Association between long-term visit-to-visit blood pressure variability and depression among Chinese middle-aged and older adults

ABSTRACT

Background

Whether there is a longitudinal association between long-term blood pressure variability (BPV) and subsequent depression among Chinese adults remains inconclusive.

Methods

This study utilized data from a nationwide cohort of the China Health and Retirement Longitudinal Study, which included participants aged > 45 years without prevalent psychiatric or memory-related diseases. The intra-individual coefficient of variation (CV) and standard deviation (SD) across 3 visits from 2011 to 2015 were used to examine the long-term variability in systolic BP (SBP) and diastolic BP (DBP). The depressive symptoms were examined using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10), and moderate-to-severe depression was defined as CES-D-10 ≥ 15.

Results

A total of 5,249 participants (mean age: 61.4 ± 8.1 years, 46.5% were men) were included in the current analysis. Individuals in the highest quartile of both BP CV and SD were independently correlated with a higher total CES-D-10 score compared to those in the lowest quartile after multivariable adjustment. 1,070 participants (20.4%) had moderate-to-severe depression during the 3-year follow-up period. Participants in the Q4 of SBP and DBP CV had 1.23-fold higher odds (95% CI: 1.01, 1.49) and 1.20-fold higher odds (95% CI: 1.01, 1.41) of moderate-to-severe depression compared to those in Q1. Subgroup analyses revealed that men with higher BP CVs had a greater risk of severe depressive symptoms (p for SBP CV-by-sex interaction = 0.050, p for SBP CV-by-sex interaction = 0.025).

Conclusions

Depression was common among Chinese middle-aged and older adults and long-term visit-to-visit BPV was positively associated with depressive symptoms, highlighting the importance of implementing intensive prevention strategies for depression and enhancing blood pressure monitors in China.

KEYWORDS:

• Blood pressure variability
• depression
• CES-D-10
• middle-aged and elder
• systolic blood pressure

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The authors thank the China Health and Retirement Longitudinal Study for sharing their data and all the staff participated in the CHARLS for their contributions to this work.

Author’s contributions

Jinni Liao contributed to the data acquisition, concept, and design, and drafted the manuscript. Weida Qiu contributed to the data acquisition, and data analysis, and drafted the manuscript. Dan Huang and Aiqun Cen provided the study concept and design. Yanli Chen contributed to the supervision of the work, and provided administrative, technical, or material support, and revised the manuscript.

Ethics statement

The CHARLS study protocol was approved by the ethics review committee at Peking University, Beijing, China (IRB00001052–11015). Written informed consent was obtained from all participants.

Data availability statement

The data analyzed in this study are available from the Institute of Social Science Survey, Peking University, Beijing, China. (http://charls.pku.edu.cn).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/00325481.2024.2358748

Additional information

Funding

This paper was not funded.