What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension and depression (n=354). Primary outcome: Mean diastolic blood pressure difference between no-minimal and moderately severe-severe depression (3.86 mmHg, 95% CI 0.45 to 7.27, p=0.022).

What does this research mean for the field?

Among medical students, moderately severe to severe depression is associated with a 3.86 mmHg higher mean diastolic blood pressure compared to having no or minimal depression. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

December 1, 2022Open Access

Hypertension and depression among medical students: is there an association?

Key Result

Among medical students, moderately severe to severe depression was associated with a 3.86 mmHg higher mean diastolic blood pressure compared to no or minimal depression.

Study Design

Type

Cross-Sectional (n=354)

Multicenter

Structured PICO

Is there an association between depression scores and blood pressure among medical students?

Population

354 medical students in their clinical years from Jordan University Hospital (Amman, Jordan), mean age 21.16 years, 55.4% female. Excluded participants previously diagnosed with hypertension.

Outcome

Frequency of hypertension and depression, and the association between depression scores (PHQ-9) and mean arterial pressure/diastolic blood pressuresurrogate

Higher depression scores are associated with higher diastolic blood pressure among medical students, suggesting a potential benefit in dual screening for both conditions.

Main Result

Effect estimate: 3.86 mmHg (95% CI 0.45 to 7.27)

p-value: p=0.022

Limitations

Relatively small sample size
Conducted during the COVID-19 pandemic, which may explain higher rates of depression

Abstract

Introduction: Several studies suggested a higher prevalence of hypertension and depression among medical students. Patients with depression have a higher prevalence of hypertension and vice versa. In this study, we assessed the frequency of hypertension and depression in a sample of medical students and the impact of depression on hypertension. Methods: We recruited medical students from the largest medical school in Jordan. For each participant, we measured blood pressure and heart rate under standardized measurement conditions. Participants were also surveyed using the 9-item Patient Health Questionnaire (PHQ-9). We performed univariate analysis followed by linear regression analysis of factors affecting mean arterial pressure. Results: 354 medical students were included. The mean age was 21 years. 196 (55.4%) were females and 158 (44.6%) were males. 139 (70.9%) of females had normal blood pressure (BP), 7 (3.6%) had elevated BP, 44 (22.4%) had stage 1 hypertension (HTN), and 6 (3.1%) had stage 2 HTN. Within males: 60 (38.0%) had normal BP, 27 (17.1%) had elevated BP, 55 (34.8%) had stage 1 HTN, and 16 (10.1%) had stage 2 HTN. 114 participants (32.2%) had no or minimal depression, 197 (55.6%) had mild-moderate depression and 43 (12.1%) had moderately severe-severe depression. There was an association between higher depression scores and higher diastolic blood pressure. Conclusion: The frequency of hypertension and depression was notably high in our sample. There was an association between higher depression scores and higher diastolic blood pressure. We strongly believe that this association should encourage us again to screen our hypertensive patients in general for depression and vice versa. We also recommend adopting screening programs for depression and hypertension in general.

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