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Hypertension and risk of depression in the elderly: a meta-analysis of prospective cohort studies

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Abstract

The objective of the study was to assess the relationship between hypertension and risk of depression. The relationship between hypertension and depression has been discussed for a long time, but the results are controversial. Studies were searched from PubMed and Cochrane up to 24 March 2014. Any prospective cohort study, which possibly reported the relationship between hypertension and depression, was included. The random effect model was used to calculate the pooled relative risk (RR). Finally, five prospective cohort studies were included for analysis, with a total of 9647 participants involved. Our meta-analysis does not support that hypertension is probably a risk factor of depression. The pooled RR was 1.16 (95% confidence interval: 0.91, 1.42) when those exposed to hypertension were compared with those who were not. Subgroup analysis, sensitivity analysis and publication bias test suggested that the overall result of this analysis was robust. Further studies are needed to exclude the effects of other confounding factors.

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References

  1. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J . Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365: 217–223.

    Article  Google Scholar 

  2. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair RH et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2224–2260.

    Article  Google Scholar 

  3. Vasan RS, Beiser A, Seshadri S, Larson MG, Kannel WB, D’Agostino RB et al. Residual lifetime risk for developing hypertension in middle-aged women and men. JAMA 2002; 287: 1003–1010.

    Article  Google Scholar 

  4. The World Health Organization. The World Health Report 2001-Mental Health: New Understanding, New Hope. World Health Report. Available from http://www.who.int/whr/2001/en/ (cited 25 March 2014).

  5. Cole MG, Bellavance F, Mansour A . Prognosis of depression in elderly community and primary care populations: a systematic review and meta-analysis. Am J Psychiatry 1999; 156: 1182–1189.

    CAS  PubMed  Google Scholar 

  6. Cole MG, Yaffe MJ . Pathway to psychiatric care of the elderly with depression. Int J Geriatr Psychitry 1996; 11: 157–161.

    Article  Google Scholar 

  7. Godin O, Elbejjani M, Kaufman JS . Body mass index, blood pressure, and risk of depression in the elderly: a marginal structural model. Am J Epidemiol 2012; 176: 204–213.

    Article  Google Scholar 

  8. Garcia-Fabela L, Melano CE, Aguilar NS, Garcia LJM, Gutierrez RLM, Avila FJA . Hypertension as a risk factor for developing depressive symptoms among community-dwelling elders. Rev Invest Clin 2009; 61: 274–280.

    PubMed  PubMed Central  Google Scholar 

  9. Murray CJ, Lopez AD . Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet 1997; 349: 1436–1442.

    Article  CAS  Google Scholar 

  10. Wiehe M, Fuchs SC, Moreira LB, Moraes RS, Pereira GM, Gus M et al. Absence of association between depression and hypertension: results of a prospectively designed population-based study. J Hum Hypertens 2006; 20: 434–439.

    Article  CAS  Google Scholar 

  11. Huang CQ, Dong BR, Lu ZC, Yue JR, Liu QX . Chronic diseases and risk for depression in old age: A meta-analysis of published literature. Ageing Res Rev 2010; 9 (2): 131–141.

    Article  Google Scholar 

  12. Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M et al The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Hospital Research Institute, 2008. Available from http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp (cited 29 April 2014).

  13. De Lemos ML . How to survive the survival plots [comment]. Lancet 2002; 360: 954.

    Article  Google Scholar 

  14. Spruance SL, Reid JE, Grace M, Samore M . Hazard ratio in clinical trials. Antimicrob Agents Chemother 2004; 48: 2787–2792.

    Article  CAS  Google Scholar 

  15. Zhang J, Yu KF . What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA 1998; 280: 1690–1691.

    Article  CAS  Google Scholar 

  16. Higgins JP, Thompson SG . Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21: 1539–1558.

    Article  Google Scholar 

  17. Higgins JP, Thompson SG, Deeks JJ, Altman DG . Measuring inconsistency in meta-analyses. Br Med J 2003; 327: 557–560.

    Article  Google Scholar 

  18. Begg CB, Mazumdar M . Operating characteristics of a rank correlation test for publication bias. Biometrics 1994; 50: 1088–1101.

    Article  CAS  Google Scholar 

  19. Egger M, Smith DG, Schneider M, Minder C . Bias in meta-analysis detected by a simple, graphical test. Br Med J 1997; 315: 629–634.

    Article  CAS  Google Scholar 

  20. Alexopoulos GS, Meyers BS, Young RC, Campbell S, Silbersweig D, Charlson M . ‘Vascular depression’ hypothesis. Arch Gen Psychiatry 1997; 54: 915–922.

    Article  CAS  Google Scholar 

  21. He FJ, Nowson CA, MacGregor GA . Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet 2006; 367: 320–326.

    Article  Google Scholar 

  22. Carpenter KM, Hasin DS, Allison DB, Faith MS . Relationships between obesity and DSM-IV major depressive disorder, suicide ideation, and suicide attempts: results from a general population study. Am J Public Health 2000; 90: 251–257.

    Article  CAS  Google Scholar 

  23. Luppino FS, De Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 2010; 67: 220–229.

    Article  Google Scholar 

  24. Vogelzangs N, Kritchevsky SB, Beekman AT, Brenes GA, Newman AB, Satterfield S et al. Obesity and onset of significant depressive symptoms: results from a prospective community-based cohort study of older men and women. J Clin Psychiatry 2010; 71: 391–399.

    Article  Google Scholar 

  25. Sachs-Ericsson N, Burns AB, Gordon KH, Eckel LA, Wonderlich SA, Crosby RD et al. Body mass index and depressive symptoms in older adults: the moderating roles of race, sex, and socioeconomic status. Am J Geriatr Psychiatry 2007; 15: 815–825.

    Article  Google Scholar 

  26. Penninx BW, Kritchevsky SB, Yaffe K, Newman AB, Simonsick EM, Rubin S et al. Inflammatory markers and depressed mood in older persons: results from the Health, Aging and Body Composition Study. Biol Psychiatry. 2003; 54 (5): 566–572.

    Article  CAS  Google Scholar 

  27. Vogelzangs N, Suthers K, Ferrucci L, Simonsick EM, Ble A, Schrager M et al. Hypercortisolemic depression is associated with the metabolic syndrome in late-life. Psychoneuroendocrinology 2007; 32 (2): 151–159.

    Article  CAS  Google Scholar 

  28. Walker BR . Activation of the hypothalamic-pituitary-adrenal axis in obesity: cause or consequence? Growth Horm IGF Res 2001; 11 (suppl A): S91–S95.

    Article  Google Scholar 

  29. Alperovitch A, Lacombe JM, Hanon O, Dartigues JF, Ritchie K, Ducimetiere P et al. Relationship between blood pressure and outdoor temperature in a large sample of elderly individuals: the Three-City Study. Arch Intern Med 2009; 169: 75–80.

    Article  Google Scholar 

  30. Stroup BCA, Markides KS, Black SA, Goodwin JS . Relationship between low blood pressure and depressive symptomatology in older people. J Am Geriatr Soc 2000; 48: 250–255.

    Article  Google Scholar 

  31. Paterniti S, Verdier-Taillefer MH, Geneste C, Bisserbe JC, Alperovitch A . Low blood pressure and risk of depression in the elderly. A prospective community-based study. Br J Psychiatry 2000; 176: 464–467.

    Article  CAS  Google Scholar 

  32. Lenoir H, Lacombe JM, Dufouil C, Ducimetiere P, Hanon O, Ritchie K et al. Relationship between blood pressure and depression in the elderly. The Three-City Study. J Hypertens 2008; 26: 1765–1772.

    Article  CAS  Google Scholar 

  33. Meng L, Chen D, Yang Y, Zheng Y, Hui R . Depression increases the risk of hypertension incidence: a meta-analysis of prospective cohort studies. J Hypertens 2012; 30: 842–851.

    Article  CAS  Google Scholar 

  34. Zimmerman JA, Mast BT, Miles T, Marjides KS . Vascular risk and depression in the Hispanic Established Population for the Epidemiologic Study of the Elderly (EPESE). Int J Geriatr Psychiatry 2009; 24: 409–416.

    Article  Google Scholar 

  35. Kim JM, Stewart R, Kim SW, Yang SJ, Shin IS, Yoon JS . Vascular risk factors and incident late-life depression in a Korean population. Br J Psychiatry 2006; 189: 26–30.

    Article  Google Scholar 

  36. Mast BT, Miles T, Penninx BW, Yaffe K, Rosano C, Satterfield S et al. Vascular disease and future risk of depressive symptomatology in older adults: findings from the Health, Aging, and Body Composition study. Biol Psychiatry 2008; 64: 320–326.

    Article  Google Scholar 

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Acknowledgements

We thank the authors for providing data that are relevant and necessary for our analysis.

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Correspondence to W Tian.

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Long, J., Duan, G., Tian, W. et al. Hypertension and risk of depression in the elderly: a meta-analysis of prospective cohort studies. J Hum Hypertens 29, 478–482 (2015). https://doi.org/10.1038/jhh.2014.112

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