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

• Type of Material: Article
• Authors: Ruth E. Zambrana, University of Maryland; Lenny López, University of California, San Francisco; Gniesha Y. Dinwiddie, University of Maryland; Roberta M. Ray, Fred Hutchinson Cancer Research Center; Charles B. Eaton, Brown University; Lawrence Phillips, Emory University; Sylvia Wassertheil-Smoller, Albert Einstein College of Medicine
• Language: English
• Date: 2016-04-28
• Publisher: Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: © 2016 Zambrana et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pone.0152765
• Title of Journal or Parent Work: PLoS ONE
• ISSN: 1932-6203
• Volume: 11
• Issue: 4
• Start Page: e0152765
• End Page: e0152765
• Grant/Funding Information: The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C.; Dr. López was supported by the RWJ Foundation Harold Amos Faculty Development Program and National Institute of Diabetes, Digestive, and Kidney Diseases (1K23DK098280-01).
• Keywords: MIDDLE-AGED WOMEN; Blood pressure; BLOOD-PRESSURE; Hypertension; PSYCHOSOCIAL FACTORS; Hispanic people; Diabetes mellitus; SOCIAL SUPPORT; Cardiovascular diseases in women; Depression; RACIAL/ETHNIC DIFFERENCES; Psychological stress; SOCIOECONOMIC-STATUS; Multidisciplinary Sciences; Women's health; Science & Technology; HEART-DISEASE
• Research Categories: Health Sciences, Mental Health; Health Sciences, Epidemiology

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.