title: Decreased nocturnal systolic blood pressure fall in older subjects with depression.
abstract: Depressed subjects have a two-fold increased risk of CV events than non-depressed ones. Altered blood pressure (BP) circadian profile may be one mechanism underlying this association. We studied 135 elderly subjects (mean age 78+/-6 yrs, range 69- 93; 30 M, 87 F). On the basis of the 15-items Geriatric Depression Scale (GDS), score>5 identified subjects with depressive symptoms. Based upon 24-h Ambulatory BP Monitoring (Spacelabs 90207), the following BP circadian profile measures were examined: SD of 24-h, day, and night SBP, DBP, MBP; 24-h, day, and night SBP and DBP load; night SBP and DBP decline; dipping status for SBP and DBP. Compared with non-depressed subjects (n=61), depressed subjects (n=74) were similar in age and more likely to be women. No significant differences in traditional CV risk factors or in medication use were observed between the two groups. After controlling for age, sex, and traditional CV risk factors, subjects with depressive symptoms presented a significantly lower night-time SBP fall than non-depressed ones (average, -4.4 mmHg for SBP) with a significantly higher occurrence of non-dipper status. The GDS score was an independent significant inverse determinant of 24-h SD of SBP. Depressive symptoms in older subjects are accompanied by lower nocturnal BP fall and are significant independent determinants of SBP variability.
authors: UO Geriatria, INRCA/IRCCS, Roma, Via Cassia 1167, 00189 Roma, Italy. angeloelefante@interfree.it
authors: Angelo
authors: A
authors: Scuteri
authors: Gianfranco
authors: G
authors: Spalletta
authors: Marcello
authors: M
authors: Cangelosi
authors: Walter
authors: W
authors: Gianni
authors: Antonio
authors: A
authors: Assisi
authors: Anna Maria
authors: AM
authors: Brancati
authors: Anna
authors: A
authors: Modestino
authors: Carlo
authors: C
authors: Caltagirone
authors: Massimo
authors: M
authors: Volpe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm / Q000502:physiology*; D003863:Depression / Q000503:physiopathology*; D003866:Depressive Disorder / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D018670:Monitoring, Ambulatory / Q000379:methods; D009991:Oscillometry; D011379:Prognosis; D012727:Sex Characteristics; D013599:Systole / Q000502:physiology*