Low blood pressure and depression in older men: a population based study

• Published in: BMJ Vol. 308; no. 6926; pp. 446 - 449
• Main Authors: Barrett-Connor, E, Palinkas, L A
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 12-02-1994; British Medical Association; BMJ Publishing Group LTD; BMJ Group
• Subjects: Age; Aged; Aged, 80 and over; Antidepressants; Antihypertensive Agents - therapeutic use; Antihypertensives; Blood Pressure; California - epidemiology; Chronic diseases; Chronic illnesses; Cohort Studies; Cross-Sectional Studies; Depression - epidemiology; Depression - etiology; Depressive disorders; Diastole; Diastolic blood pressure; Disease; Drugs; Fatigue; Humans; Hypertension; Hypotension - complications; Hypotension - epidemiology; Inventory; Male; Mental depression; Middle Aged; Population; Studies; Systole; Systolic blood pressure; Weight loss; California
• DOI: 10.1136/bmj.308.6926.446
• EISSN: 1468-5833; 1756-1833
• ISSN: 0959-8138

Abstract Objective : To determine if an association exists between low blood pressure and depressive symptoms in older men living in the community. Design : Cross sectional, population based study. Setting : Town of Rancho Bernardo, California, United States. Subjects : 846 men aged 60-89 years. Comparisons between hypotensive, normotensive, and hypertensive groups were limited to 594 men not taking drugs for hypertension. Main Outcome Measures : Mean scores on Beck depression inventory and prevalence of scores >= 13. Results - Men with diastolic blood pressure <75 mm Hg had significantly higher depression scores (mean scores 6.35 v 4.96; P<0.001) and more categorical depression (7.6% v 1.8% with scores >=13; P<0.01) than men with diastolic blood pressure levels between 75 and 85 mm Hg. Men with diastolic blood pressure levels >85 mm Hg had higher depression scores than men with intermediate blood pressure levels (mean scores 5.85 v 4.96; P<0.05). Men with diastolic hypotension scored significantly higher on both affective and somatic item subscales of the Beck depression inventory and on individual measures of fatigue, pessimism, sadness, loss of appetite, weight loss, and preoccupation with health. Low diastolic blood pressure was a significant predictor of both mean depression score and prevalence of categorical depression, independent of age and change in weight since the baseline visit. The presence of several chronic diseases was associated with depressed mood and higher blood pressure but not with low blood pressure. Conclusion : The association of relatively low diastolic blood pressure with higher depressive symptom scores and rates of categorical depression was independent of age or weight loss. Since fatigue is a prominent symptom of depression, any association of low blood pressure with fatigue could reflect depressive disorders or clinically important depression.