[Interaction of hypertensive comorbidity patterns and social participation on depressive symptoms]

To explore the relationship between hypertensive comorbidity patterns and social participation and depressive symptoms in middle-aged and elderly hypertensive patients.

Using the data from the 2015, 2018 and 2020 of the China Health and Retirement Longitudinal Study, 2786 middle and elderly adults aged 45 and above with hypertension were included. Data analysis was performed in Stata 17.0 statistical software, using frequency and percentage to describe baseline characteristics. The generalized estimation equation(GEE) was used to to analyze the data, and GEE was constructed with the depressive symptoms of middle and elderly people as the dependent variable. The unifactorial and multifactorial analysis of the effects of hypertensive comorbidity patterns and social participation on depressive symptoms, and the influence of the interaction between hypertensive comorbidity patterns and social participation on depressive symptoms were analyzed.

Among the baseline characteristics of 2786 middle and older adults with hypertension, 2319(83.24%) had hypertensive comorbidity and 1558(55.92%) had social participant. The result of unifactorial GEE analysis of depressive symptoms in middle and older adults showed that the risk of depressive symptoms was higher in hypertensive comorbidity than in hypertension without comorbidity(OR=2.31, 95%CI 1.97-2.71, P<0.01), and lower in middle and older adults with social participation than in those without social participation(OR=0.71, 95%CI 0.64-0.78, P<0.01). The result of multifactorial GEE analysis of depressive symptoms in middle and older adults showed that the risk of depressive symptoms was higher in hypertensive comorbidity than in hypertension without comorbidity(OR=2.06, 95%CI 1.75-2.41, P<0.01), and lower in middle and older adults with social participation than in those without social participation(OR=0.78, 95%CI 0.70-0.87, P<0.01). Analysis of the interaction of hypertensive comorbidity and social participation on depressive symptoms in middle and older adults showed that middle and older adults with hypertensive comorbidity and no social participation had a 2.20 times higher risk of depressive symptoms than those with hypertension without comorbidity and no social participation(OR=2.20, 95%CI 1.78-2.72, P<0.01).

Comorbidity is severe in the hypertensive population, and social participation in the hypertensive comorbidity population may reduce the risk of developing depressive symptoms.