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 symptomato logy and blood pressure control and the longitudinal association betwe en depressive symptomatology and blood pressure control, stroke, and c ardiovascular-related mortality. Data are from the East Boston, Massac husetts; New Haven, Connecticut; and Iowa sites of the Established Pop ulations for Epidemiologic Studies of the Elderly, conducted between 1 982 and 1988. Age-adjusted site- and gender-specific analyses were con ducted, unadjusted and adjusted for baseline health status. There was no consistent association, cross-sectionally or longitudinally, betwee n depressive symptoms and blood pressure control. Rates of stroke were 2.3 to 2.7 times higher in most subgroups with high depressive sympto matology in contrast to their nondepressed counterparts. Rates of card iovascular 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 ad ults with diagnosed hypertension may place them at increased risk of s troke and possibly cardiovascular-related death relative to other elde rly persons with diagnosed hypertension. Because the fate of stroke in this subpopulation was exceptionally high, further evaluation of the role of depressive symptoms in the progression of hypertensive disease seems warranted.