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Depression, BP extremes may predict CV events
LONDON — The combination of depressive symptoms and very high or low BP levels may signal increased risk for CV events among patients with existing heart disease, diabetes or stroke.
Researchers studied the relationship between depression and BP levels on the influence of CV-related mortality, HF, MI and stroke using data from 35,537 patients with existing heart disease, diabetes or stroke.
The community-based study, conducted in Scotland, stratified patients by BP levels: very high (≥ 160 mm Hg systolic, ≥ 100 mm Hg diastolic), high (140-159 mm Hg systolic, 90-99 mm Hg diastolic), normal (130-139 mm Hg systolic, 80-90 mm Hg diastolic), tightly controlled (120-129 mm Hg systolic, 80-84 mm Hg diastolic) or low (< 120 mm Hg systolic, < 80 mm Hg diastolic). The researchers used the hospital anxiety and depression score (HADS-D) to assess depressive symptoms.
During 4 years, 3,939 patients (11%) experienced at least one CV event.
The researchers identified a significant interaction between depressive symptoms and systolic BP in the prediction of a major CV event (P = .03). At 4 years, the risk for CV events and mortality was 83% higher among patients with depressive symptoms and very high systolic BP (HR = 1.83; 95% CI, 1.46-2.3; P < .001) and 36% higher among patients with depressive symptoms and low systolic BP (HR = 1.36; 95% CI, 1.15-1.62; P < .001), compared with those with no depression and normal BP, Bhautesh Jani, MBBS, MRCS, MRCGP, DFSRH, clinical academic fellow at the Institute of Health and Wellbeing, University of Glasgow, Scotland, reported at the European Society of Cardiology Congress.
Bhautesh Jani
The results were adjusted for risk factors including age, sex, BMI, cholesterol, antidepressant use, existing medical conditions and socioeconomic status.
He noted that the data were collected from routine clinical practice and cautioned that this is not a research study. “This is not a randomized controlled trial, so we don’t know if screening for depression in patients with extremes in blood pressure will be of any benefit. We need to do more [research] on the relationship between depression and BP, especially in patients with existing heart disease,” Jani said.
He concluded that “those who have extremes of blood pressure or have depressive symptoms are at higher risk. But until now the combined effect of having both together [was] unknown.” – by Katie Kalvaitis
Reference:
Jani B, et al. Abstract P1374. Presented at: European Society of Cardiology Congress; Aug. 29-Sept. 2, 2015; London.
Disclosure: Jani reports no relevant financial disclosures.