Abstract P190: Hypertension, Hypertension Awareness and Depressive Symptom Severity in a Large Hispanic Population
Introduction: Limited evidence suggests that greater psychological distress among those with elevated blood pressure may be due to awareness or labeling of this condition rather than elevated blood pressure itself. However, studies have not examined this phenomenon among specific race/ethnic groups, among whom chronic disease and disease diagnoses may have varied psychological impact due to group-specific cultural, social, and health-related factors.
Hypothesis: Hispanic adults with a lifetime hypertension (HTN) diagnosis will have elevated depression symptom severity compared to those without a diagnosis, regardless of current HTN status.
Methods: As part of a large community survey of health and health behaviors, 3,403 Hispanic adults residing in Northern Manhattan were assessed for past month depression symptoms using the Patient Health Questionnaire (range 0-27). Systolic and diagnostic blood pressure (SBP, DBP) was calculated as the average of the last two of three sphygmomanometer readings. Using JNC 7 criteria, current HTN was defined as SBP≥140 mmHg or DBP≥90 mmHg. Participants were also asked to report whether they had ever been diagnosed with HTN by a health professional, and were categorized into four groups: (1) no diagnosis, no current HTN, (2) no diagnosis, current HTN, (3) diagnosis, no current HTN, (4) diagnosis, current HTN. Analysis of variance evaluated the overall association between HTN group and mean depression score. Multivariable linear regression further examined differences in mean depression score by HTN group adjusting for age, sex, marital status, education, and insurance status.
Results: More than half of participants had no diagnosis and no current HTN (group 1: 56.6% [1,889 of 3,332]), while 27.4% (912 of 3,332) had HTN but no diagnosis (group 2), 5.7% (187 of 3,332) had a diagnosis but no HTN (group 3), and 10.3% (344 of 3,332) had HTN and a diagnosis (group 4). Mean depression score was higher among those with a diagnosis compared to those without (group 1=0.86, group 2=1.48, group 3=0.78, group 4=1.76, p<0.01). In the adjusted regression model, only groups with a diagnosis had significant, albeit modestly, higher mean depression scores compared to group 1, and mean depression score did not differ significantly between these groups (group 2: beta=0.43, p<0.01; group 3: beta=-0.11, p=0.66; group 4: beta=0.72, p<0.01). Sensitivity analyses that varied the definition of HTN and restricted to those with no other chronic disease yielded similar results.
Conclusions: This study supports previous work highlighting the psychological impact of HTN diagnosis and extends this evidence to Hispanic adults. Findings from this study may have important implications for clinical practice and strategies to improve mental health among those with chronic illness.
Author Disclosures: E. Goldmann: None. E.T. Roberts: None. B. Boden-Albala: None.
- © 2017 by American Heart Association, Inc.