Key result
Depression linked to ~52% higher mortality in hypertensive patients sitting over six hours daily.
Why the study?
Depression involves chronic inflammation that can be affected by sedentary behavior, but whether sedentary behavior modifies the association between depression and mortality risk in hypertension was unknown.
Does sedentary behavior modify the association between depression and risk of all-cause death in patients with hypertension?
Cohort (n=8,124)
Yes
Does sedentary behavior modify the association between depression and risk of all-cause death in patients with hypertension?
Effect estimate: HR 1.52 (95% CI 1.22-1.91)
p-value: p=<0.001
Reducing sedentary time to less than 6 hours per day may mitigate the increased mortality risk associated with depression in hypertensive patients.
Sedentary time may modify depression-mortality risk in hypertension; leaves open whether reducing sitting improves outcomes.
OBJECTIVE: The pathogenic mechanism of depression involves chronic inflammation, which can be affected by sedentary behavior. This study aimed to determine whether sedentary behavior modified the association between depression and risk of death in the hypertensive population. METHODS: Data from the National Health and Nutrition Examination Survey (2007-2018) was analyzed. Depression was assessed through the Health Questionnaire-9, and sedentary behavior was evaluated using self-reported sitting hours in a day. Deaths were ascertained through the National Death Index until 31 December 2019. The interaction effect was evaluated through multivariable Cox regression analysis. RESULTS: Eight thousand one hundred and twenty-four patients with hypertension were involved in the study. During a median follow-up of 7.3 years, we confirmed 1384 all-cause and 373 cardiovascular deaths. Separate analyses revealed that both depression and sitting for 6 h per day or more were correlated with increased risks of all-cause and cardiovascular deaths. Of note, we found that sitting time modified the link between depression and the risk of all-cause death (P for interaction: 0.02). Compared with the nondepression group, the depression group was correlated with an elevated risk of all-cause death among participants with sitting time of more than 6 h/day [hazard ratio 1.52, 95% confidence interval (CI) 1.22-1.91, P < 0.001], but not among participants with sitting time of less than 6 h/day (hazard ratio 0.95, 95% CI 0.65-1.39, P = 0.76). CONCLUSION: Sedentary behavior modified the link between depression and the risk of all-cause death. Reducing sedentary time might attenuate the detrimental effects of depression on survival in the hypertensive population.
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Wang et al. (2024) conducted a cohort in Hypertension (n=8,124). Depression and sedentary behavior (>6 hours/day sitting) vs. Nondepression and <6 hours/day sitting was evaluated on All-cause death (HR 1.52, 95% CI 1.22-1.91, p=<0.001). Depression increased the risk of all-cause death in hypertensive patients sitting >6 hours/day (HR 1.52; 95% CI 1.22-1.91; P<0.001), but not in those sitting <6 hours/day.
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