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

Jani, B. D. , Cavanagh, J., Barry, S. J.E. , Der, G. , Sattar, N. and Mair, F. 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. (doi:10.1111/jch.12813) (PMID:27040355)

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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.

Item Type:Articles
Keywords:Blood pressure, depression, coronary heart disease, diabetes, stroke: cardiovascular outcomes.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Der, Mr Geoffrey and Cavanagh, Professor Jonathan and Jani, Dr Bhautesh and Barry, Dr Sarah and Mair, Professor Frances and Sattar, Professor Naveed
Authors: Jani, B. D., Cavanagh, J., Barry, S. J.E., Der, G., Sattar, N., and Mair, F. S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO Unit
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Journal of Clinical Hypertension
Publisher:Wiley
ISSN:1524-6175
ISSN (Online):1751-7176
Published Online:03 April 2016
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in Journal of Clinical Hypertension 18(10): 1027-1035
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
599461Exploring the potential role for allostatic load markers in risk assessment of patients presenting with depressive symptomsFrances MairScottish Executive Health Department (SEHHD-CSO)CAF/12/04IHW - GENERAL PRACTICE & PRIMARY CARE