抑郁状态和体重指数对老年人群高血压发病风险的联合影响：一项基于全国人群队列研究的证据。

Joint effects of depressive status and body mass index on the risk of incident hypertension in aging population: evidence from a nationwide population-based cohort study.

机构信息

Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No. 222 South Tianshui Road, Lanzhou, Gansu, P. R. China.

出版信息

BMC Psychiatry. 2023 Aug 19;23(1):608. doi: 10.1186/s12888-023-05105-z.

DOI:10.1186/s12888-023-05105-z

PMID:37598204

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10439533/

Abstract

BACKGROUND

The impact of depressive status (DS) on hypertension incidence is still controversial and has not been studied in Chinese middle-aged and elderly population. This study aimed to explore the relationship between DS and incident hypertension and analyze the joint effects of DS and body mass index (BMI) on hypertension incidence.

METHODS

We conducted a prospective cohort study using data from the China Health and Retirement Longitudinal Study (CHARLS), a nationwide population-based study. In 2013, DS was identified using scores from the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) among eligible respondents from CHARLS, and hypertension occurrence was observed until 2018. The multiple Cox models were employed to calculate the associations between DS and hypertension incidence. In addition, we also computed the multiplicative interaction (MI) between DS and BMI of incident hypertension and assessed their additive interaction (AI) through relative excess risk due to interaction (RERI), attributable proportion (AP) or synthetic index (S). Positive AI was indicated by RERI > 0, AP > 0 or S > 1.

RESULTS

Over the 5-year follow-up, depressive symptoms increased the risk of hypertension incidence by 19% (hazard ratio (HR) = 1.19, 95% confidence interval (CI): (1.01, 1.41)), while depression was associated with a 24% increased risk (HR = 1.24; 95% CI: (1.03, 1.50)). Significant MIs between DS and overweight or obesity were observed and almost all of AI indexes showed positive joint effects on incident hypertension, of which the depression-obesity combination had the largest joint effect (RERI = 4.47, 95%CI: (0.28, 8.66); AP = 0.67, 95%CI: (0.50, 0.85); S = 4.86,95%CI: (2.66, 8.86)).

CONCLUSION

DS could lead to hypertension and this impact was amplified when coexisting with higher BMI. It highlighted a need for precise interventions targeting weight management and depression treatment in the aging population to prevent hypertension.

摘要

背景

抑郁状态（DS）对高血压发病率的影响仍存在争议，在中国中老年人群中尚未进行研究。本研究旨在探讨 DS 与高血压发病的关系，并分析 DS 与体重指数（BMI）联合对高血压发病的影响。

方法

我们使用中国健康与养老追踪调查（CHARLS）的数据进行了一项前瞻性队列研究，CHARLS 是一项全国性的基于人群的研究。2013 年，在 CHARLS 中，使用 10 项流行病学研究中心抑郁量表（CES-D-10）的得分来确定符合条件的受访者的 DS，并观察到 2018 年高血压的发生情况。使用多 Cox 模型计算 DS 与高血压发病之间的关系。此外，我们还计算了 DS 和 BMI 对高血压发病的联合作用的乘法交互作用（MI），并通过交互归因超额风险（RERI）、归因比例（AP）或综合指数（S）评估其相加交互作用（AI）。正的 AI 表示 RERI>0、AP>0 或 S>1。

结果

在 5 年的随访中，抑郁症状使高血压发病风险增加 19%（风险比（HR）=1.19，95%置信区间（CI）：（1.01，1.41）），而抑郁与高血压发病风险增加 24%相关（HR=1.24；95%CI：（1.03，1.50））。观察到 DS 和超重或肥胖之间存在显著的 MI，几乎所有的 AI 指标均显示出对高血压发病的阳性联合作用，其中抑郁与肥胖的联合作用最大（RERI=4.47，95%CI：（0.28，8.66）；AP=0.67，95%CI：（0.50，0.85）；S=4.86，95%CI：（2.66，8.86））。