Ellins Elizabeth A, Summers Richard, White Carla, John Ann, Osborn David P J, Lloyd Keith, Akbari Ashley, Gravenor Michael B, Halcox Julian P
Faculty of Medicine, Swansea University Medical School, Health and Life Science, Swansea University, Swansea, United Kingdom.
Division of Psychiatry, University College London, London, United Kingdom.
PLoS One. 2025 Jun 25;20(6):e0326583. doi: 10.1371/journal.pone.0326583. eCollection 2025.
To explore differences in blood pressure treatment and control in patients with and without depression and a diagnosis of hypertension (HTN). Also to examine the possible impact of sex, socio-economic status (deprivation) and location of residence on any differences.
A retrospective observational cohort study (2010-2019) using individual level linked anonymised routinely-collected electronic health record (EHR) data sources was carried out. Patients with a prior or new diagnosis of hypertension, with and without depression were included. Outcome variables were prescription of antihypertensive therapy (AHT) within one year of entering the study for prior HTN or post for new HTN and documentation of blood pressure <140/90 mmHg. Logistic regression was used to explore the association between depression and outcome variables adjusting for sex, age group, deprivation, location of residence and other risk factors.
Depression was associated with higher likelihood of AHT prescription in both prior (OR 1.71 95%CI 1.64-1.78 p < 0.001) and new HTN patients (OR 2.67 95%CI 2.38-3.00 p < 0.001). Similarly, depression was associated with successful blood pressure control in both prior (OR 1.42 95%CI 1.37-1.46 p < 0.001) and new HTN (OR 1.23 95%CI 1.08-1.40 p < 0.001). Females were less likely to be prescribed AHT than males, mainly driven by non-depressed females in both HTN groups. Depressed females were the most likely to have controlled blood pressure in both HTN groups.
Patients with depression are more likely to be prescribed AHT and have documented blood pressure control. Sex differences existed in treatment and control, indicating opportunities for potential improvements in these areas.
探讨患有和未患有抑郁症且被诊断为高血压（HTN）的患者在血压治疗和控制方面的差异。同时研究性别、社会经济地位（贫困程度）和居住地点对这些差异可能产生的影响。
进行了一项回顾性观察队列研究（2010 - 2019年），使用个体层面关联的匿名常规收集电子健康记录（EHR）数据源。纳入有既往或新诊断高血压且伴有或不伴有抑郁症的患者。结局变量为对于既往高血压患者在进入研究后一年内或新诊断高血压患者在诊断后接受抗高血压治疗（AHT）的处方情况以及血压<140/90 mmHg的记录。采用逻辑回归分析探讨抑郁症与结局变量之间的关联，并对性别、年龄组、贫困程度、居住地点和其他危险因素进行校正。
抑郁症与既往高血压患者（比值比[OR] 1.71，95%置信区间[CI] 1.64 - 1.78，p < 0.001）和新诊断高血压患者（OR 2.67，95%CI 2.38 - 3.00，p < 0.001）接受AHT处方的可能性更高相关。同样，抑郁症与既往高血压患者（OR 1.42，95%CI 1.37 - 1.46，p < 0.001）和新诊断高血压患者（OR 1.23，95%CI 1.08 - 1.40，p < 0.001）血压成功得到控制相关。女性接受AHT处方的可能性低于男性，主要是由两个高血压组中未患抑郁症的女性导致的。在两个高血压组中，患抑郁症的女性血压最有可能得到控制。
患有抑郁症的患者更有可能接受AHT处方且有血压得到控制的记录。在治疗和控制方面存在性别差异，表明在这些领域有潜在改善的机会。
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