Relationship between blood pressure values, depressive symptoms and cardiovascular outcomes in patients with cardiometabolic disease

Bhautesh Dinesh Jani, Jonathan Cavanagh, Sarah J.E. Barry, Geoff Der, Naveed Sattar, Frances S. Mair

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Abstract

We studied joint effect of blood pressure-BP and depression on risk of major adverse cardiovascular outcome in patients with existing cardiometabolic disease. A cohort of 35537 patients with coronary heart disease, diabetes or stroke underwent depression screening and BP was recorded concurrently. We used Cox?s proportional hazards to calculate risk of major adverse cardiovascular event-MACE (myocardial infarction/heart failure/stroke or cardiovascular death) over 4 years associated with baseline BP and depression. 11% (3939) had experienced MACE within 4 years. Patients with very high systolic BP-SBP (160-240) hazard ratio-HR 1.28 and with depression (HR 1.22) at baseline had significantly higher adjusted risk. Depression had significant interaction with SBP in risk prediction (p=0.03). Patients with combination of SBP and depression at baseline had 83% higher adjusted risk of MACE, as compared to patients with reference SBP and without depression. Patients with cardiometabolic disease and comorbid depression may benefit from closer monitoring of SBP.
Original languageEnglish
Pages (from-to)1027-1035
Number of pages9
JournalJournal of Clinical Hypertension
Volume18
Issue number10
Early online date3 Apr 2016
DOIs
Publication statusPublished - 1 Oct 2016

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Keywords

  • blood pressure
  • cardiovascular outcomes
  • stroke
  • diabetes
  • coronary heart disease
  • depression

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