Depressive Symptom Trajectories and Hypertension Risk Among Chinese Middle‐Aged and Older Adults: The China Health and Retirement Longitudinal Study

BACKGROUND: Hypertension remains a formidable global public health challenge. Previous studies have shown that depressive symptoms were associated with the risk of hypertension. Depressive symptoms may vary over time. The purpose of this study was to determine the association between trajectories of depressive symptoms and the risk of hypertension among Chinese middle-aged and older adults. METHODS: A total of 6737 individuals aged 45 and above from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020 were included. Group-based trajectory modeling was used to identify trajectories of depressive symptoms measured by the Center for Epidemiologic Studies Depression scores from 2011 to 2015, and a multivariable competitive logistic regression model was used to examine the association of depressive symptom trajectories with hypertension during follow-up. RESULTS: Five trajectories of depressive symptoms were identified: stable-low (63.8%), increasing to decreasing (5.7%), increasing (11.0%), decreasing (12.9%), and stable-high (6.6%). During 2015-2020, a total of 1710 individuals experienced hypertension. Compared with participants in the stable-low depressive symptom trajectory group, those following increasing to decreasing (OR: 1.41, 95% CI: 1.10-1.79), increasing (OR: 1.45, 95% CI: 1.21-1.74), decreasing (OR: 1.32, 95% CI: 1.10-1.57), and stable-high depressive symptom trajectories (OR: 1.66, 95% CI: 1.31-2.10) all showed a significantly higher risk of hypertension. CONCLUSIONS: Depressive symptoms trajectories were strongly related to the risk of hypertension in middle-aged and older adults in China. Dynamic changes in depressive symptoms may be clinically instructive for hypertension prevention in Chinese middle-aged and elderly populations.