Do depression symptoms predict early hypertension incidence in young adults in the CARDIA study?

Background: Hypertension has been linked to several psychological factors, including depression, but the relation between hypertension incidence and d epressive symptoms has not been adequately examined. Objective: To determine if depressive symptoms independently predict hypert ension incidence. Design and Setting: A prospective, multicenter, epidemiological cohort of y oung adults (aged 23-35 years at study entry) from the general community wi thout hypertension followed up for 5 years. Subjects: A sample of 3343 adults from 4 urban areas stratified fur race (b lack and white) from the CARDIA (Coronary Artery Risk Development in Young Adults) study. Main Outcome Measure Hypertension incidence, which was defined as blood pre ssure higher than 160/95 mm Hg (assessed on a single occasion) or the use o f prescribed antihypertensive medication. Results: Participants with high scores (greater than or equal to 16) on the Center for Epidemiological Studies Depression (CES-D) Scale were at signif icant risk for hypertension incidence compared with those with low CES-D sc ores (less than or equal to 7; odds ratio, 2.10; 95% confidence interval, 1 .22-3.61) after adjustment for other hypertension risk factors leg, age, re sting systolic blood pressure at the 5-year examination, physical activity, daily alcohol use, parental history of hypertension, education, presence o f diabetes mellitus or heart disease, sex, and race) in fixed logistic mode ls. Those with intermediate depressive symptoms (CES-D scores 8-15) were al so at significant risk (adjusted odds ratio, 1.78; 95% confidence interval, 1.06-2.98). These associations were significant in blacks alone but were n ot found in whites, who had a lower hypertension incidence (29 [2%] of 1806 ) than blacks (89 [6%] of 1537). Conclusions: Depressive symptoms were predictive of later hypertension inci dence in young adults, and young blacks with depressive symptoms were at hi gh risk of developing hypertension.