Relationship of depressive symptoms to hypertension in a household survey in Harlem

Objective: Two possible explanations for an hypothesized association betwee n depression and hypertension were examined: (1) shared stress-related risk factors are associated with both depression and hypertension and (2) life- style factors associated with depression lead to hypertension. Methods: A p redominantly black sample of 695 adults were interviewed in the Harlem Hous ehold Survey. Two measures of hypertension were used and compared-1) self-r eport and 2) elevated blood pressure (above 140/90 mm Hg)-on the basis of t he mean of two blood pressure measures. Depressive symptoms were measured b y use of a 24-item scale based on the Diagnostic Interview Schedule. Logist ic regression models were used to test associations between hypertension an d depressive symptoms, stressors, and life-style factors. Results: Depressi ve symptoms were associated with self-reported hypertension but not with el evated blood pressure. The association between self-reported hypertension a nd depressive symptoms was explained partly by shared stress-related risk f actors but not by life-style factors. Several stressors and life-style vari ables were risk factors for elevated blood pressure independently of depres sive symptoms. The findings are consistent with studies that have measured hypertension variously by either self-report or blood pressure. Possible ex planations were explored (labeling and help-seeking) but were not supported by the data, Conclusions: An association was found between self-reported h ypertension and depressive symptoms, Which was explained partly by shared s tress-related risk factors. Elevated blood pressure was associated with str essors and life-style factors but not with depressive symptomatology. Resea rch on illness representations and cultural dimensions of health suggest av enues for further investigation.