The Relation between Blood Pressure and Depressive Symptoms in the Baltimore Longitudinal Study of Aging

Prior studies have identified inconsistent cross-sectional and longitudinal associations between depressive symptoms and blood pressure (BP). The present study examined whether the coincident relation between BP and depressive symptoms is curvilinear, where depressive symptoms predict both higher and lower BP. A total of 2,087 participants from the Baltimore Longitudinal Study of Aging (aged 19 to 97, 53% men, 74% white) underwent clinical BP measurement and completed the Center for Epidemiological Studies-Depression scale on up to 14 occasions (Mean=3.8, SD=2.6) over up to 29 years (Mean=7.8, SD=6.4) of follow-up. Both cross-sectional (linear regression) and longitudinal (mixed-effects regression) analyses were performed to identify whether depressive symptomatology significantly predicted coincident BP, following statistical adjustment for common risk factors for depression and cardiovascular disease. Also, exploratory analyses were conducted to whether the relation between depressive symptoms and BP was modified by age and/or sex. Data analyses revealed that the main hypothesis was not supported either cross-sectionally or longitudinally. Instead, there was evidence that greater depressive symptoms were associated with greater BP levels. Exploratory analyses revealed sex and age differences in the relation between depressive symptoms and BP, where greater levels of depressive symptoms may confer risk for increased BP levels particularly for women and older adults, even with very few depressive symptoms. These results point to the importance of preventing, detecting, and lowering depressive symptoms as a way to prevent hypertension and cardiovascular disease, particularly for women and older adults