The relationship of depression with the level of blood pressure in population-based Kangbuk Samsung Health Study

There has been increasing evidence about psychosomatic relationship between mood disorder and blood pressure (BP). However, the degree to which BP categories are associated with depression has been less well described. Thus, this study was to investigate the association of depression with BP categories. A total of 90,643 men and 68,933 women were enrolled in this study. They were stratified into four groups (normal, prehypertension, newly diagnosed hypertension, and recognized hypertension) according to the BP levels and the history of hypertension. Center for Epidemiological Studies–Depression was used to evaluate the depressive symptom, and the degree of depression was evaluated by the cutoff of Center for Epidemiological Studies–Depression (mild: 16–20, moderate: 21–24, severe: ≥25). The multivariate logistic regression was used in calculating odds ratios for depression according to the four BP categories, with adjustment for multiple confounding factors. Subgroup analysis was conducted by gender and age. The adjusted odds ratios for depression tended to decrease from normal to newly diagnosed hypertension, but significantly increased in recognized hypertension (normal: reference, prehypertension: 0.85 [0.80–0.91], newly diagnosed hypertension: 0.75 [0.65–0.86], recognized hypertension: 1.11 [1.03–1.20]). Subgroup analysis also indicated the similar pattern of relationship, which was more prominent in male and middle-aged subgroup than any other subgroups. Depression was inversely associated with elevated BP. However, recognized hypertension had the increased likelihood of depression in male and young age group. These findings suggest that the association between depression and BP may be moderated by the chronicity of hypertension in men and young individuals.