Examining the Interplay of Social Support, Depression, and Blood Pressure: The Strong Heart Family Study

Thesis (Master's)--University of Washington, 2023Compared to the general US population, American Indian (AI) adults have disproportionately higher rates of mental health symptoms, including depression. In 2019, over 18% (n=260,000) of surveyed American Indians/Alaska Natives (AI/AN) 18 years of age or older experienced mental illness during the past year. Several cross-sectional studies have also shown that depression is common in individuals with uncontrolled hypertension (HTN) and may interfere with blood pressure control. To date, few studies have examined the association of symptoms consistent with depression with the development of HTN among AIs despite the high burden of HTN and depression in this population. The purpose of this analysis was to examine the association of depressive symptoms on incident HTN in a large cohort of AIs. As a secondary exploratory analysis, we also examined whether self-reported community and cultural engagement (CCE) impacted this relationship. Results from our analysis suggest that participants who reported depressive symptoms were more likely to develop HTN during a 3-to-8-year follow-up when compared to participants who did not report depressive symptoms. CCE did not appear to impact the observed association of depression and incident HTN. In conclusion, we found those who experienced symptoms consistent with depression to be at increased risk of incident HTN, consistent with our hypothesis