Depression and hypertension share many common risk factors, such as stress, poverty and ethnicity. Researchers have sought to understand whether these shared factors were responsible for the association between depression and hypertension, or whether life-style factors associated with depression, such as obesity, alcohol abuse and smoking) might lead to hypertension.
This study found none of the above to be true. However, there was an association between depression and self-reported hypertension, which applies to patients who said they had hypertension, even if they did not have high blood pressure as measured during the study, says Marian Reiff, Ph.D., of Columbia University.
Social and lifestyle factors were found to be associated with hypertension, but that association was not affected by the presence or absence of depression. And depression was no more common in people who tested positive for high blood pressure than those who had normal blood pressure.
The reasons for the unexpected results are unclear. The researchers suggest that it could be due to measurement error, since only one blood pressure measurement per subject was available. However, positive tests for hypertension in this study did correspond closely with risk factors for the disease such as obesity and sedentary lifestyles.
Another possibility is that depression may make people more likely to think they have diseases including hypertension, or that the meanings that lay people ascribe to "hypertension" may differ from clinical definitions, Reiff says.
Adjusting for stress reduced the association between depression and self-reported hypertension, but the association remained statistically significant. Depressed respondents still four times more likely to say they had hypertension.
The study data included 408 women and 287 men, the majority of whom were black. The data was taken from a survey of central Harlem households conducted between 1992 and 1994. During the interviews, respondents were asked about hypertension and depression symptoms. Their blood pressure was also measured.
Psychosomatic Medicine is the official bimonthly peer-reviewed journal of the American Psychosomatic Society. For information about the journal, contact Joel E. Dimsdale, MD, at 619-543-5468.
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Psychosomatic Medicine