June 6, 2014Open Access
Symptoms of anxiety and depression across adulthood and blood pressure in late middle age
Key Result
Cumulative symptoms of anxiety and depression across adulthood were associated with lower systolic blood pressure at age 60-64 (-3.93 mmHg for 3-4 time-points vs never; 95% CI -7.19 to -0.68).
Study Design
Type
Cohort (n=1,683)
Structured PICO
Do cumulative symptoms of anxiety and depression across adulthood affect blood pressure in late middle age?
P
Population
1683 participants from the MRC NSHD
I
Intervention
Affective symptoms (anxiety and depression) at ages 36, 43, 53 and 60-64 years, assessed as a categorical cumulative score
C
Comparator
Participants never meeting case criteria for affective symptoms
O
Outcome
Systolic blood pressure (SBP) and diastolic blood pressure (DBP) at age 60-64surrogate
A cumulative history of anxiety and depression symptoms across adulthood is associated with lower systolic blood pressure in late middle age, independent of lifestyle factors and antihypertensive treatment.
Main Result
Effect estimate: Difference -3.93 mmHg (95% CI -7.19 to -0.68)
p-value: p=0.022
Abstract
OBJECTIVE: Previous studies testing the hypothesis that symptoms of anxiety and depression increase blood pressure (BP) levels show inconsistent and limited findings. We examined the association between those symptoms across adult life and BP in late middle age. METHODS: Using data from 1683 participants from the MRC NSHD, we investigated associations between affective symptoms at ages 36, 43, 53 and 60-64 years and SBP and DBP at age 60-64. Multivariable linear regression was used to examine the effect on BP of affective symptoms at each age separately and as a categorical cumulative score based on the number of times an individual was classified as a 'case'. Models were adjusted for sex, BMI, educational attainment, socio-economic position, heart rate, lifestyle factors and antihypertensive treatment. RESULTS: In fully adjusted models, we observed lower SBP in study members with case-level symptoms at one to two time-points -1.83 mmHg; 95% confidence interval (CI) -3.74 to 0.01 and at three to four time-points (-3.93 mmHg; 95% CI -7.19 to -0.68) compared with those never meeting case criteria suggesting a cumulative inverse impact of affective symptoms on SBP across adulthood (P value for trend 0.022). Sex and BMI had a large impact on the estimates while not other confounders. Potential mediators such as heart rate and lifestyle behaviours had a little impact on the association. SBP at age 36 and behavioural changes across adulthood, as additional covariates, had a little impact on the association. A similar but weaker trend was observed for DBP. CONCLUSION: A cumulative effect of symptoms of anxiety and depression across adulthood results in lower SBP in late middle age that is not explained by lifestyle factors and antihypertensive treatment. Mechanisms by which mood may impact BP should be investigated.