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Association of depression with hypertensive left ventricular hypertrophy in age, sex, and education level-specific
Shuang Shi1, Gongchang Guan1, Junkui Wang1
1Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
Insights
Depression significantly increases the risk of left ventricular hypertrophy (LVH) in hypertension patients. This association is particularly strong in men under 60 with higher education.
Area of Science:
- Cardiology
- Psychiatry
- Public Health
Background:
- Hypertension and depression are linked to adverse cardiovascular outcomes and reduced quality of life.
- Left ventricular hypertrophy (LVH) is a major risk factor for cardiovascular mortality.
- Depression may contribute to the development of LVH in hypertensive individuals.
Purpose of the Study:
- To investigate the association between depression and LVH in patients with uncomplicated hypertension.
- To identify demographic and clinical factors influencing this relationship.
Main Methods:
- 353 hypertensive patients were enrolled between November 2017 and May 2021.
- Depression was assessed using the Hamilton Depression Scale (HAM-D), with scores ≥20 indicating depression.
- Linear and logistic regression analyses were employed to examine associations and interactions.
Main Results:
- A positive association was found between HAM-D scores and left ventricular mass index (LVMI).
- Hypertensive patients with depression exhibited a significantly higher risk of LVH compared to those without depression (OR, 2.51).
- The association between depression and LVH was significant in patients <60 years, males, and those with higher education levels.
Conclusions:
- Depression is an independent risk factor for LVH in hypertensive patients.
- Specific subgroups, including younger males and individuals with higher education, face a heightened risk.
- These findings underscore the importance of screening for depression in hypertensive patients to mitigate cardiovascular risk.
Abstract:
Previous studies have shown that hypertension and depression are associated with worse cardiovascular outcomes and reduced quality of life. Left ventricular hypertrophy (LVH) is strongly linked to increased mortality and cardiovascular disease, and depression may be one of the key factors contributing to hypertensive LVH. The authors consecutively enrolled 353 patients with uncomplicated hypertension between November 2017 and May 2021. All participants completed the Hamilton Depression Scale (HAM-D) to assess their depression status, with depression defined as a HAM-D score of 20 or higher. Linear regression analysis revealed a positive association between HAM-D and LVMI (adjusted β, 1.51, 95% CI, 1.19-1.83, p < .001). Logistic regression models showed that individuals with hypertension and depression had a higher risk of LVH than those with hypertension alone (adjusted OR, 2.51, 95% CI, 1.14-5.52, p = .022). The association between depression and LVH significantly interacted with age, sex, education levels, but not BMI and household income. Following age, sex, and education levels stratification, an independent association of depression and LVH was observed only in age <60 years (age <60 years: OR, 7.36, 95% CI, 2.25-24.13, p < .001), male (male: OR, 16.16, 95% CI, 3.80-68.73, p < .001), and higher education levels (high school and above: OR, 11.09, 95% CI, 2.91-42.22, p < .001). Our findings suggest that depression is a significant risk factor for LVH in hypertensive patients, particularly in those who are under 60 years of age, male, and have higher education levels.
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