title: Sex and age differences in the relation of depressive symptoms with blood pressure.
abstract: BACKGROUND
  Longitudinal associations between depressive symptoms and blood pressure have been inconsistent. Most studies have examined incident hypertension as an outcome, and few have examined effect modification.
  
  
  METHODS
  This study examined moderating influences of sex and age on coincident trajectories of depressive symptoms and blood pressure among 2,087 participants from the Baltimore Longitudinal Study of Aging (aged 19-97 years; 53% men; 74% white). Participants underwent clinical blood pressure measurement and completed the Center for Epidemiological Studies-Depression (CES-D) scale on up to 14 occasions (mean = 3.8; SD = 2.6) over up to 29 years (mean = 7.8; SD = 6.4). CES-D was log-transformed (CES-D(log)) for analyses.
  
  
  RESULTS
  Mixed-effects regression revealed that prospective relations of CES-D(log) to diastolic blood pressure differed by age in women (b = 0.095; P = 0.001) but not men; greater CES-D(log) attenuated the expected age-related decline in diastolic blood pressure. Across all testing sessions, greater CES-D(log) was associated significantly with higher average systolic blood pressure for women (b = 2.238; P = 0.006) but not men. Age-stratified analyses showed that greater CES-D(log) was associated significantly with higher average systolic (b = 3.348; P = 0.02) and diastolic (b = 1.730; P < 0.03) blood pressure for older adults (≥58.8 years at first visit). In the younger age cohort, sex moderated the relation of CES-D(log) to systolic blood pressure (b = -3.563; P = 0.007); greater CES-D(log) in women, but lesser CES-D(log) in men, was associated with higher systolic blood pressure.
  
  
  CONCLUSIONS
  Results demonstrate sex and age differences in the relation between depressive symptoms and blood pressure. Findings suggest the potential importance of preventing, detecting, and lowering depressive symptoms to prevent hypertension among women and older adults.
authors: Department of Psychology, University of Maryland-Baltimore County, Baltimore, Maryland.
authors: Mauli T
authors: MT
authors: Shah
authors: Alan B
authors: AB
authors: Zonderman
authors: Shari R
authors: SR
authors: Waldstein
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015142:Baltimore / Q000453:epidemiology; D001795:Blood Pressure Determination; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors
keywords: age factors; blood pressure; depressive symptoms; hypertension; longitudinal studies; older adults; repeated measures; sex factors; women.
references: Stress. 2009 Jan;12(1):1-21
references: 19116888
references: Hypertension. 2011 Apr;57(4):710-6
references: 21339474
references: Circulation. 2010 Feb 23;121(7):e46-e215
references: 20019324
references: J Hypertens. 2008 Sep;26(9):1738-9
references: 18698205
references: Women Health. 1991;17(3):33-57
references: 1957530
references: Psychol Med. 2010 Feb;40(2):225-37
references: 19531277
references: Hypertension. 2003 Dec;42(6):1206-52
references: 14656957
references: Transl Psychiatry. 2012 Mar 13;2:e92
references: 22832857
references: Biol Psychiatry. 2002 Aug 1;52(3):175-84
references: 12182924
references: Int J Nurs Stud. 2010 Feb;47(2):229-38
references: 19665709
references: J Affect Disord. 1993 Oct-Nov;29(2-3):85-96
references: 8300981
references: BMC Med Res Methodol. 2012 Feb 29;12:21
references: 22375553
references: Am J Hypertens. 2012 Apr;25(4):505-11
references: 22258334
references: Psychol Med. 2010 Sep;40(9):1569-78
references: 19939325
references: J Hypertens. 2012 May;30(5):842-51
references: 22343537
references: Psychiatry Res. 1981 Oct;5(2):171-81
references: 6945612
references: J Clin Psychol. 2006 Jan;62(1):123-46
references: 16287149
references: Psychol Med. 2005 Sep;35(9):1241-52
references: 16168147
references: Hypertension. 2001 Oct;38(4):798-802
references: 11641289
references: Biol Psychiatry. 2002 Aug 1;52(3):253-64
references: 12182931
references: Exp Gerontol. 2004 May;39(5):687-99
references: 15130663
references: Psychosom Med. 2009 Feb;71(2):171-86
references: 19188531
references: Hypertension. 2005 Mar;45(3):349-51
references: 15710783
references: Arch Fam Med. 1997 Jan-Feb;6(1):43-9
references: 9003169
references: JAMA Psychiatry. 2013 Aug;70(8):803-11
references: 23760442
references: World J Biol Psychiatry. 2010 Dec;11(8):922-33
references: 20950120
references: Psychosom Med. 2010 Nov;72(9):842-54
references: 20841557
references: Br J Psychiatry. 2008 Aug;193(2):108-13
references: 18669991
references: Psychol Bull. 2005 Mar;131(2):260-300
references: 15740422
references: Psychol Bull. 1996 Sep;120(2):293-320
references: 8831299
references: J Nephrol. 2011 Jan-Feb;24(1):23-34
references: 20437401
references: Psychosom Med. 2009 Apr;71(3):273-9
references: 19196807
references: Annu Rev Clin Psychol. 2005;1:293-319
references: 17716090