Predicting factors of depression in patients with primary hypertension: a community-based study

OBJECTIVE To investigate the factors that may predict the occurrence of depression in patients with primary hypertension. METHODS We conducted a cross-sectional survey on 891 hypertensive patients and 651 normal subjects (control group) from a single community. Zung self-rating depression scale (SDS) was applied to evaluate the symptoms of depression, which was diagnosed when the SDS score was >41. RESULTS There was no significant difference in gender distribution (female, 48.5 vs. 47.6%) and age (65.3±9.2 vs. 64.0±7.9 years) between the hypertensive control groups (P>0.05). Depression was diagnosed in 139 hypertensive patients (15.6%) and 27 (4.2%) control subjects (P<0.01). The average SDS score was higher in patients with hypertension duration of more than 3 years (33.3±9.0 vs. 30.6±7.6, P<0.001), in patients with severe hypertension (44.0±7.8 vs. 28.9±4.9, P<0.001) and in patients with a history of hospitalization for cardiovascular disorders (38.1±9.3 vs. 32.0±8.4, P<0.001). Multivariate regression analysis showed that the degree and the duration of hypertension, as well as hospitalization history, were independent predictors of depression in the hypertensive patients. CONCLUSIONS Hypertension is associated with a higher prevalence of depression that can be predicted by the duration and severity of hypertension as well as a history of hospitalization.