Abstract

Background: Patients with severe mental illness including depression may have multiple co-morbid physical illnesses. Systemic hypertension and lifestyle factors may increase mortality in patients with depression.

Objective: To study co-morbid hypertension and associated lifestyle factors in patients with major depression.

Methods: Cross section observational study at a tertiary care hospital.

Results: Patients evaluated after exclusion were 400. Majority of patients 69(34.5%) had moderate depression. The mean duration of illness was 58.94 ± 77.26 months with no significant difference between males and females (P = 0.830). Co-morbid psychiatric illness was present in 73(36.5%) study subjects. Co-morbid conditions were present in 106 (26.5%) patients. The prevalence of hypertension in our cohort was 18.5%. A total of 216 patients (54%) were found to be obese; it was significantly higher (Chi-square test, P = 0.024) in females (63.7%) as compared to males (47.5%). Inadequate physical activity was seen in 44.5% patients. On correlation analysis, a significant correlation (P<0.05) was observed between hypertension with obesity and family history of non-communicable disease. On binary logistic regression, in patients with depression, those with positive family history of non-communicable disease (OR = 2.6), increased duration of illness (OR = 1.3) and physical inactivity (OR = 2.1) were more likely to have hypertension.

Conclusion: A bidirectional association may exist between depression and hypertension with increased risk of cardiovascular morbidity.

Keywords: Major Depression; Hypertension; Global Physical Activity Questionnaire; Body Mass Index

References

1. Frenk J., et al. “Health professionals for a new century: transforming education to strengthen health systems in an interdependent world”. Lancet 9756 (2010): 1923-1958.
2. NCD mortality and morbidity.
3. Williams JBW. “A Structured Interview Guide for the Hamilton Depression Rating Scale”. Archives Of General Psychiatry 8 (1988): 742-747.
4. Zimmerman M., et al. “Severity classification on the Hamilton Depression Rating Scale”. Journal of Affective Disorders 2 (2013): 384-388.
5. Piccirillo JF., et al. “The changing prevalence of comorbidity across the age spectrum”. Critical Reviews in Oncology/Hematology 2 (2008): 124-132.
6. Gilman SE., et al. “Depression and mortality in a longitudinal study: 1952-2011”. CMAJ42 (2017): E1304-E1310.
7. Ong KL., et al. “Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004”. Hypertension1 (2007): 69-75.
8. Lacruz ME., et al. “Prevalence and Incidence of Hypertension in the General Adult Population: Results of the CARLA-Cohort Study”. Medicine (Baltimore)22 (2015): e952.
9. Singh S., et al. “Prevalence and associated risk factors of hypertension: A cross sectional study in urban Varanasi”. International Journal of Hypertension 16 (2017): 126-136.
10. Anchala R., et al. “Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension”. Journal of Hypertens 6 (2014): 1170-1177.
11. Adamis D and Ball C. “Physical morbidity in elderly psychiatric inpatients: Prevalence and possible relations between the major mental disorders and physical illness”. International Journal of Geriatric Psychiatry 3 (2000): 248-253.
12. Nakagawara M., et al. “Hypertension in depression”. Psychology Research1 (1987): 85-86.
13. Jonas BS., et al. “Are symptoms of anxiety and depression risk factors for hypertension? Longitudinal evidence from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study”. Archives of Family Medicine 1 (1997): 43-49.
14. Jonas BS and Lando JF. “Negative affect as a prospective risk factor for hypertension”. Psychosome Medicine2 (2000): 188-196.
15. Kario K., et al. “Gender differences in associations of diurnal blood pressure variation, awake physical activity, and sleep quality with negative affect”. Hypertension5 (2001): 997-1002.
16. Pradeepa R., et al. “Prevalence of generalized and abdominal obesity in urban and rural India- the ICMR - INDIAB Study (Phase-I) [ICMR - INDIAB-3]”. Indian Journal of Medical Research 142 (2015): 139-146.
17. Brummett BH., et al. “Effect of smoking and sedentary behavior on the association between depressive symptoms and mortality from coronary heart disease”. American Journal of Cardiology5 (2003): 529-532.
18. Teychenne M., et al. “Physical activity and likelihood of depression in adults: a review”. Preventive Medicine 46 (2008): 397-941.
19. Roshanaei-Moghaddam B., et al. “The longitudinal effects of depression on physical activity”. General Hospital Psychiatry 31 (2009): 306-315.

Citation

Citation: Varun Malhotra., et al. “A Study of Hypertension and Associated Health Related Life Style Behaviours in Patients with Depression". Acta Scientific Ophthalmology 3.11 (2020): 39-45.

Copyright

Copyright: © 2020 Varun Malhotra., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.