Do Depressive Symptoms Predict Blood Pressure Control in US Veterans?
Do Depressive Symptoms Predict Blood Pressure Control in US Veterans?
复制标题
DOI：
10.1007/s11606-021-06709-5
复制
发表时间：
2021-03-26
影响因子：
5.7
通讯作者：
Blake, Erin C.
中科院分区：
文献类型：
--
作者：
Lee, Sharon Y.;Waring, Molly E.;Blake, Erin C.
背景高血压是美国退伍军人中最常见的慢性疾病。血压控制对于预防和管理心血管疾病至关重要。虽然抑郁症状是血压不受控制的已知风险因素，退伍军人的抑郁症状发生率很高，但没有研究探讨美国退伍军人抑郁症状与血压控制之间的关系。目的：我们研究了在美国退伍军人中，中度至重度抑郁症状与无至轻微抑郁症状相比，是否与血压不受控制的风险较高相关。我们分析了来自国家健康和营养检查调查（2013-2016）的退伍军人的人口样本。Logistic回归模型根据婚姻状况、年龄和体重指数进行调整。所有的分析都是加权的;结果可推广到美国退伍军人。参与者分析了864名退伍军人的样本，代表约1880万美国退伍军人。抑郁症状通过患者健康问卷-9进行评估。未控制的血压定义为平均收缩压>= 130和/或舒张压>= 80。对于抑郁症状，78.2%（SE = 1.6）的美国退伍军人有无至最小，18.2%（SE = 1.2）有轻度至中度，3.5%（SE = 0.8）有中度至重度。43%（SE = 3.0）的美国退伍军人有不受控制的血压。与无至轻微抑郁症状相比，中度至重度抑郁症状与血压不受控制的风险较低相关（aOR = 0.28，95% CI [0.09，0.85]）。轻度至中度抑郁症状与血压控制无关（aOR = 0.98，95%CI [0.59，1.65]）。结论：美国退伍军人与中度严重到严重的抑郁症状不太可能有不受控制的血压比退伍军人与无至最小的症状。未来的研究应该检查退伍军人特有的因素，这些因素可能解释与抑郁症状和血压控制之间的假设关系相反的发现。
Background High blood pressure is the most common chronic condition among US veterans. Blood pressure control is essential to preventing and managing cardiovascular diseases. While depressive symptoms are a known risk factor for uncontrolled blood pressure and veterans experience high rates of depressive symptoms, no research has examined the relationship between depressive symptoms and blood pressure control among US veterans. Objective We examined whether moderately severe-to-severe depressive symptoms, compared to none-to-minimal, are associated with higher risk of uncontrolled blood pressure among US veterans. Design We analyzed a population-based sample of veterans from the National Health and Nutrition Examination Survey (2013-2016). Logistic regression models were adjusted for marital status, age, and body mass index. All analyses were weighted; results are generalizable to US veterans. Participants A sample of 864 veterans was analyzed, representing approximately 18.8 million US veterans. Main Measures Depressive symptoms were assessed by the Patient Health Questionnaire-9. Uncontrolled blood pressure was defined as average systolic blood pressure >= 130 and/or diastolic blood pressure >= 80. Key Results For depressive symptoms, 78.2% (SE = 1.6) of US veterans had none-to-minimal, 18.2% (SE = 1.2) had mild-to-moderate, and 3.5% (SE = 0.8) had moderately severe-to-severe. Forty-three percent (SE = 3.0) of US veterans had uncontrolled blood pressure. Moderately severe-to-severe depressive symptoms, compared to none-to-minimal, were associated with lower risk for uncontrolled blood pressure (aOR = .28, 95% CI [.09, .85]). Mild-to-moderate depressive symptoms were not associated with blood pressure control (aOR = .98, 95% CI [.59, 1.65]). Conclusions US veterans with moderately severe-to-severe depressive symptoms were less likely to have uncontrolled blood pressure than veterans with none-to-minimal symptoms. Future research should examine factors unique to veterans that may explain findings opposite of the hypothesized relationship between depressive symptoms and blood pressure control.