Low Blood Pressure and Depressive Symptoms among Chinese Older Subjects: A Population-based Study

Background

The relationships between blood pressure and depression are unclear. There are inconsistent reports of an association between low blood pressure and depressive symptoms.

Methods

In a population-based sample of 2611 Chinese older adults aged 55 years and above, including participants with treated (n = 1088), untreated (n = 545), or no hypertension (n = 978), depressive symptoms were determined by the 15-item Geriatric Depression Scale (≥5), and current systolic blood pressure and diastolic blood pressure measurements were used to classify participants into high, normal, and low blood pressure groups. Estimates of association were adjusted for confounding by use of antihypertensive and depressogenic drugs and other covariables in hierarchical regression analyses.

Results

Systolic blood pressure and diastolic blood pressure were negatively associated with Geriatric Depression Scale scores, independent of other variables. Low systolic blood pressure (odds ratio [OR] 1.54; 95% confidence interval [CI], 1.07-2.22), low diastolic blood pressure (OR 1.67; 95% CI, 0.98-2.85), and low systolic blood pressure or diastolic blood pressure (or both) (OR 1.55; 95% CI, 1.10-2.19) were independently associated with depressive symptoms. The associations with depressive symptoms were particularly observed for low systolic blood pressure (OR 2.13; 95% CI, 1.13-4.03) among treated hypertensive participants, and low diastolic blood pressure (OR 2.42; 95% CI, 1.26-4.68) among untreated or nonhypertensive participants.

Conclusion

Low blood pressure was independently associated with depressive symptoms in both older subjects who were treated for hypertension and those who were not.