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Prevalence and Predictors of Co-occurring Hypertension and Depression Among Community-Dwelling Older Adults

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Abstract

The objectives of this study were to estimate the prevalence of co-occurring hypertension and depression among community-dwelling older adults and to examine predictors of co-occurring hypertension among community-dwelling older adults. A secondary analysis was conducted from a statewide survey of community-dwelling older adults in the state of Alabama. Binomial logistic regression was used to examine predictors of co-occurring hypertension and depression. The prevalence of co-occurring hypertension and depression among community-dwelling older adults was 35%. In the multivariate analysis, non-Hispanic African American ethnicity (OR = 1.690, CI 1.221–2.341) and diabetes (OR = 1.668, CI 1.173–2.372) were positively associated with co-occurring hypertension and depression. Income ≥ $20,000 (OR = 0.544, CI 0.400–0.739), ≥ 3 meals on average per day (OR = 0.576, CI 0.429–0.774), and higher self-ratings of general health (OR = 0.728, CI 0.628–0.843) and physical activity (OR = 0.827, CI 0.694–0.986) were negatively associated with co-occurring hypertension and depression. Public health professionals and clinicians who provide care to older adults in public health, community health, and primary care settings are in ideal positions to develop intervention strategies to curb the prevalence and incidence of co-occurring hypertension and depression in this population. If intervention strategies are not implemented in these respective settings, unfortunately community-dwelling older adults of non-Hispanic African American ethnicity, with diabetes, or with low self-ratings of general health and physical activity will likely suffer from cardiovascular disease at much higher rates than their counterparts.

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References

  1. Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358(18):1887–98. https://doi.org/10.1056/NEJMoa0801369.

    Article  CAS  PubMed  Google Scholar 

  2. Benenson I, Waldron FA, Bradshaw MJ. Treating hypertension in older adults: beyond the guidelines. J Am Assoc Nurse Pract. 2019;1. https://doi.org/10.1097/JXX.0000000000000220.

  3. Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 2017;135(10):e146–603. https://doi.org/10.1161/CIR.0000000000000485.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Booth JN, Li J, Zhang L, Chen L, Muntner P, Egan B. Trends in prehypertension and hypertension risk factors in US adults. Hypertension. 2017;70(2):275–84. https://doi.org/10.1161/HYPERTENSIONAHA.116.09004.

    Article  CAS  PubMed  Google Scholar 

  5. Bosworth HB, Bartash RM, Olsen MK, Steffens DC. The association of psychosocial factors and depression with hypertension among older adults. Int J Geriatr Psychiatry. 2003;18(12):1142–8. https://doi.org/10.1002/gps.1026.

    Article  PubMed  Google Scholar 

  6. Carris NW, Smith SM. Quality of life in treatment-resistant hypertension. Curr Hypertens Rep. 2015;17(8):61. https://doi.org/10.1007/s11906-015-0578-5.

    Article  CAS  PubMed  Google Scholar 

  7. Castrejón-Pérez RC, Gutiérrez-Robledo LM, Cesari M, Pérez-Zepeda MU. Diabetes mellitus, hypertension and frailty: a population-based, cross-sectional study of Mexican older adults. Geriatr Gerontol Int. 2016. https://doi.org/10.1111/ggi.12805.

  8. Cheung BMY, Li C. Diabetes and hypertension: is there a common metabolic pathway? Curr Atheroscler Rep. 2012;14(2):160–6. https://doi.org/10.1007/s11883-012-0227-2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Chiaie RD, Iannucci G, Paroli M, Salviati M, Caredda M, Pasquini M, et al. Symptomatic subsyndromal depression in hospitalized hypertensive patients. J Affect Disord. 2011;135(1–3):168–76. https://doi.org/10.1016/j.jad.2011.07.008.

    Article  PubMed  Google Scholar 

  10. Cushman WC, Johnson KC. The 2017 U.S. hypertension guidelines: what is important for older adults? J Am Geriatr Soc. 2018;66(6):1062–7. https://doi.org/10.1111/jgs.15395.

    Article  PubMed  Google Scholar 

  11. Díaz-Gutiérrez J, Ruiz-Estigarribia L, Bes-Rastrollo M, Ruiz-Canela M, Martin-Moreno JM, Martínez-González MA. The role of lifestyle behaviour on the risk of hypertension in the SUN cohort: the hypertension preventive score. Prev Med. 2019;123:171–8. https://doi.org/10.1016/j.ypmed.2019.03.026.

    Article  PubMed  Google Scholar 

  12. Ellulu MS. Obesity, hypertension, and type-2 diabetes mellitus: the interrelationships and the determinants among adults in Gaza City, Palestine. Osong Public Health Res Perspect. 2018;9(6):289–98. https://doi.org/10.24171/j.phrp.2018.9.6.02.

    Article  PubMed  PubMed Central  Google Scholar 

  13. García-Esquinas E, Graciani A, Guallar-Castillón P, López-García E, Rodríguez-Mañas L, Rodríguez-Artalejo F. Diabetes and risk of frailty and its potential mechanisms: a prospective cohort study of older adults. J Am Med Dir Assoc. 2015;16(9):748–54. https://doi.org/10.1016/j.jamda.2015.04.008.

    Article  PubMed  Google Scholar 

  14. Giles T, Aranda JM, Suh D-C, Choi I-S, Preblick R, Rocha R, et al. Ethnic/racial variations in blood pressure awareness, treatment, and control. J Clin Hypertens (Greenwich, Conn.). 2007;9(5):345–54.

    Article  Google Scholar 

  15. Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. JAMA. 2003;290(2):199–206. https://doi.org/10.1001/jama.290.2.199.

    Article  PubMed  Google Scholar 

  16. Huang C-Q, Dong B-R, Lu Z-C, Yue J-R, Liu Q-X. Chronic diseases and risk for depression in old age: a meta-analysis of published literature. Ageing Res Rev. 2010;9(2):131–41. https://doi.org/10.1016/j.arr.2009.05.005.

    Article  PubMed  Google Scholar 

  17. Iyer AS, Ahmed MI, Filippatos GS, Ekundayo OJ, Aban IB, Love TE, et al. Uncontrolled hypertension and increased risk for incident heart failure in older adults with hypertension: findings from a propensity-matched prospective population study. J Am Soc Hypertens. 2010;4(1):22–31. https://doi.org/10.1016/j.jash.2010.02.002.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Jin Y, Luo Y, He P. Hypertension, socioeconomic status and depressive symptoms in Chinese middle-aged and older adults: findings from the China health and retirement longitudinal study. J Affect Disord. 2019;252:237–44. https://doi.org/10.1016/j.jad.2019.04.002.

    Article  PubMed  Google Scholar 

  19. Khot UN, Khot MB, Bajzer CT, Sapp SK, Ohman EM, Brener SJ, et al. Prevalence of conventional risk factors in patients with coronary heart disease. JAMA. 2003;290(7):898–904. https://doi.org/10.1001/jama.290.7.898.

    Article  PubMed  Google Scholar 

  20. Kumar S, Nakulan A, Thoppil S, Parassery R, Kunnukattil S. Screening for depression among community-dwelling elders: usefulness of the center for epidemiologic studies depression scale. Indian J Psychol Med. 2016;38(5):483–5. https://doi.org/10.4103/0253-7176.191380.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Lee S, Lee S, Harada K, Bae S, Makizako H, Doi T, et al. Relationship between chronic kidney disease with diabetes or hypertension and frailty in community-dwelling Japanese older adults. Geriatr Gerontol Int. 2016. https://doi.org/10.1111/ggi.12910.

  22. Li Z, Li Y, Chen L, Chen P, Hu Y. Prevalence of depression in patients with hypertension. Medicine. 2015;94(31):e1317. https://doi.org/10.1097/MD.0000000000001317.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Liu C-Y, Zhang W, Ji L-N, Wang J-G, ATTEND investigators, for the A. Comparison between newly diagnosed hypertension in diabetes and newly diagnosed diabetes in hypertension. Diabetol Metab Syndr. 2019;11:69. https://doi.org/10.1186/s13098-019-0465-3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Logan AG. Hypertension in aging patients. Expert Rev Cardiovasc Ther. 2011;9(1):113–20. https://doi.org/10.1586/erc.10.171.

    Article  CAS  PubMed  Google Scholar 

  25. Ma C. The prevalence of depressive symptoms and associated factors in countryside-dwelling older Chinese patients with hypertension. J Clin Nurs. 2018;27(15–16):2933–41. https://doi.org/10.1111/jocn.14349.

    Article  PubMed  Google Scholar 

  26. Ma L, Tang Z, Sun F, Diao L, Li Y, Wang J, et al. Risk factors for depression among elderly subjects with hypertension living at home in China. Int J Clin Exp Med. 2015;8(2):2923–8.

    PubMed  PubMed Central  Google Scholar 

  27. Maatouk I, Herzog W, Böhlen F, Quinzler R, Löwe B, Saum K-U, et al. Association of hypertension with depression and generalized anxiety symptoms in a large population-based sample of older adults. J Hypertens. 2016;34(9):1711–20. https://doi.org/10.1097/HJH.0000000000001006.

    Article  CAS  PubMed  Google Scholar 

  28. Meeks TW, Vahia IV, Lavretsky H, Kulkarni G, Jeste DV. A tune in “a minor” can “b major”: a review of epidemiology, illness course, and public health implications of subthreshold depression in older adults. J Affect Disord. 2011;129(1–3):126–42. https://doi.org/10.1016/J.JAD.2010.09.015.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Moghani Lankarani M, Assari S. Diabetes, hypertension, obesity, and long-term risk of renal disease mortality: racial and socioeconomic differences. J Diabetes Investig. 2017;8(4):590–9. https://doi.org/10.1111/jdi.12618.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Muntner P, Abdalla M, Correa A, Griswold M, Hall JE, Jones DW, et al. Hypertension in Blacks: unanswered questions and future directions for the JHS (Jackson Heart Study). Hypertension (Dallas, Tex. : 1979). 2017;69(5):761–9. https://doi.org/10.1161/HYPERTENSIONAHA.117.09061.

    Article  CAS  Google Scholar 

  31. Nakulan A, Sumesh TP, Kumar S, Rejani PP, Shaji KS. Prevalence and risk factors for depression among community resident older people in Kerala. Indian J Psychiatry. 2015;57(3):262–6. https://doi.org/10.4103/0019-5545.166640.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Nguyen B, Bauman A, Ding D. Association between lifestyle risk factors and incident hypertension among middle-aged and older Australians. Prev Med. 2019;118:73–80. https://doi.org/10.1016/j.ypmed.2018.10.007.

    Article  PubMed  Google Scholar 

  33. Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011-2012. NCHS Data Brief. 2013;133:1–8.

    Google Scholar 

  34. Oh J-Y, Allison MA, Barrett-Connor E. Different impacts of hypertension and diabetes mellitus on all-cause and cardiovascular mortality in community-dwelling older adults: the Rancho Bernardo Study. J Hypertens. 2017;35(1):55–62. https://doi.org/10.1097/HJH.0000000000001145.

    Article  CAS  PubMed  Google Scholar 

  35. Oh H, Noh H, Sims OT, Guo Y, Sawyer P. A comparison of urban and non-urban African American older adults on health-related characteristics. Soc Work Health Care. 2018;57(9):762–73. https://doi.org/10.1080/00981389.2018.1497748.

    Article  PubMed  Google Scholar 

  36. Pimenta E, Oparil S. Management of hypertension in the elderly. Nat Rev Cardiol. 2012;9(5):286–96. https://doi.org/10.1038/nrcardio.2012.27.

    Article  CAS  PubMed  Google Scholar 

  37. Sacks FM, Campos H. Dietary therapy in hypertension. N Engl J Med. 2010;362(22):2102–12. https://doi.org/10.1056/NEJMct0911013.

    Article  CAS  PubMed  Google Scholar 

  38. Sims OT, Oh H, Noh H, Melton PA, Sheffield S, Ingram K, et al. Prevalence and predictors of co-occurring diabetes and hypertension in community-dwelling older adults. Geriatr Gerontol Int. 2018;18(9):1356–60. https://doi.org/10.1111/ggi.13489.

    Article  PubMed  Google Scholar 

  39. Tanner EK, Martinez IL, Harris M. Examining functional and social determinants of depression in community-dwelling older adults: implications for practice. Geriatr Nurs. 2014;35(3):236–40. https://doi.org/10.1016/j.gerinurse.2014.04.006.

    Article  PubMed  Google Scholar 

  40. Umpierre D, Santos LP, Botton CE, Wilhelm EN, Helal L, Schaun GZ, et al. The “Hypertension Approaches in the Elderly: a Lifestyle” multicenter, randomized trial (HAEL Study): rationale and methodological protocol. BMC Public Health. 2019;19(1):657. https://doi.org/10.1186/s12889-019-6970-3.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Vieira ER, Brown E, Raue P. Depression in older adults: screening and referral. J Geriatr Phys Ther (2001). 2014;37(1):24–30. https://doi.org/10.1519/JPT.0b013e31828df26f.

    Article  Google Scholar 

  42. Weiss J, Freeman M, Low A, Fu R, Kerfoot A, Paynter R, et al. Benefits and harms of intensive blood pressure treatment in adults aged 60 years or older. Ann Intern Med. 2017;166(6):419–29. https://doi.org/10.7326/M16-1754.

    Article  PubMed  Google Scholar 

  43. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17(1):37–49.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Community Health and Human Services, School of Education, University of Alabama at Birmingham, 901 13th Street South, Birmingham, AL, 35294-1250, USA

    Cicily A. Gray

  2. Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA

    Omar T. Sims

  3. Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA

    Omar T. Sims

  4. Comprehensive Center for Healthy Aging, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Omar T. Sims

  5. Center for AIDS Research, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Omar T. Sims

  6. Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, USA

    Omar T. Sims

  7. Department of Social Work, School of Social Sciences & Education, California State University, Dorothy Donahoe Hall A109, Bakersfield, CA, 93311, USA

    Hyejung Oh

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  1. Cicily A. Gray
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Correspondence to Cicily A. Gray.

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Dr. Sims has received research support from the National Institute on Drug Abuse. Authors Gray and Oh declare that they have no conflicts of interest.

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Analysis of this study—a retrospective analysis of secondary data—was approved by the institutional review board at University of Alabama at Birmingham.

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Gray, C.A., Sims, O.T. & Oh, H. Prevalence and Predictors of Co-occurring Hypertension and Depression Among Community-Dwelling Older Adults. J. Racial and Ethnic Health Disparities 7, 365–373 (2020). https://doi.org/10.1007/s40615-019-00665-x

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