Do depression symptoms predict early hypertension incidence in young adults in the CARDIA study?
Do depression symptoms predict early hypertension incidence in young adults in the CARDIA study?
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DOI：
10.1001/archinte.160.10.1495
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发表时间：
2000-05-22
影响因子：
--
通讯作者：
Markovitz, JH
中科院分区：
文献类型：
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作者：
Davidson, K;Jonas, BS;Markovitz, JH
背景：高血压与多种心理因素有关，包括抑郁，但高血压发病率和抑郁症状之间的关系还没有得到充分的研究。目的：确定抑郁症状是否独立预测高血压发病率。设计和地点：来自普通社区的前瞻性、多中心、流行病学队列(研究开始时年龄为23-35岁)，随访5年。对象：来自4个城市地区的3343名成年人分层(黑人和白人)，来自CARDIA(青年冠状动脉风险发展)研究。主要结果衡量高血压发病率，结果：在流行病学研究中心抑郁量表(CES-D)上得分高(大于或等于16)的参与者与CES-D得分低(小于或等于7；在固定Logistic模型中，调整其他高血压危险因素后，优势比为2.10；95%可信区间为1.22-3.61)。那些有中度抑郁症状(CES-D评分8-15)的人也有显著的风险(调整后的优势比为1.78；95%可信区间为1.06-2.98)。这些关联在黑人中有显著意义，但在白人中没有发现，白人的高血压发病率(1806年为29[2%])低于黑人(89[6%]/1537)。结论：抑郁症状是青年高血压发病的预测因素，有抑郁症状的青年黑人患高血压的风险较高。
Background: Hypertension has been linked to several psychological factors, including depression, but the relation between hypertension incidence and depressive symptoms has not been adequately examined.Objective: To determine if depressive symptoms independently predict hypertension incidence.Design and Setting: A prospective, multicenter, epidemiological cohort of young adults (aged 23-35 years at study entry) from the general community without hypertension followed up for 5 years.Subjects: A sample of 3343 adults from 4 urban areas stratified fur race (black and white) from the CARDIA (Coronary Artery Risk Development in Young Adults) study.Main Outcome Measure Hypertension incidence, which was defined as blood pressure higher than 160/95 mm Hg (assessed on a single occasion) or the use of prescribed antihypertensive medication.Results: Participants with high scores (greater than or equal to 16) on the Center for Epidemiological Studies Depression (CES-D) Scale were at significant risk for hypertension incidence compared with those with low CES-D scores (less than or equal to 7; odds ratio, 2.10; 95% confidence interval, 1.22-3.61) after adjustment for other hypertension risk factors leg, age, resting systolic blood pressure at the 5-year examination, physical activity, daily alcohol use, parental history of hypertension, education, presence of diabetes mellitus or heart disease, sex, and race) in fixed logistic models. Those with intermediate depressive symptoms (CES-D scores 8-15) were also at significant risk (adjusted odds ratio, 1.78; 95% confidence interval, 1.06-2.98). These associations were significant in blacks alone but were not found in whites, who had a lower hypertension incidence (29 [2%] of 1806) than blacks (89 [6%] of 1537).Conclusions: Depressive symptoms were predictive of later hypertension incidence in young adults, and young blacks with depressive symptoms were at high risk of developing hypertension.