Association of Baseline Depressive Symptoms with Prevalent and Incident Pre-Hypertension and Hypertension in Postmenopausal Hispanic Women: Results from the Women's Health Initiative

Ruth E Zambrana, Lenny López, Gniesha Y Dinwiddie, Roberta M Ray, Charles B Eaton, Lawrence S Phillips, Sylvia Wassertheil-Smoller, Ruth E Zambrana, Lenny López, Gniesha Y Dinwiddie, Roberta M Ray, Charles B Eaton, Lawrence S Phillips, Sylvia Wassertheil-Smoller

Abstract

Background: Depression and depressive symptoms are risk factors for hypertension (HTN) and cardiovascular disease (CVD). Hispanic women have higher rates of depressive symptoms compared to other racial/ethnic groups yet few studies have investigated its association with incident prehypertension and hypertension among postmenopausal Hispanic women. This study aims to assess if an association exists between baseline depression and incident hypertension at 3 years follow-up among postmenopausal Hispanic women.

Methods: Prospective cohort study, Women's Health Initiative (WHI), included 4,680 Hispanic women who participated in the observational and clinical trial studies at baseline and at third-year follow-up. Baseline current depressive symptoms and past depression history were measured as well as important correlates of depression-social support, optimism, life events and caregiving. Multinomial logistic regression was used to estimate prevalent and incident prehypertension and hypertension in relation to depressive symptoms.

Results: Prevalence of current baseline depression ranged from 26% to 28% by hypertension category and education moderated these rates. In age-adjusted models, women with depression were more likely to be hypertensive (OR = 1.25; 95% CI 1.04-1.51), although results were attenuated when adjusting for covariates. Depression at baseline in normotensive Hispanic women was associated with incident hypertension at year 3 follow-up (OR = 1.74; 95% CI 1.10-2.74) after adjustment for insurance and behavioral factors. However, further adjustment for clinical covariates attenuated the association. Analyses of psychosocial variables correlated with depression but did not alter findings. Low rates of antidepressant medication usage were also reported.

Conclusions: In the largest longitudinal study to date of older Hispanic women which included physiologic, behavioral and psychosocial moderators of depression, there was no association between baseline depressive symptoms and prevalent nor incident pre-hypertension and hypertension. We found low rates of antidepressant medication usage among Hispanic women suggesting a possible point for clinical intervention.

Trial registration: Clinicaltrials.gov NCT00000611.

Conflict of interest statement

Competing Interests: The authors have declared the following interests: Dr. Phillips: Advisory Panel, Boehringer Ingelheim Pharmaceuticals, Inc.; Employee, Veterans Administration; Research Support, Novo Nordisk, Inc., Eli Lilly and Company, PhaseBio, Roche Pharmaceuticals, Amylin Pharmaceuticals, Inc., Sanofi, Merck, Cystic Fibrosis Foundation; Other Relationship (expert witness), Centers for Medicare and Medicaid Services. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.

References

    1. Wassertheil-Smoller S, Anderson G, Psaty B, Black H, Manson J, Wong N et al. Hypertension and Its Treatment in Postmenopausal Women: Baseline Data from the Women's Health Initiative. Hypertension. 2000;36(5):780–789.
    1. Cooper-DeHoff R, Zhou Q, Gaxiola E, Cangiano J, Garcia-Barreto D, Handberg E et al. Influence of Hispanic Ethnicity on Blood Pressure Control and Cardiovascular Outcomes in Women with CAD and Hypertension: Findings from INVEST. Journal of Women's Health. 2007;16(5):632–640.
    1. Daviglus M, Talavera G, Avilés-Santa M, Allison M, Cai J, Criqui M et al. Prevalence of Major Cardiovascular Risk Factors and Cardiovascular Diseases Among Hispanic/Latino Individuals of Diverse Backgrounds in the United States. JAMA. 2012;308(17):1775 10.1001/jama.2012.14517
    1. Zambrana R, Lopez L, Dinwiddie G, Ray R, Phillips L, Trevisan M et al. Prevalence and Incident Prehypertension and Hypertension in Postmenopausal Hispanic Women: Results from the Women's Health Initiative. American Journal of Hypertension. 2014;27(3):372–381. 10.1093/ajh/hpt279
    1. Barton M, Meyer M. Postmenopausal Hypertension: Mechanisms and Therapy. Hypertension. 2009;54(1):11–18. 10.1161/HYPERTENSIONAHA.108.120022
    1. Low C, Thurston R, Matthews K. Psychosocial Factors in the Development of Heart Disease in Women: Current Research and Future Directions. Psychosomatic Medicine. 2010;72(9):842–854. 10.1097/PSY.0b013e3181f6934f
    1. Shah M, Zonderman A, Waldstein S. Sex and Age Differences in the Relation of Depressive Symptoms With Blood Pressure. American Journal of Hypertension. 2013;26(12):1413–1420. 10.1093/ajh/hpt135
    1. Read J, Gorman B. Racial/Ethnic Differences in Hypertension and Depression among U.S. Adult Women. Ethnicity & Disease. 2007;17:389–396.
    1. Kim C, McGorray S, Bartholomew B, Marsh M, Dicken T, Wassertheil-Smoller S et al. Depressive Symptoms and Heart Rate Variability in Postmenopausal Women. Arch Intern Med. 2005;165(11):1239
    1. Bromberger J, Harlow S, Avis N, Kravitz H, Cordal A. Racial/Ethnic Differences in the Prevalence of Depressive Symptoms Among Middle-Aged Women: The Study of Women’s Health Across the Nation (SWAN). Am J Public Health. 2004;94(8):1378–1385.
    1. Licht C, de Geus E, Seldenrijk A, van Hout H, Zitman F, van Dyck R et al. Depression Is Associated With Decreased Blood Pressure, but Antidepressant Use Increases the Risk for Hypertension. Hypertension. 2009;53(4):631–638. 10.1161/HYPERTENSIONAHA.108.126698
    1. Matthews K. Blood Pressure Reactivity to Psychological Stress Predicts Hypertension in the CARDIA Study. Circulation. 2004;110(1):74–78.
    1. Scuteri A. Depression and cardiovascular risk: does blood pressure play a role?. Journal of Hypertension. 2008;26(9):1738–1739. 10.1097/HJH.0b013e32830dfff7
    1. Rutledge T, Hogan B. A Quantitative Review of Prospective Evidence Linking Psychological Factors With Hypertension Development. Psychosomatic Medicine. 2002;64(5):758–766.
    1. Lima R, Wofford M, Reckelhoff J. Hypertension in Postmenopausal Women. Curr Hypertens Rep. 2012;14(3):254–260. 10.1007/s11906-012-0260-0
    1. Alegría M, Mulvaney-Day N, Torres M, Polo A, Cao Z, Canino G. Prevalence of Psychiatric Disorders Across Latino Subgroups in the United States. Am J Public Health. 2007;97(1):68–75.
    1. Wassertheil-Smoller S, Arredondo E, Cai J, Castaneda S, Choca J, Gallo L et al. Depression, anxiety, antidepressant use, and cardiovascular disease among Hispanic men and women of different national backgrounds: results from the Hispanic Community Health Study/Study of Latinos. Annals of Epidemiology. 2014;24(11):822–830. 10.1016/j.annepidem.2014.09.003
    1. Swenson C, Baster J, Shetterly SM, Scarbro SL, Hamman RF. Depressive Symptoms in Hispanic and Non-Hispanic White Rural Elderly The San Luis Valley Health and Aging Study. American Journal of Epidemiology. 2000;152(11):1048–1055.
    1. Wassertheil-Smoller S, Shumaker S, Ockene J, Talavera G, Greenland P, Cochrane B et al. Depression and Cardiovascular Sequelae in Postmenopausal Women. Arch Intern Med. 2004;164(3):289
    1. Zambrana R, Thornton Dill B. Disparities in Latina Health: An Intersectional Analysis Race, Class, Gender and Health. 1st ed. San Francisco: Jossey-Bass; 2006. p. 192–227.
    1. Acevedo-Garcia D, Lochner K, Osypuk T, Subramanian S. Future Directions in Residential Segregation and Health Research: A Multilevel Approach. Am J Public Health. 2003;93(2):215–221.
    1. Ai A, Appel H, Huang B, Lee K. Overall Health and Healthcare Utilization Among Latino American Women in the United States. Journal of Women's Health. 2012;21(8):878–885. 10.1089/jwh.2011.3431
    1. Henry J. Kaiser Foundation. Women's Health Care Chartbook: Key Findings from the Kaiser Women's Health Survey. Washington, DC: Henry J. Kaiser Foundation; 2011.
    1. Vital Signs: Awareness and Treatment of Uncontrolled Hypertension Among Adults—United States, 2003–2010 [Internet]. . 2016. Available: . Accessed 23 March 2016.
    1. Räikkönen K, Matthews K, Kuller L. Trajectory of psychological risk and incident hypertension in middle-aged women. Hypertension [Internet]. 2001;38:798–802. Available: .
    1. Kaplan M, Nunes A. The psychosocial determinants of hypertension. Nutrition, Metabolism and Cardiovascular Diseases. 2003;13(1):52–59.
    1. Bosworth H, Bartash R, Olsen M, Steffens D. The association of psychosocial factors and depression with hypertension among older adults. Int J Geriat Psychiatry. 2003;18(12):1142–1148.
    1. Stern S, Dhanda R, Hazuda H. Helplessness predicts the development of hypertension in older Mexican and European Americans. Journal of Psychosomatic Research. 2009;67(4):333–337. 10.1016/j.jpsychores.2009.04.007
    1. Din-Dzietham R, Nembhard W, Collins R, Davis S. Perceived stress following race-based discrimination at work is associated with hypertension in African–Americans. The metro Atlanta heart disease study, 1999–2001. Social Science & Medicine. 2004;58(3):449–461.
    1. Conway F, Magai C, Springer C, Jones S. Optimism and pessimism as predictors of physical and psychological health among grandmothers raising their grandchildren. Journal of Research in Personality. 2008;42(5):1352–1357.
    1. Wulsin L, Singal B. Do Depressive Symptoms Increase the Risk for the Onset of Coronary Disease? A Systematic Quantitative Review. Psychosomatic Medicine. 2003;65(2):201–210.
    1. Alferi S, Carver C, Antoni M, Weiss S, Durán R. An exploratory study of social support, distress, and life disruption among low-income Hispanic women under treatment for early stage breast cancer. Health Psychology. 2001;20(1):41–46.
    1. DiMatteo M. Social Support and Patient Adherence to Medical Treatment: A Meta-Analysis. Health Psychology. 2004;23(2):207–218.
    1. Lee S, Colditz G, Berkman L, Kawachi I. Caregiving to Children and Grandchildren and Risk of Coronary Heart Disease in Women. Am J Public Health. 2003;93(11):1939–1944.
    1. Shaw W, Patterson T, Semple S, Dimsdale J, Ziegler M, Grant I. Emotional expressiveness, hostility and blood pressure in a longitudinal cohort of Alzheimer caregivers. Journal of Psychosomatic Research. 2003;54(4):293–302.
    1. Anderson G, Manson J, Wallace R, Lund B, Hall D, Davis S et al. Implementation of the women's health initiative study design. Annals of Epidemiology. 2003;13(9):S5–S17.
    1. Women’s Health Initiative Study Group. Design of the Women’s Health Initiative Clinical Trial and Observational Study. Controlled Clinical Trials. 1998;19(1):61–109.
    1. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report. JAMA. 2003;289(19):2560–2571. 10.1001/jama.289.19.2560
    1. Burnam M, Wells K, Leake B, Landsverk J. Development of a Brief Screening Instrument for Detecting Depressive Disorders on JSTOR [Internet]. . 1988. Available: . Accessed 23 March 2016.
    1. Melchior L, Huba G, Brown V, Reback C. A Short Depression Index for Women. Educational and Psychological Measurement. 1993;53(4):1117–1125.
    1. Bertone-Johnson E, Powers S, Spangler L, Larson J, Michael Y, Millen A et al. Vitamin D Supplementation and Depression in the Women's Health Initiative Calcium and Vitamin D Trial. American Journal of Epidemiology. 2012;176(1):1–13. 10.1093/aje/kwr482
    1. Berkman L, Syme S. Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. American Journal of Epidemiology [Internet]. 1979;109(2):186–204. Available: . Accessed 23 March 2016.
    1. Ruberman W, Weinblatt E, Goldberg J, Chaudhary B. Psychosocial Influences on Mortality after Myocardial Infarction. New England Journal of Medicine. 1984;311(9):552–559.
    1. Sherbourne C, Stewart A. The MOS social support survey. Social Science & Medicine. 1991;32(6):705–714.
    1. Scheier M, Carver C. Optimism, coping, and health: Assessment and implications of generalized outcome expectancies. Health Psychology. 1985;4(3):219–247.
    1. Brown L, Potter J, Foster B. Caregiver Burden Should Be Evaluated During Geriatric Assessment. Journal of the American Geriatrics Society. 1990;38(4):455–460.
    1. Spangler L, Scholes D, Brunner R, Robbins J, Reed S, Newton K et al. Depressive Symptoms, Bone Loss, and Fractures in Postmenopausal Women. J Gen Intern Med. 2008;23(5):567–574. 10.1007/s11606-008-0525-0
    1. Gonzalez H, Haan M, Hinton L. Acculturation and the Prevalence of Depression in Older Mexican Americans: Baseline Results of the Sacramento Area Latino Study on Aging. Journal of the American Geriatrics Society. 2001;49(7):948–953.
    1. Doornbos M, Zandee G, DeGroot J, De Maagd-Rodriguez M. Using Community-Based Participatory Research to Explore Social Determinants of Women's Mental Health and Barriers to Help-Seeking in Three Urban, Ethnically Diverse, Impoverished, and Underserved Communities. Archives of Psychiatric Nursing. 2013;27(6):278–284. 10.1016/j.apnu.2013.09.001
    1. Handberg E, Eastwood J, Eteiba W, Johnson B, Krantz D, Thompson D et al. Clinical implications of the Women’s Ischemia Syndrome Evaluation: inter-relationships between symptoms, psychosocial factors and cardiovascular outcomes. Women's Health. 2013;9(5):479–490. 10.2217/whe.13.50
    1. Delaney J, Oddson B, Kramer H, Shea S, Psaty B, McClelland R. Baseline Depressive Symptoms Are Not Associated With Clinically Important Levels of Incident Hypertension During Two Years of Follow-Up: The Multi-Ethnic Study of Atherosclerosis. Hypertension. 2010;55(2):408–414. 10.1161/HYPERTENSIONAHA.109.139824
    1. Meyer C, Armenian H, Eaton W, Ford D. Incident hypertension associated with depression in the Baltimore Epidemiologic Catchment area follow-up study. Journal of Affective Disorders. 2004;83(2–3):127–133.
    1. Nabi H, Chastang J, Lefevre T, Dugravot A, Melchior M, Marmot M et al. Trajectories of Depressive Episodes and Hypertension Over 24 Years: The Whitehall II Prospective Cohort Study. Hypertension. 2011;57(4):710–716. 10.1161/HYPERTENSIONAHA.110.164061
    1. Davidson K, Jonas B, Dixon K, Markovitz J. Do Depression Symptoms Predict Early Hypertension Incidence in Young Adults in the CARDIA Study?. Arch Intern Med. 2000;160(10):1495
    1. Ostir G, Berges I, Markides K, Ottenbacher K. Hypertension in Older Adults and the Role of Positive Emotions. Psychosomatic Medicine. 2006;68(5):727–733.
    1. Jonas B, Lando J. Negative Affect as a Prospective Risk Factor for Hypertension. Psychosomatic Medicine. 2000;62(2):188–196.
    1. Grewen K, Girdler S, West S, Bragdon E, Costello N, Light K. Stable Pessimistic Attributions Interact with Socioeconomic Status to Influence Blood Pressure and Vulnerability to Hypertension. Journal of Women's Health & Gender-Based Medicine. 2000;9(8):905–915.
    1. Bell C, Thorpe R, LaVeist T. Race/Ethnicity and Hypertension: The Role of Social Support. American Journal of Hypertension. 2010;23(5):534–540. 10.1038/ajh.2010.28
    1. World Health Organization. The world health report. Mental health: new understanding, new hope. 2001 Geneva: World Health Organization; 2001.
    1. Hicken M, Lee H, Morenoff J, House J, Williams D. Racial/Ethnic Disparities in Hypertension Prevalence: Reconsidering the Role of Chronic Stress. Am J Public Health. 2014;104(1):117–123. 10.2105/AJPH.2013.301395
    1. Williams D, Mohammed S, Leavell J, Collins C. Race, socioeconomic status, and health: Complexities, ongoing challenges, and research opportunities. Annals of the New York Academy of Sciences. 2010;1186(1):69–101.
    1. Mujahid M, Roux A, Cooper R, Shea S, Williams D. Neighborhood Stressors and Race/Ethnic Differences in Hypertension Prevalence (The Multi-Ethnic Study of Atherosclerosis). American Journal of Hypertension. 2011;24(2):187–193. 10.1038/ajh.2010.200
    1. Hicks L, Shaykevich S, Bates D, Ayanian J. Determinants of racial/ethnic differences in blood pressure management among hypertensive patients. BMC Cardiovasc Disord. 2005;5(1):16
    1. Howard B, Kuller L, Langer R, Manson JE, Allen C, Assaf A et al. Risk of Cardiovascular Disease by Hysterectomy Status, With and Without Oophorectomy: The Women's Health Initiative Observational Study. Circulation. 2005;111(12):1462–1470.
    1. Dinwiddie G, Zambrana R, Garza M. Exploring Risk Factors in Latino Cardiovascular Disease: The Role of Education, Nativity, and Gender. Am J Public Health. 2014;104(9):1742–1750. 10.2105/AJPH.2013.301280
    1. Sorlie P, Allison M, Aviles-Santa M, Cai J, Daviglus M, Howard A et al. Prevalence of Hypertension, Awareness, Treatment, and Control in the Hispanic Community Health Study/Study of Latinos. American Journal of Hypertension. 2014;27(6):793–800. 10.1093/ajh/hpu003

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir