Depression Incidence in Patients with Hypertension in a Single Outpatient Center

Introduction: Hypertension and depression are both highly prevalent in the United States and each condition is commonly managed in the outpatient setting. This study aims to investigate the incidence of depression in patients who are diagnosed with hypertension. Methods: A retrospective cohort study was conducted analyzing 9,240 adult patients at a single-center outpatient clinic between 2019 and 2022. Blood pressure and PHQ-9 from the latest outpatient visit were recorded. Demographic data associated with hypertension were also obtained. Bivariate statistical analysis was performed. Multivariate linear and logistic regression models were adjusted for co-morbid conditions. Results: Out of the 9,240 patients studied, 3,694 (40%) had a diagnosis of hypertension. Patients with hypertension were more likely to be older (61.96 ± 14.95 vs 39.85 ± 15.61, p=0.000), male (37% vs 33%, p =0.002) and black (45.2% vs 23.3%, p<0.001) compared with those without a diagnosis of hypertension. The mean PHQ-9 score was higher in patients with hypertension than in those without (2.97 ± 4.66 vs 2.70 ± 4.93, p=0.000). Patients with hypertension were more likely to have uncontrolled depression defined as PHQ-9 score >4 (22.55% vs 19.4%, p<0.001) even when adjusted for co-morbid conditions (adj OR 1.216 95% CI 1.06 -1.34 p=0.005). Conclusions: In this cohort of patients, a diagnosis of hypertension was associated with an increased rate of uncontrolled depressive symptoms. Hence patients with hypertension should be screened using validated PHQ-9 tools in the outpatient setting and offered appropriate treatment for depression.