Zhang Wenya, Liang Jie, Li Chenglong, Pan Yang, Gao Darui, Wang Yongqian, Xie Wuxiang, Zheng Fanfan
School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
National Institute of Health Data Science at Peking University, Beijing, China.
J Gerontol A Biol Sci Med Sci. 2025 May 5;80(6). doi: 10.1093/gerona/glaf080.
The association of cumulative blood pressure (BP) with progression rate of depressive symptoms and functional impairment remained largely unknown, and this study aims to explore whether higher cumulative BP is associated with a faster rate of aggravation of depressive symptoms and functional impairment.
This longitudinal cohort study adopted data from the English Longitudinal Study of Ageing (ELSA) and the Health and Retirement Study (HRS). Cumulative BP was calculated as area under the curve using BP measurements from 3 visits (wave 0, 2, and 4) in ELSA and 2 visits (wave 8 and 10) in HRS. Depressive symptoms were evaluated in a biennial frequency via Center for Epidemiological Studies Depression (CES-D) scale, while functional status was measured every 2 years using adapted versions of Katz Activities of Daily Living (ADL) scale and Lawton Instrumental Activities of Daily Living (IADL) scale.
A total of 3 500 and 6 036 participants from ELSA and HRS were included. Elevated cumulative pulse pressure was significantly associated with accelerated aggravation of depressive symptoms (p < .001 for both). Elevated cumulative systolic BP and pulse pressure were significantly associated with accelerated decline of ADL function (p < .001 for both) and IADL function (p < .001 for both). However, elevated cumulative diastolic BP was associated with decelerated decline of IADL function (p = .031 in ELSA and p < .001 in HRS).
Elevated cumulative BP was associated with accelerated aggravation of depressive symptoms and functional impairment, suggesting that controlling systolic BP and pulse pressure while maintaining adequate diastolic BP is of paramount importance for adults to achieve health longevity.
累积血压（BP）与抑郁症状进展率及功能损害之间的关联在很大程度上仍不清楚，本研究旨在探讨较高的累积血压是否与抑郁症状和功能损害的更快加重率相关。
这项纵向队列研究采用了英国老龄化纵向研究（ELSA）和健康与退休研究（HRS）的数据。累积血压通过曲线下面积计算，使用ELSA中3次访视（第0、2和4波）以及HRS中2次访视（第8和10波）的血压测量值。抑郁症状通过流行病学研究中心抑郁量表（CES-D）每两年评估一次，而功能状态则每两年使用改良版的 Katz 日常生活活动量表（ADL）和 Lawton 工具性日常生活活动量表（IADL）进行测量。
ELSA和HRS分别纳入了3500名和6036名参与者。累积脉压升高与抑郁症状的加速加重显著相关（两者p均<0.001）。累积收缩压和脉压升高与ADL功能（两者p均<0.001）和IADL功能的加速下降显著相关（两者p均<0.001）。然而，累积舒张压升高与IADL功能的下降减速相关（在ELSA中p = 0.031，在HRS中p < 0.001）。
累积血压升高与抑郁症状和功能损害的加速加重相关，这表明对于成年人实现健康长寿而言，控制收缩压和脉压同时维持足够的舒张压至关重要。
