Background: Depression may delay the identification, treatment or control of hypertension (HT) due to competing demands on provider's time and attention, or impact of depression on adherence to lifestyle treatment or pharmacotherapy of HT.
Objective: We seek to test whether incident hypertensive patients with depression had lower rates of hypertension control, recognition and treatment initiation than patients without depression.
Methods: Data were obtained from the CVRN Hypertension Superset Registry derived from the VDW from three sites including HPMG. Adults meeting incident hypertension criteria and with two consecutive elevated blood pressure measures from 2003 through 2009 were followed until they achieved two consecutive blood pressures under control. Recognition of HT by diagnosis codes, and initiation of treatment for hypertension were also assessed. Depression status was classified based on an algorithm including outpatient and inpatient diagnoses, and classified as definite depression, possible depression or no evidence of depression. Crude and adjusted outcome rates were calculated at 6 month and 12 month after hypertension onset.
Results: We analyzed 210,000 subjects, mean age 50+14 years, 53% female, with mean follow up of 4.5 years. At 1-year those with definite depression, possible depression and no depression had 67%, 63%, and 53% at BP goal, 23%, 25% and 28% with hypertension recognition, and 29%, 30%, and 32% with treatment initiation.
Conclusion: Patients with depression had better HT control than patients without depression, perhaps due to transient elevation of BP associated with depression, or perhaps due to increased numbers of outpatient visits.