Prevalence and correlates of depression among black and Latino stroke survivors with uncontrolled hypertension: a cross-sectional study

Adebayo O Ogunlade, Stephen K Williams, Jennifer Joseph, Deborah O Onakomaiya, Joseph P Eimicke, Jeanne A Teresi, Olajide Williams, Gbenga Ogedegbe, Tanya M Spruill, Adebayo O Ogunlade, Stephen K Williams, Jennifer Joseph, Deborah O Onakomaiya, Joseph P Eimicke, Jeanne A Teresi, Olajide Williams, Gbenga Ogedegbe, Tanya M Spruill

Abstract

Objective: To examine the prevalence and correlates of depression in a cohort of black and Hispanic stroke survivors with uncontrolled hypertension.

Setting: Baseline survey data from 10 stroke centres across New York City.

Participants: Black and Hispanic stroke survivors with uncontrolled hypertension (n=450).

Outcome measures: Depressive symptoms were assessed with the 8-item Patient Reported Outcomes Measurement Information System (PROMIS) measure. Depression was defined as a PROMIS score ≥55. Other data collected included clinical factors, health-related quality of life (EuroQoL five dimensions (EQ-5D)), functional independence (Barthel Index, BI), stroke-related disability (Modified Rankin Score), physical function (PROMIS Physical Function) and executive functioning (Frontal Assessment Battery).

Results: The mean age was 61.7±11.1 years, 44% of participants were women and 51% were black. Poststroke depression was noted in 32% of the cohort. Examining bivariate relationships, patients with depression were observed to have poorer function and quality of life as evidenced by significantly lower PROMIS physical function scores (36.9±8.32 vs 43.4±10.19, p<0.001); BI scores (79.9±19.2 vs 88.1±15.1, p<0.001); EQ-5D scores (0.66±0.24 vs 0.83±0.17, p<0.001) and higher Rankin scores (2.10±1.00 vs 1.46±1.01, p<0.001) compared with those without depression. Multivariate (model adjusted) significant correlates of depression included lower self-reported quality of life (OR=0.02 (CI 0.004 to 0.12) being younger (OR=0.94; 95% CI 0.91 to 0.97); not married (OR=0.46; CI 0.24 to 0.89)); and foreign-born (OR=3.34, 95% CI 1.4 to 7.97). There was a trend for higher comorbidity to be uniquely associated with depression (≥3 comorbid conditions, OR=1.49, 95% CI 1.00 to 2.23).

Conclusions: Poststroke depression is common among black and Hispanic stroke survivors with higher rates noted among foreign-born patients and those with high comorbidity. These findings highlight the importance of screening for depression in minority stroke survivors.

Trial registration number: http://www.clinicaltrials.gov. Unique identifier: NCT01070056.

Keywords: depression & mood disorders; hypertension; stroke.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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