August 1, 2002Open Access
Depression and mortality in a high-risk population
Key Result
Depression was associated with a 43% increased risk of mortality (HR 1.43) in older adults with moderate hypertension, independent of cardiovascular risk factors and cognitive decline.
Study Design
Type
Cohort (n=2,584)
Multicenter
Yes
PICO
P
Population
2,584 older adults aged 65-75 years with moderate hypertension, free of serious cardiovascular disease or dementia, followed for 11 years.
E
Exposure / Comparator
Depression vs No depression
O
Primary Outcome
Mortality — HR 1.43 (1.03-1.98), p=0.040
Main Result
Hazard Ratio: 1.43 (95% CI 1.03–1.98)
p-value: p=0.040
Limitations
- Restricted to a relatively healthy group, limiting generalisability to younger or normotensive populations.
- Smoking was coded only as a binary variable, which might lead to residual confounding.
- Depression was measured using a questionnaire rather than clinical interviews, potentially leading to misclassification.
- Unable to control effectively for exercise or alcohol intake.
Abstract
BACKGROUND: It is not clear whether the increased mortality associated with depression can be explained by the effects of potential confounding variables. AIMS: To measure the effect of depression on mortality after controlling for cognitive decline, cardiovascular risk factors and antidepressant use. METHOD: A prospective cohort study derived from data from a multi-centre randomised controlled trial of moderate hypertension. A total of 2584 participants, aged 65-75 years at study entry, were followed up for 11 years. RESULTS: Depression on the SelfCARE-D scale was associated with mortality after controlling for gender. After controlling for cardiovascular risk factors, cognitive decline and antidepressant use, depression continued to have a modest effect (hazard ratio=1.43; 95% C11.03-1.98). Depression in males and in people aged under 70 years significantly increased the risk of death. CONCLUSIONS: Depression was associated with mortality only after controlling for gender. There was a modest but robust association between depression and mortality that was not explained by confounding by cardiovascular risk factors, cognitive decline or history of antidepressant use.
Cite This Study
Abas et al. (Thu,) conducted a cohort in Moderate hypertension (n=2,584). Depression vs. No depression was evaluated on Mortality (HR 1.43, 95% CI 1.03-1.98, p=0.040). Depression was associated with a 43% increased risk of mortality (HR 1.43) in older adults with moderate hypertension, independent of cardiovascular risk factors and cognitive decline.