Tohoku University Graduate School of Medicine, Sendai, Japan.
Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
Hypertens Res. 2024 Nov;47(11):2989-3000. doi: 10.1038/s41440-024-01790-9. Epub 2024 Jul 10.
Depression is comorbid with somatic diseases; however, the relationship between depressive symptoms and hypertension (HT), a risk factor for cardiovascular events, remains unclear. Home blood pressure (BP) is more reproducible and accurately predictive of cardiovascular diseases than office BP. Therefore, we focused on home BP and investigated whether depressive symptoms contributed to the future onset of home HT. This prospective cohort study used data from the Tohoku Medical Megabank Community-Cohort Study (conducted in the Miyagi Prefecture, Japan) and included participants with home normotension (systolic blood pressure (SBP) < 135 mmHg and diastolic blood pressure (DBP) < 85 mmHg). Depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression Scale-Japanese version at the baseline survey. In the secondary survey, approximately 4 years later, the onset of home HT was evaluated (SBP ≥ 135 mmHg or DBP ≥ 85 mmHg) and was compared in participants with and without depressive symptoms. Of the 3 082 (mean age: 54.2 years; females: 80.9%) participants, 729 (23.7%) had depressive symptoms at the baseline survey. During the 3.5-year follow-up, 124 (17.0%) and 388 (16.5%) participants with and without depressive symptoms, respectively, developed home HT. Multivariable adjusted odds ratios were 1.37 (95% confidence interval (CI): 1.02-1.84), 1.18 (95% CI: 0.86-1.61), and 1.66 (95% CI: 1.17-2.36) for home, morning, and evening HT, respectively. This relationship was consistent in the subgroup analyses according to age, sex, BP pattern, and drinking habit. Depressive symptoms increased the risk of new-onset home HT, particularly evening HT, among individuals with home normotension. This prospective cohort study revealed that depressive symptoms are risk factors for new-onset home hypertension, particularly evening hypertension among individuals with home normotension. Assessing home blood pressure in individuals with depressive symptoms is important for the prevention of hypertension and concomitant cardiovascular diseases.
抑郁症与躯体疾病共病；然而，抑郁症状与高血压（HT）的关系，心血管事件的一个危险因素，仍然不清楚。家庭血压（BP）比诊室 BP 更具可重复性和更准确地预测心血管疾病。因此，我们专注于家庭 BP，并研究抑郁症状是否导致未来家庭 HT 的发生。这项前瞻性队列研究使用了东北医疗 Megabank 社区队列研究（在日本宫城县进行）的数据，纳入了家庭正常血压（收缩压（SBP）<135mmHg 和舒张压（DBP）<85mmHg）的参与者。抑郁症状在基线调查时使用流行病学研究中心抑郁量表-日本版进行评估。在二次调查中，大约 4 年后，评估了家庭 HT 的发病情况（SBP≥135mmHg 或 DBP≥85mmHg），并比较了有和无抑郁症状的参与者。在 3082 名（平均年龄：54.2 岁；女性：80.9%）参与者中，729 名（23.7%）在基线调查时存在抑郁症状。在 3.5 年的随访期间，分别有 124 名（17.0%）和 388 名（16.5%）有和无抑郁症状的参与者发展为家庭 HT。多变量调整后的比值比分别为 1.37（95%可信区间（CI）：1.02-1.84）、1.18（95% CI：0.86-1.61）和 1.66（95% CI：1.17-2.36），适用于家庭、早晨和晚上 HT。根据年龄、性别、BP 模式和饮酒习惯的亚组分析，这种关系是一致的。抑郁症状增加了家庭正常血压者新发家庭 HT 的风险，尤其是晚上 HT 的风险。这项前瞻性队列研究表明，抑郁症状是家庭正常血压者新发家庭高血压的危险因素，尤其是晚上高血压的危险因素。评估有抑郁症状的个体的家庭血压对于高血压和伴随的心血管疾病的预防很重要。
