: 38116262 PMCID: PMC10728465 DOI: 10.1016/j.pmedr.2023.102495] [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] [Received: 07/07/2023] [Revised: 11/04/2023] [Accepted: 11/05/2023] [Indexed: 12/21/2023] Open
Abstract
Uncontrolled hypertension and diabetes are a challenge for healthcare providers worldwide. The research documenting the underlying risk factors of uncontrolled chronic illnesses in community cohorts from India is negligible. The current cross-sectional household door-knock survey conducted among 759 participants aged 30 and above from a geographically well-defined area examines the cognitive risk factors associated with hypertension and diabetes control in the Indian population. The study used an assessment tool consisting of a socio-demographic questionnaire, items to measure cognitive factors, and onsite hypertension and diabetes measurements. Results suggested that among the participants, more than 36% had hypertension, 26% had diabetes, and of those with diagnosed diabetes and hypertension, more than 22% with hypertension and 48% with diabetes had uncontrolled conditions. Univariate analysis suggests that cognitive functioning was negatively associated with uncontrolled hypertension and psychological impairments of depression and anxiety were positively associated. The associations were not significant for uncontrolled diabetes. Only if treatments integrate psychological and cognitive interventions to ensure adherence to medical and lifestyle modifications will it achieve the WHO target of 80% control of detected conditions. The findings can inform the policies and programs to optimise government spending and modify the current chronic condition management practices.
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Affiliation(s)
- Saju Madavanakadu Devassy
- Department of Social Work, Rajagiri College of Social Sciences, Kalamassery, Cochin, Kerala, India
- International Centre for Consortium Research in Social Care, Kalamassery, Cochin, Kerala, India
- University of Edinburgh, Scotland
| | | | - Lorane Scaria
- Department of Social Work, Rajagiri College of Social Sciences, Kalamassery, Cochin, Kerala, India
- International Centre for Consortium Research in Social Care, Kalamassery, Cochin, Kerala, India
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Odame EA, Atandoh PH, Mamudu L, Adzrago D, Tagoe I, Sulley S, Boms M, Tetteh-Bator E, McNeel TS, Williams F. Associations of depression with hypertension and citizenship among U.S. adults: A cross-sectional study of the interactions of hypertension and citizenship. Prev Med Rep 2023; 36:102523. [PMID: 38116249 PMCID: PMC10728450 DOI: 10.1016/j.pmedr.2023.102523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023] Open
Abstract
With the increasing prevalence of hypertension-related cardiovascular deaths and depression, this study examined the associations of depression with hypertension, citizenship status, and interaction of hypertension and citizenship status among U.S. adults. Data from the 2015-2018 National Health Interview Survey (NHIS), including 63,985 individuals, were analyzed. Depression status was the outcome, with hypertension and U.S. citizenship status as the main independent variables. Using odds ratio (OR) estimates, we evaluated the associations between hypertension and depression, and citizenship status. The result indicates that a higher proportion of U.S. adults with hypertension reported depression compared to those who did not have hypertension (42.9 % vs. 37.5 %). In terms of U.S. citizenship status, a higher proportion of U.S. citizens reported depression than non-citizens (39.6 % vs. 31.6 %). However, non-citizens with hypertension were more likely to report depression compared to U.S. citizens without hypertension (OR = 1.46; 95 % CI = 1.15, 1.86). While hypertension marginally increased the odds of depression among the general U.S. population, being a non-U.S. citizen with hypertension significantly increased the risk of depression by 46 %. The findings imply that the healthy immigrant paradox, in the context of hypertension-depression prevention and control, may not apply to non-citizens with hypertension. We therefore recommend community-based screenings and more tailored interventions to address these health disparities while taking into consideration the unique cultural norms, behaviors and healthcare barriers encountered by specific immigrant communities.
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Affiliation(s)
- Emmanuel A. Odame
- Department of Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Paul H. Atandoh
- Department of Mathematics, Mercer University, Macon, GA, USA
| | - Lohuwa Mamudu
- Department of Public Health, California State University, Fullerton, CA, USA
| | - David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Ishmael Tagoe
- Division of Health Services, College of Nursing and Advanced Health Professions, The Chicago School of Professional Psychology, IL, USA
| | - Saanie Sulley
- National Healthy Start Association, Washington, DC, USA
| | - Maureen Boms
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Erasmus Tetteh-Bator
- Department of Mathematics and Statistics, College of Arts and Sciences, University of South Florida, Tampa, FL, USA
| | | | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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Chen TY, Kao CW, Cheng SM, Liu CY. Factors influencing self-care among patients with primary hypertension: path analysis of mediating roles of self-efficacy and depressive symptoms. Eur J Cardiovasc Nurs 2023; 22:620-627. [PMID: 36637099 DOI: 10.1093/eurjcn/zvad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/14/2023]
Abstract
AIMS Blood pressure control requires medication adherence and lifestyle modifications. Social cognitive theory suggests social support, psychological adaptation, and self-efficacy can reinforce lifestyle modifications. This study investigated if self-efficacy was a mediator between self-rated health status (SRHS), social support, depressive symptoms, anxiety, and self-care among patients with hypertension. METHOD AND RESULTS This cross-sectional study recruited patients with primary hypertension by convenience sampling (N = 318) from an outpatient cardiology clinic. Data included participant characteristics and self-report scales for social support, SRHS, anxiety, depressive symptoms, Self-efficacy and self-care diet quality and weight management. We used path analysis to test the hypothesized model. The mean age of participants was 63.91 ± 11.80 years. Mean scale scores for social support and depressive symptoms were 54.23 ± 13.26 and 6.14 ± 3.14, respectively; SRHS was 66.91 ± 13.80, self-efficacy was 34.31 ± 11.62, self-care for diet quality and weight management were 36.50 ± 13.19 and 27.38 ± 8.64, respectively. Bootstrapping demonstrated self-efficacy was the mediator between social support and self-care for diet quality and weight management; depressive symptoms mediated the relationship between social support and self-efficacy. In addition, the variable of depressive symptoms was also a mediator between SRHS and self-efficacy. The final model showed SRHS, social support, depressive symptoms, and self-efficacy explained 28% of self-care. CONCLUSION Our findings suggest developing theory-based interventions for patients with hypertension that provide education and/or psychological support for increasing patients' self-efficacy and reducing depressive symptoms simultaneously to facilitate their long-term self-care behaviours.
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Affiliation(s)
- Ting-Yu Chen
- Department of Nursing, Chang Gung University of Science and Technology, Rm. A611, No. 2, Sec. W., Jiapu Rd., Puzi City, Chiayi County 613016, Taiwan
| | - Chi-Wen Kao
- National Defense Medical Center, School of Nursing, No.161, Sec. 6, Minquan E. Rd, Neihu Dist., Taipei 11490, Taiwan
| | - Shu-Meng Cheng
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec.2, Chenggong Rd., Neihu District, Taipei City 114202, Taiwan
| | - Chieh-Yu Liu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, No. 365, Ming-te Road, Peitou District, Taipei City 112303, Taiwan
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Zhang Y, Chen J, Tang R, Deng J, Guo H, Wu X, Xu Q. Combined influence of depression and low-grade inflammation on mortality in peritoneal dialysis patients. BMC Nephrol 2023; 24:241. [PMID: 37587401 PMCID: PMC10433560 DOI: 10.1186/s12882-023-03291-2] [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: 05/22/2023] [Accepted: 08/06/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND The relationship between depression and systemic inflammation as risk factors for mortality is not well understood and requires further investigation. METHODS Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) between July 01, 2015 to December 31, 2019, were analyzed and followed up until December 31, 2020. According to their status of depression (PHQ-9 score ≥ 5) and low-grade inflammation (hs-CRP level ≥ 3 mg/L), patients were divided into four groups (G1, without depression, nor inflammation; G2, with depression, without inflammation; G3, with inflammation, without depression; G4, with both depression and inflammation). We performed Kaplan-Meier and multivariable Cox proportional analyses of mortality for the combined influence of depression and systemic inflammation in this cohort. RESULTS During the mean follow-up of 36.3 ± 14.8 months, 73 deaths were recorded in 358 participants. Compared with patients in group G1, patients in group G2 and G3 carried 137% {hazard ratio (HR): 2.37, 95% confidence interval (CI): 1.06-5.23, p = 0.035} and 140% (HR: 2.40, 95% CI: 1.01-5.69, p = 0.048) higher risk of mortality. Patients in group G4 (with both depression and inflammation) showed the highest risks of all-cause mortality with 276% higher mortality risk (HR: 3.76, 95% CI: 1.73-8.15, p = 0.001), respectively. CONCLUSION The combined of depression and inflammation is associated with all-cause mortality in peritoneal dialysis patients, suggesting a need for further study of depression and low-grade inflammation in PD patients and potential relationship between them.
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Affiliation(s)
- Yanxia Zhang
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Jiexin Chen
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Ruiying Tang
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Jihong Deng
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Huankai Guo
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Xianfeng Wu
- Department of Nephrology, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Qingdong Xu
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China.
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García-Lara RA, Suleiman-Martos N, Membrive-Jiménez MJ, García-Morales V, Quesada-Caballero M, Guisado-Requena IM, Gómez-Urquiza JL. Prevalence of Depression and Related Factors among Patients with Chronic Disease during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:diagnostics12123094. [PMID: 36553100 PMCID: PMC9777242 DOI: 10.3390/diagnostics12123094] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/04/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
The management of chronic diseases in the midst of the COVID-19 pandemic is especially challenging, and reducing potential psychological harm is essential. This review aims to determine the prevalence of depression during the COVID-19 pandemic in patients with chronic disease, and to characterize the impacts of related factors. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The meta-analysis was performed using StatsDirect software. The review identified 33 articles with a total of 50,905 patients with chronic diseases. Four meta-analyses were performed to estimate the prevalence of depression. In diabetic patients, the prevalence ranged from 17% (95% CI = 7-31) (PHQ-9) to 33% (95% CI = 16-51) (PHQ-8); in obese patients, the prevalence was 48% (95% CI = 26-71); and in hypertensive patients, the prevalence was 18% (95% CI = 13-24). The factors significantly associated with depression were female sex, being single, deterioration in the clinical parameters of diabetes, a decrease in self-care behavior, reduced physical activity and sleep time and fear of contagion. The COVID-19 pandemic has significantly increased levels of depression among persons with chronic disease. Pandemics and other emergency events have a major impact on mental health, so early psychological interventions and health management policies are needed to reinforce chronic patients' physical and mental health.
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Affiliation(s)
- Rubén A. García-Lara
- UGC Orgiva, Granada-South Health Management Area, Andalusian Health Service, Calle La Madre s/n, Lanjarón, 18420 Granada, Spain
| | - Nora Suleiman-Martos
- Nursing Department, Faculty of Health Sciences, University of Granada, Av. de la Ilustración, 60, 18016 Granada, Spain
- Correspondence:
| | | | - Victoria García-Morales
- Department of Biomedicine, Biotechnology and Public Health, Faculty of Medicine, University of Cadiz, Pl. Falla, 9, 11003 Cadiz, Spain
| | - Miguel Quesada-Caballero
- UGC La Caleta Granada-Metropolitano, Andalusian Health Service, Av. del Sur, 11, 18014 Granada, Spain
| | - Isabel M. Guisado-Requena
- Nursing Department, Faculty of Health Sciences, University of Castilla la Mancha, 02006 Albacete, Spain
| | - José L. Gómez-Urquiza
- Nursing Department, Faculty of Health Sciences, University of Granada, Cortadura del Valle s/n, 51001 Ceuta, Spain
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Yousuf FS, Arif A, Bibi R, Almas A. Association of Depression and Anxiety With Hypertensive Crisis: A Cross-Sectional Study From a Hospital Setting in Karachi, Pakistan. Cureus 2022; 14:e29792. [PMID: 36340519 PMCID: PMC9618291 DOI: 10.7759/cureus.29792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Hypertension, a leading risk factor for cardiovascular death, has been closely linked with depression and anxiety. The aim of this study was to examine the association of depression or anxiety with hypertensive crisis in patients and also see if the association is affected by age group or gender. This was carried out in a hospital setting. Methods This cross-sectional study was conducted between July 2019 and March 2022 on 290 patients admitted to the Aga Khan University Hospital (AKUH), Karachi, Pakistan. All adult patients more than 18 years of age admitted with uncontrolled hypertension with a systolic blood pressure of >140 and a diastolic blood pressure of >90 admitted through emergency were included. A hypertensive crisis was defined as a systolic blood pressure greater than 180 mm Hg or a diastolic blood pressure greater than or equal to 120 mm Hg, with or without accompanying end organ damage. Symptoms of depression and anxiety were evaluated using the Hospital Anxiety and Depression Scale (HADS), with a cut-off score ≥8. Results Of the patients identified with uncontrolled hypertension, a total of 140 (48.3%) of the patients presented with a hypertensive crisis, while 150 (51.3%) did not have a hypertensive crisis at presentation. In the hypertensive crisis group, 60 (49.3%) had HADS scores consistent with depression, while 83 (59.3%) had HADS scores consistent with anxiety. In patients with hypertensive crisis, HADS depression and anxiety were most prevalent in the 61-75 age group (39.7%). In the comparison of gender, it was found that males and females with hypertensive crisis had an almost equal prevalence of anxiety (49.4% in males versus 50.6% in females). A slightly higher prevalence of depression was seen in females with hypertensive crises when compared to males. Conclusion We found no association between depression or anxiety with hypertensive crisis, and the association is not affected by age group or gender. However, do note that half of the patients with hypertensive crises had depression or anxiety. Future large multicentered studies are required to study the link in greater detail.
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Abdisa L, Girma S, Lami M, Hiko A, Yadeta E, Geneti Y, Balcha T, Assefa N, Letta S. Uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at public hospitals, Eastern Ethiopia: A multicenter study. SAGE Open Med 2022; 10:20503121221104442. [PMID: 35769491 PMCID: PMC9234929 DOI: 10.1177/20503121221104442] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 05/11/2022] [Indexed: 12/03/2022] Open
Abstract
Objective: The aim of this study was to assess the magnitude of uncontrolled
hypertension and associated factors among adult hypertensive patients on
follow-up at public hospitals in Eastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted among 415 hypertensive
patients in Eastern Ethiopia from June 15 to July 15, 2021. A systematic
random sampling technique was used to select the study participants. Data
were collected through face-to-face interviews and reviewing patients’
charts. Bivariable and multivariable logistic regression analyses were
performed to identify factors associated with uncontrolled hypertension. Results: This study revealed that magnitude of uncontrolled hypertension was 48% (95%
confidence interval = 43.1%−52.8%). Being male (adjusted odds ratio = 2.05,
95% confidence interval = 1.29–3.26), age ⩾55 years (adjusted odds
ratio = 3.16, 95% confidence interval = 1.96–5.08), non-adherence to
medication (adjusted odds ratio = 1.83, 95% confidence
interval = 1.14–2.94), low diet quality (adjusted odds ratio = 4.04, 95%
confidence interval = 2.44–8.44), physically inactive (adjusted odds
ratio = 3.20, 95% confidence interval = 1.84–5.56), and having comorbidity
(adjusted odds ratio = 3.04, 95% confidence interval = 1.90–4.85) were
significantly associated with uncontrolled hypertension. Conclusions: In our sample of hypertensive patients on follow-up at public hospitals in
Eastern Ethiopia, half had uncontrolled hypertension. Older age, male sex,
non-adherence to antihypertensive medication, low diet quality, physically
inactive, and having comorbidity were found to be predictors of uncontrolled
hypertension. Therefore, sustained health education on self-care practices
with special emphasis on older, males, and patients with comorbid
conditions.
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Affiliation(s)
- Lemesa Abdisa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
| | - Sagni Girma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
| | - Magarsa Lami
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
| | - Ahmed Hiko
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
| | - Elias Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
| | - Yomilan Geneti
- Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Tegenu Balcha
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
| | - Nega Assefa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
| | - Shiferaw Letta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
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Breeden M, Gillis A, Salas J, Scherrer JF. Antidepressant treatment and blood pressure control in patients with comorbid depression and treatment resistant hypertension. J Psychosom Res 2022; 153:110692. [PMID: 34906849 DOI: 10.1016/j.jpsychores.2021.110692] [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: 07/27/2021] [Revised: 11/12/2021] [Accepted: 12/03/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Though inconsistent, the majority of studies support an association between depression and incident hypertension and poor blood pressure control. However, none have investigated whether antidepressant medication (ADM) therapy is associated with blood pressure control in patients with comorbid depression and treatment resistant hypertension. METHODS Optum® de-identified Electronic Health Record data (2010-2018) were used to create a retrospective cohort of patients (≥18 years of age) with comorbid depression and treatment resistant hypertension. Patients were categorized into adequate ADM, inadequate ADM and no ADM treatment. A modified Poisson regression approach with robust error variance was used to estimate the association between ADM status and blood pressure control before and after adjusting for covariates. RESULTS Patients were, on average, 55.7 (SD ± 9.9) years of age, 63.9% were female, 76.2% were white and 19.2% Black race. In crude models, inadequate ADM (RR = 1.06; 95%CI:1.01-1.11) and adequate ADM (RR = 1.08; 95%CI:1.03-1.14), compared to no ADM treatment, were associated with blood pressure control. After adjusting for covariates this relationship was attenuated and no longer significant. CONCLUSIONS The modest association between ADM therapy and blood pressure control in patients with treatment resistant hypertension is largely explained by traditional risk factors for hypertension such as obesity and older age. Treating depression is not a robust factor in blood pressure control among those with treatment resistant hypertension.
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Affiliation(s)
- Matthew Breeden
- Department of Family and Community Medicine, Saint Louis University School of Medicine, 1008 S. Spring, St. Louis, MO 63110, USA.
| | - Auston Gillis
- Department of Family and Community Medicine, Saint Louis University School of Medicine, 1008 S. Spring, St. Louis, MO 63110, USA
| | - Joanne Salas
- Department of Family and Community Medicine, Saint Louis University School of Medicine, 1008 S. Spring, St. Louis, MO 63110, USA; Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, 1008 S. Spring, St. Louis, MO 63110, USA
| | - Jeffrey F Scherrer
- Department of Family and Community Medicine, Saint Louis University School of Medicine, 1008 S. Spring, St. Louis, MO 63110, USA; Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, 1008 S. Spring, St. Louis, MO 63110, USA
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