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    Association of depression with mortality in an elderly treated hypertensive population

    Access Status
    Fulltext not available
    Authors
    Chowdhury, E.
    Berk, M.
    Nelson, M.
    Wing, L.
    Reid, Christopher
    Date
    2018
    Type
    Journal Article
    
    Metadata
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    Citation
    Chowdhury, E. and Berk, M. and Nelson, M. and Wing, L. and Reid, C. 2018. Association of depression with mortality in an elderly treated hypertensive population. International Psychogeriatrics./ 31 (3): pp. 371-381.
    Source Title
    International Psychogeriatrics
    DOI
    10.1017/S1041610218000856
    ISSN
    1041-6102
    School
    School of Public Health
    URI
    http://hdl.handle.net/20.500.11937/74402
    Collection
    • Curtin Research Publications
    Abstract

    Background:Both elevated blood pressure and/or depression increase the risk of cardiovascular disease and mortality. This study in treated elderly hypertensive patients explored the incidence of depression, its association (pre-existing and incident) with mortality and predictors of incident depression.Methods:Data from 6,083 hypertensive patients aged =65 years enrolled in the Second Australian National Blood Pressure study were used. Participants were followed for a median of 10.8 years (including 4.1 years in-trial) and classified into: "no depression," "pre-existing" and "incident" depression groups based on either being "diagnosed with depressive disorders" and/or "treated with an anti-depressant drug" at baseline or during in-trial period. Further, we redefined "depression" restricted to presence of both conditions for sensitivity analyses. For the current study, end-points were all-cause and any cardiovascular mortality.Results:313 (5%) participants had pre-existing depression and a further 916 (15%) participants developed depression during the trial period (incidence 4% per annum). Increased (hazard-ratio, 95% confidence-interval) all-cause mortality was observed among those with either pre-existing (1.23, 1.01-1.50; p = 0.03) or incident (1.26, 1.12-1.41; p < 0.001) depression compared to those without. For cardiovascular mortality, a 24% increased risk (1.24, 1.05-1.47; p = 0.01) was observed among those with incident depression. The sensitivity analyses, using the restricted depression definition showed similar associations. Incident depression was associated with being female, aged =75 years, being an active smoker at study entry, and developing new diabetes during the study period.Conclusions:This elderly cohort had a high incidence of depression irrespective of their randomised antihypertensive regimen. Both pre-existing and incident depression were associated with increased mortality.

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