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.