Depressive symptomatology and hypertension-associated morbidity and mortality in older adults.

This study determines, in a population of older adults with diagnosed hypertension, the concurrent association between depressive symptomatology and blood pressure control and the longitudinal association between depressive symptomatology and blood pressure control, stroke, and cardiovascular-related mortality. Data are from the East Boston, Massachusetts; New Haven, Connecticut; and Iowa sites of the Established Populations for Epidemiologic Studies of the Elderly, conducted between 1982 and 1988. Age-adjusted site-and gender-specific analyses were conducted, unadjusted and adjusted for baseline health status. There was no consistent association, cross-sectionally or longitudinally, between depressive symptoms and blood pressure control. Rates of stroke were 2.3 to 2.7 times higher in most subgroups with high depressive symptomatology in contrast to their nondepressed counterparts. Rates of cardiovascular disease-related death were also elevated in most subgroups, achieving statistical significance in women from New Haven and Iowa. This study presents evidence that high depressive symptoms in older adults with diagnosed hypertension may place them at increased risk of stroke and possibly cardiovascular-related death relative to other elderly persons with diagnosed hypertension. Because the rate of stroke in this subpopulation was exceptionally high, further evaluation of the role of depressive symptoms in the progression of hypertensive disease seems warranted.