Do Depressive Symptoms Predict Blood Pressure Control in US Veterans?

• Published in: Journal of general internal medicine : JGIM 2022-01, Vol.37 (1), p.57-63
• Main Authors: Lee, Sharon Y., Waring, Molly E., Park, Crystal L., Blake, Erin C.
• Format: Article
• Language: English
• Subjects: Agent Orange; Blood Pressure; Body mass; Body mass index; Body size; Cardiovascular diseases; Cross-Sectional Studies; Depression - diagnosis; Depression - epidemiology; Humans; Hypertension; Internal Medicine; Medicine; Medicine & Public Health; Mental depression; Nutrition; Nutrition Surveys; Original Research; Regression analysis; Regression models; Risk analysis; Risk factors; Signs and symptoms; Veterans
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-021-06709-5

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.