title: Association of Baseline Depressive Symptoms with Prevalent and Incident Pre-Hypertension and Hypertension in Postmenopausal Hispanic Women: Results from the Women's Health Initiative.
abstract: Depression and depressive symptoms are risk factors for hypertension (HTN) and cardiovascular disease (CVD). Hispanic women have higher rates of depressive symptoms compared to other racial/ethnic groups yet few studies have investigated its association with incident prehypertension and hypertension among postmenopausal Hispanic women. This study aims to assess if an association exists between baseline depression and incident hypertension at 3 years follow-up among postmenopausal Hispanic women.
  
  
  
  Prospective cohort study, Women's Health Initiative (WHI), included 4,680 Hispanic women who participated in the observational and clinical trial studies at baseline and at third-year follow-up. Baseline current depressive symptoms and past depression history were measured as well as important correlates of depression-social support, optimism, life events and caregiving. Multinomial logistic regression was used to estimate prevalent and incident prehypertension and hypertension in relation to depressive symptoms.
  
  
  
  Prevalence of current baseline depression ranged from 26% to 28% by hypertension category and education moderated these rates. In age-adjusted models, women with depression were more likely to be hypertensive (OR = 1.25; 95% CI 1.04-1.51), although results were attenuated when adjusting for covariates. Depression at baseline in normotensive Hispanic women was associated with incident hypertension at year 3 follow-up (OR = 1.74; 95% CI 1.10-2.74) after adjustment for insurance and behavioral factors. However, further adjustment for clinical covariates attenuated the association. Analyses of psychosocial variables correlated with depression but did not alter findings. Low rates of antidepressant medication usage were also reported.
  
  
  
  In the largest longitudinal study to date of older Hispanic women which included physiologic, behavioral and psychosocial moderators of depression, there was no association between baseline depressive symptoms and prevalent nor incident pre-hypertension and hypertension. We found low rates of antidepressant medication usage among Hispanic women suggesting a possible point for clinical intervention.
  
  
  
  Clinicaltrials.gov NCT00000611.
authors.affiliation: Department of Women's Studies, Consortium on Race, Gender and Ethnicity, University of Maryland, College Park, Maryland, United States of America.
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Zambrana
authors.affiliation: Division of Hospital Medicine, University of California, San Francisco, California, United States of America.
authors.forename: Lenny
authors.initials: L
authors.lastname: López
authors.affiliation: African American Studies Department, University of Maryland, College Park, Maryland, United States of America.
authors.forename: Gniesha Y
authors.initials: GY
authors.lastname: Dinwiddie
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America.
authors.forename: Roberta M
authors.initials: RM
authors.lastname: Ray
authors.affiliation: Family Medicine & Epidemiology, Alpert Medical School, Brown University, Providence, Rhode Island, United States of America.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Eaton
authors.affiliation: Division of Endocrinology and Metabolism, Emory University School of Medicine, Atlanta, Georgia, United States of America.
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Phillips
authors.affiliation: Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Wassertheil-Smoller
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003863:Depression / Q000150:complications* / Q000188:drug therapy; D003866:Depressive Disorder / Q000150:complications* / Q000188:drug therapy; D005006:Ethnicity; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D016015:Logistic Models; D008137:Longitudinal Studies; D008875:Middle Aged; D017698:Postmenopause / Q000523:psychology*; D058246:Prehypertension / Q000209:etiology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D016387:Women's Health
chemical_list: D000928:Antidepressive Agents