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

Jani, Bhautesh Dinesh and Cavanagh, Jonathan and Barry, Sarah J.E. and Der, Geoff and Sattar, Naveed and Mair, Frances S. (2016) Relationship between blood pressure values, depressive symptoms and cardiovascular outcomes in patients with cardiometabolic disease. Journal of Clinical Hypertension, 18 (10). pp. 1027-1035. ISSN 1751-7176

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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.