Hypertension, socioeconomic status and depressive symptoms in Chinese middle-aged and older adults: Findings from the China health and retirement longitudinal study
Hypertension, socioeconomic status and depressive symptoms in Chinese middle-aged and older adults: Findings from the China health and retirement longitudinal study
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DOI：
10.1016/j.jad.2019.04.002
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发表时间：
2019-06-01
影响因子：
6.6
通讯作者：
He, Ping
中科院分区：
文献类型：
--
作者：
Jin, Yinzi;Luo, Yanan;He, Ping
背景：本研究旨在探讨中国中老年人群中高血压诊断对抑郁症状的影响，以及社会经济地位（SES）在其影响中的调节作用。方法：我们使用的数据来自中国健康与退休纵向研究的全国代表性调查，包括2011-12年基线时无抑郁症状的6273名参与者。我们根据10项流行病学研究中心抑郁量表评估抑郁症状。我们采用Cox比例风险回归模型，研究2011- 2015年基线诊断高血压状态对随后抑郁症状的影响，并报告风险比（hr）。结果：经控制变量校正后，诊断为高血压的参与者比非高血压的参与者更容易出现抑郁症状（HR = 1.12, 95% CI: 1.02-1.23）。这种影响只发生在社会经济地位较低的群体中，包括农村居民（HR = 1.13, 95% CI: 1.02-1.26）、低于平均家庭收入（HR = 1.14, 95% CI: 1.02-1.26）和小学或以下教育程度（HR = 1.12, 95% CI: 1.00-1.25）。局限性：没有包括高血压发病或持续时间的测量，这可能会改变对抑郁症状的估计影响。结论：高血压是导致抑郁障碍的慢性应激源，对这种应激源的反应仅发生在社会经济地位较低的个体中。我们的研究结果强调了在老龄化背景下检查精神和身体健康之间联系的重要性，并为制定可能导致心理压力的高血压的检测和管理策略提供了线索，这可能有助于对抗抑郁症状，特别是在低社会经济地位人群中。
Background: This study aimed to examine the effect of diagnosed hypertension on depressive symptoms and socioeconomic status (SES) as moderator in the effect in middle-aged and older adults in China.Methods: We used data from the nationally representative survey of China Health and Retirement Longitudinal Study, including 6273 participants free from depressive symptoms at baseline in 2011-12. We assessed the depressive symptoms based on the 10-item Center for Epidemiological Studies Depression scale. We conducted Cox proportional hazards regression models to examine the effect of baseline diagnosed hypertension status on the subsequent depressive symptoms in 2011-15 with the report of Hazards ratios (HRs).Results: The diagnosed hypertensive participants were more likely to have depressive symptoms than non-hypertensive peers (HR = 1.12, 95% CI: 1.02-1.23) after adjusted for controlled variables. The effect only occurred in the group of low SES, with rural residency (HR = 1.13, 95% CI: 1.02-1.26), below-average household income (HR = 1.14, 95% CI: 1.02-1.26) and primary school or below educational attainment (HR = 1.12, 95% CI: 1.00-1.25).Limitations: Measures of the onset or duration of hypertension were not included, which may modify the estimated effects on depressive symptoms.Conclusions: Diagnosed hypertension is a chronic stressor leading to depressive disorders, and the responses to this stressor merely occurred among the low socioeconomic individuals. Our findings underscored the importance of examining the connection between mental and physical health in the context of aging and shed lights on the action to developing strategies for detection and management of hypertension that could cause psychological stress, which may contribute to fighting against depressive symptoms, especially in the low SES population.