Association of depression with mortality in an elderly treated hypertensive population

Background:Both elevated blood pressure and/or depression increase the risk of cardiovascular disease and mortality. This study in treated elderly hypertensive patients explored the incidence of depression, its association (pre-existing and incident) with mortality and predictors of incident depress...

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Main Authors: Chowdhury, E., Berk, M., Nelson, M., Wing, L., Reid, Christopher
Format: Journal Article
Published: Cambridge University Press 2018
Online Access:http://hdl.handle.net/20.500.11937/74402
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author Chowdhury, E.
Berk, M.
Nelson, M.
Wing, L.
Reid, Christopher
author_facet Chowdhury, E.
Berk, M.
Nelson, M.
Wing, L.
Reid, Christopher
author_sort Chowdhury, E.
building Curtin Institutional Repository
collection Online Access
description Background:Both elevated blood pressure and/or depression increase the risk of cardiovascular disease and mortality. This study in treated elderly hypertensive patients explored the incidence of depression, its association (pre-existing and incident) with mortality and predictors of incident depression.Methods:Data from 6,083 hypertensive patients aged =65 years enrolled in the Second Australian National Blood Pressure study were used. Participants were followed for a median of 10.8 years (including 4.1 years in-trial) and classified into: "no depression," "pre-existing" and "incident" depression groups based on either being "diagnosed with depressive disorders" and/or "treated with an anti-depressant drug" at baseline or during in-trial period. Further, we redefined "depression" restricted to presence of both conditions for sensitivity analyses. For the current study, end-points were all-cause and any cardiovascular mortality.Results:313 (5%) participants had pre-existing depression and a further 916 (15%) participants developed depression during the trial period (incidence 4% per annum). Increased (hazard-ratio, 95% confidence-interval) all-cause mortality was observed among those with either pre-existing (1.23, 1.01-1.50; p = 0.03) or incident (1.26, 1.12-1.41; p < 0.001) depression compared to those without. For cardiovascular mortality, a 24% increased risk (1.24, 1.05-1.47; p = 0.01) was observed among those with incident depression. The sensitivity analyses, using the restricted depression definition showed similar associations. Incident depression was associated with being female, aged =75 years, being an active smoker at study entry, and developing new diabetes during the study period.Conclusions:This elderly cohort had a high incidence of depression irrespective of their randomised antihypertensive regimen. Both pre-existing and incident depression were associated with increased mortality.
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spelling curtin-20.500.11937-744022019-07-16T03:17:17Z Association of depression with mortality in an elderly treated hypertensive population Chowdhury, E. Berk, M. Nelson, M. Wing, L. Reid, Christopher Background:Both elevated blood pressure and/or depression increase the risk of cardiovascular disease and mortality. This study in treated elderly hypertensive patients explored the incidence of depression, its association (pre-existing and incident) with mortality and predictors of incident depression.Methods:Data from 6,083 hypertensive patients aged =65 years enrolled in the Second Australian National Blood Pressure study were used. Participants were followed for a median of 10.8 years (including 4.1 years in-trial) and classified into: "no depression," "pre-existing" and "incident" depression groups based on either being "diagnosed with depressive disorders" and/or "treated with an anti-depressant drug" at baseline or during in-trial period. Further, we redefined "depression" restricted to presence of both conditions for sensitivity analyses. For the current study, end-points were all-cause and any cardiovascular mortality.Results:313 (5%) participants had pre-existing depression and a further 916 (15%) participants developed depression during the trial period (incidence 4% per annum). Increased (hazard-ratio, 95% confidence-interval) all-cause mortality was observed among those with either pre-existing (1.23, 1.01-1.50; p = 0.03) or incident (1.26, 1.12-1.41; p < 0.001) depression compared to those without. For cardiovascular mortality, a 24% increased risk (1.24, 1.05-1.47; p = 0.01) was observed among those with incident depression. The sensitivity analyses, using the restricted depression definition showed similar associations. Incident depression was associated with being female, aged =75 years, being an active smoker at study entry, and developing new diabetes during the study period.Conclusions:This elderly cohort had a high incidence of depression irrespective of their randomised antihypertensive regimen. Both pre-existing and incident depression were associated with increased mortality. 2018 Journal Article http://hdl.handle.net/20.500.11937/74402 10.1017/S1041610218000856 Cambridge University Press restricted
spellingShingle Chowdhury, E.
Berk, M.
Nelson, M.
Wing, L.
Reid, Christopher
Association of depression with mortality in an elderly treated hypertensive population
title Association of depression with mortality in an elderly treated hypertensive population
title_full Association of depression with mortality in an elderly treated hypertensive population
title_fullStr Association of depression with mortality in an elderly treated hypertensive population
title_full_unstemmed Association of depression with mortality in an elderly treated hypertensive population
title_short Association of depression with mortality in an elderly treated hypertensive population
title_sort association of depression with mortality in an elderly treated hypertensive population
url http://hdl.handle.net/20.500.11937/74402