The link of depression, untreated hypertension, and diabetes with mortality in postmenopausal women: A cohort study

ABSTRACT

Objective

To explore the association of depression, as well as untreated hypertension or diabetes with all-cause death in community-based postmenopausal women in Beijing.

Methods

A cohort of 863 community-based postmenopausal women with no history of cardiovascular heart disease (CHD), stroke, cancer, or dementia was investigated on 20 July–28 September 2009 at baseline. Depression was diagnosed using the 30-item Center for Epidemiologic Studies Depression (CES-D) scale with CES-D ≥ 11. Meanwhile, data on health behavior, physical comorbidity, and social support at baseline were collected. These individuals were followed up from 20 July to 30 August 2014. All-cause mortality and cause of death were surveyed.

Results

After a median follow-up of 4.97 years, 120 subjects died of all-cause. Twenty-four died of stroke, 19 died of myocardial infarction, 21 died of cancer. The others died of aging, infection, and accident. Depression and untreated HP were significantly associated with all-cause mortality in Cox models after full adjustment for all of the potential confounders (Depression HR: 2.16, 95%CI: 1.35–3.46; Untreated hypertension HR: 1.84, 95%CI: 1.12–3.02). However, negative correlation of untreated diabetes on all-cause mortality was observed in this population (HR: 1.36, 95%CI: 0.75–2.49). When depression was co-existing with hypertension/diabetes, the HR for mortality elevated significantly (Depression co-existing with hypertension HR = 3.87, 95% CI: 2.07–7.23; Depression co-existing with diabetes HR = 5.02, 95% CI: 1.5–16.79).

Conclusions

It is suggested we should take sufficient care of postmenopausal females with depression and control blood pressure and glucose more effectively.

Abbreviations: HP: Hypertension; DM: Diabetes; TC: Cholesterol; TG: Triglyceride; BMI: Body-Mass Index; CES-D: Center for Epidemiologic Studies Depression; CDC: Centers for Disease Control and Prevention; HR: Hazard Ratio; CI: Confidence Interval; ADL: Activities of daily living scale

KEYWORDS:

• All-cause death
• depression
• diabetes mellitus
• epidemiology
• hypertension

Disclosure of interest

The authors report no conflicts of interest.

Authors’ contribution

Shaochen Guan contributed to study design, acquisition of subjects and/or data, analysis and interpretation of data, and preparation of manuscript; Xiang Gu, Zhongying Zhang, Hongjun Liu, and Zhe Tang contributed to acquisition of subjects and/or data, analysis, and interpretation of data; Xiaoguang Wu, and Chunxiu Wang contributed to analysis and interpretation of data. Xianghua Fang contributed to study design, analysis and interpretation of data, and review of the manuscript.

Additional information

Funding

This study was supported by the United National Population Fund under [Grant UNFPA, CPR/90/P23]; and United National Development Program Fund under [Grant CPR/96/301].