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Association of hypertension with depression and generalized anxiety symptoms in a large population-based sample of older adults

Maatouk, Imada; Herzog, Wolfganga; Böhlen, Friederikea; Quinzler, Renateb; Löwe, Berndc; Saum, Kai-Uwed; Brenner, Hermannd; Wild, Beatea

doi: 10.1097/HJH.0000000000001006

Objective: The aim of the study was to assess the association of hypertension and symptoms of depression and generalized anxiety in a large cohort of elderly people.

Methods: Data were derived from the 8-year follow-up (2008–2010) of the epidemiological ESTHER-cohort study. A total of 3124 randomly chosen participants aged 57–84 were visited at their homes by trained study doctors. General practitioner based diagnosis, self-reported status of hypertension, medication, and blood pressure measurement were considered to define the existence of hypertension. Depression and general anxiety severity were assessed using validated questionnaires. Logistic regression analyses were performed to determine cross-sectional associations between hypertension and clinically significant symptoms of depression (CSD) and generalized anxiety. Well known lifestyle risk factors for hypertension such as obesity were included in multivariate cross-sectional analyses.

Results: Hypertension was prevalent in 1659 participants [53.1%; 95% confidence interval (CI) = (51.3; 54.9)]. CSD was detected in 163 participants [5.2%; 95%-CI = (4.4; 6.0)]. Symptoms of generalized anxiety were found in 434 participants [13.9%; 95%-CI = (12.7; 15.1)]. Patients with CSD showed significantly higher odds of being hypertensive [odds ratio (OR) = 1.76; 95%-CI = (1.14; 2.74)]. Participants with symptoms of generalized anxiety were found to have no higher odds for a hypertension diagnosis [OR = 1.1; 95%-CI = (0.85; 1.44)]. Overweight [OR = 1.86; 95%-CI = (1.53; 2.25)] as well as obesity [OR = 3.58; 95%-CI = (2.84; 4.52)] was significantly associated with hypertension.

Conclusion: CSD appear to be related to hypertension in elderly adults. No association was found between symptoms of generalized anxiety and hypertension.

aDepartment of General Internal Medicine and Psychosomatics, Medical University Hospital

bDepartment of Clinical Pharmacology, Medical University Hospital, Heidelberg

cDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center, Hamburg-Eppendorf, Hamburg

dDivision of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany

Correspondence to Imad Maatouk, Department of General Internal Medicine and Psychosomatics, Medical University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. Tel: +49 0 6221 56 37585; fax: +49 0 6221 56 5749; e-mail:

Abbreviations: CSD, clinically significant symptoms of depression; GAD, generalized anxiety disorder; GP, general practitioner; PA, physical activity

Received 7 February, 2016

Revised 4 April, 2016

Accepted 15 May, 2016

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