Key result
The combination of very high systolic blood pressure and depressive symptoms was associated with an 83% higher adjusted risk of major adverse cardiovascular events compared to reference blood pressure without depression.
Why the study?
Does the combination of high systolic blood pressure and depression increase the risk of major adverse cardiovascular events in patients with cardiometabolic disease?
Cohort (n=35,537)
Yes
Does the combination of high systolic blood pressure and depression increase the risk of major adverse cardiovascular events in patients with cardiometabolic disease?
The combination of high systolic blood pressure and depression synergistically increases the risk of major adverse cardiovascular events in patients with cardiometabolic disease, highlighting the need for closer monitoring.
Supports hypothesis of synergistic risk in cardiometabolic disease; leaves open whether integrated interventions reduce MACE.
The authors studied the joint effect of blood pressure (BP) and depression on the risk of major adverse cardiovascular outcome in patients with existing cardiometabolic disease. A cohort of 35,537 patients with coronary heart disease, diabetes, or stroke underwent depression screening and BP measurement recorded concurrently. The authors used Cox's proportional hazards to calculate risk of major adverse cardiovascular event (MACE; myocardial infarction/heart failure/stroke or cardiovascular death) over 4 years associated with baseline BP and depression. A total of 11% (3939) had experienced a MACE within 4 years. Patients with very high systolic BP (160-240 mm Hg; hazard ratio, 1.28) and depression (hazard ratio, 1.22) at baseline had significantly higher adjusted risk. Depression had a significant interaction with systolic BP in risk prediction (P=.03). Patients with a combination of high systolic BP and depression at baseline had 83% higher adjusted risk of MACE, as compared with patients with reference systolic BP without depression. Patients with cardiometabolic disease and comorbid depression may benefit from closer monitoring of systolic BP.
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Jani et al. (2016) conducted a cohort in Cardiometabolic disease (coronary heart disease, diabetes, or stroke) (n=35,537). Combination of very high systolic blood pressure (160-240 mm Hg) and depressive symptoms vs. Reference systolic blood pressure (130-139 mm Hg) without depressive symptoms was evaluated on Major adverse cardiovascular event (cardiovascular death or admission due to myocardial infarction/stroke/heart failure) (HR 1.83, 95% CI 1.46-2.30, p=0.03). The combination of very high systolic blood pressure and depressive symptoms was associated with an 83% higher adjusted risk of major adverse cardiovascular events compared to reference blood pressure without depression.
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