Relationship of depressive symptoms to hypertension in a household survey in Harlem.
OBJECTIVE
Two possible explanations for an hypothesized association between depression and hypertension were examined: (1) shared stress-related risk factors are associated with both depression and hypertension and (2) life-style factors associated with depression lead to hypertension.


METHODS
A predominantly black sample of 695 adults were interviewed in the Harlem Household Survey. Two measures of hypertension were used and compared-1) self-report and 2) elevated blood pressure (above 140/90 mm Hg)-on the basis of the mean of two blood pressure measures. Depressive symptoms were measured by use of a 24-item scale based on the Diagnostic Interview Schedule. Logistic regression models were used to test associations between hypertension and depressive symptoms, stressors, and life-style factors.


RESULTS
Depressive symptoms were associated with self-reported hypertension but not with elevated blood pressure. The association between self-reported hypertension and depressive symptoms was explained partly by shared stress-related risk factors but not by life-style factors. Several stressors and life-style variables were risk factors for elevated blood pressure independently of depressive symptoms. The findings are consistent with studies that have measured hypertension variously by either self-report or blood pressure. Possible explanations were explored (labeling and help-seeking) but were not supported by the data.


CONCLUSIONS
An association was found between self-reported hypertension and depressive symptoms, which was explained partly by shared stress-related risk factors. Elevated blood pressure was associated with stressors and life-style factors but not with depressive symptomatology. Research on illness representations and cultural dimensions of health suggest avenues for further investigation.
Reiff
M
M
Division of Sociomedical Sciences, Joseph L. Mailman School of Public Health, Columbia University, New York, New York 10032, USA. mr82@columbia.edu
Schwartz
S
S
Northridge
M
M
D000328:Adult; D001741:Black or African American / Q000523:psychology; D000368:Aged; D001794:Blood Pressure; D001795:Blood Pressure Determination; D003863:Depression / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology*; D008016:Life Change Events; D008019:Life Style / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D011159:Population Surveillance; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012494:Sampling Studies; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000503:physiopathology*