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April 1, 2025BMJ OpenOpen Access

Association of depressive symptoms with non-fatal cardiovascular disease in middle-aged and elderly patients with hypertension: a cohort study from China

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Why the study?

The study explored the association between depressive symptoms and non-fatal cardiovascular disease, along with other risk factors, in middle-aged and elderly patients with hypertension in China.

Are depressive symptoms associated with an increased risk of non-fatal cardiovascular disease in middle-aged and elderly patients with hypertension?

Population

1755 middle-aged and elderly patients with hypertension aged 45 and above in China

Comparison

Varying levels of depressive symptoms

Design

Prospective cohort study

Follow-up

9-year period

Key result

Severe depressive symptoms significantly increased the risk of non-fatal cardiovascular disease by 67% (HR 1.67) compared to no depressive symptoms in middle-aged and elderly patients with hypertension.

Authors

CXCongshang XieLGLei GaoZWZezhong Wang

Discussion

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Member takes

Overview

Depressive symptoms may identify higher-risk hypertensive patients; leaves open whether intervention reduces non-fatal CVD events.

Study Design

Type

Cohort (n=1,755)

Multicenter

Yes

Structured PICO

Are depressive symptoms associated with an increased risk of non-fatal cardiovascular disease in middle-aged and elderly patients with hypertension?

P
Population
1,755 middle-aged and elderly patients with hypertension in China, free of malignancy and prior stroke, followed for up to 9 years.
E
Exposure
Depressive symptoms (measured using the Center for Epidemiologic Studies Depression Scale-10)
O
Outcome
Non-fatal cardiovascular disease (ascertained based on self-reported, physician-diagnosed heart disease)hard clinical

Main Result

Hazard Ratio: 1.67 (95% CI 1.37–2.02)

Depressive symptoms have a graded, positive linear correlation with incident non-fatal cardiovascular disease in middle-aged and elderly Chinese patients with hypertension.

Limitations

  • Identification of hypertension and non-fatal cardiovascular disease was based on a structured questionnaire, introducing potential recall bias due to lack of access to medical records.
  • Exclusion of all deaths during follow-up potentially introduced selection bias by eliminating competing risks unrelated to cardiovascular outcomes.
  • The precise cause of depression cannot be ascertained due to the observational nature of the baseline characteristics.

Cite This Study

Xie et al. (2025) conducted a cohort in Hypertension (n=1,755). Severe depressive symptoms vs. No depressive symptoms was evaluated on Non-fatal cardiovascular disease (HR 1.67, 95% CI 1.37 to 2.02). Severe depressive symptoms significantly increased the risk of non-fatal cardiovascular disease by 67% (HR 1.67) compared to no depressive symptoms in middle-aged and elderly patients with hypertension.

synapsesocial.com/papers/6a7dbfbea76b9ebabb045380https://doi.org/10.1136/bmjopen-2024-087905
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