Home Blood Pressure Is Associated with Depressive Symptoms in an Elderly Population Aged 70 Years and Over: A Population-Based, Cross-Sectional Analysis

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Abstract
Although several epidemiologic studies have assessed the relationship between low blood pressure and depressive symptoms in geriatric populations, the results have been inconsistent. Because the white-coat phenomenon is observed frequently in patients with depressive symptoms, we have considered that blood pressure measured in nonmedical settings is important in assessing the relationship between blood pressure and depressive symptoms among the geriatric population. The aim of this study was to investigate the relationships between home blood pressure and depressive symptoms in a community-based elderly population aged 70 years and over. We analyzed a cross-sectional survey comprised of 888 community-dwelling Japanese aged 70 years and older. Blood pressure was self-measured at home, and depressive symptoms were evaluated using the 30-item Geriatric Depression Scale (GDS 30) with a cutoff point of 11. The prevalence of depressive symptoms was 34.8%. For all subjects, after adjustments for potentially confounding factors, the odds ratios of having depressive symptoms by increasing quartiles of systolic blood pressure of subjects not taking antihypertensive drugs to subjects taking them were 1.00, 0.97, 0.88, 0.59, and 0.70. Statistically significant inverse relationships were observed in subjects not taking antihypertensive drugs. No apparent association between diastolic blood pressure and depressive symptoms was observed in any subjects or in a stratified analysis of antihypertensive drug use. In this study, a higher home systolic blood pressure was independently and continuously related to a lower prevalence of depressive symptoms in participants not using antihypertensive medication. Further study is required to clarify the causality of this relationship.