Role of educational intervention in the management of comorbid depression and hypertension

To assess the effect of health education on blood pressure control and depression symptoms, we conducted a prospective study in 272 patients with essential hypertension. Depression symptoms were assessed by the Zung Self-rating Depression Scale (SDS). There was no significant difference in the level of hypertension and SDS scores between the educational (n = 138) and control (n = 134) group before the study (p > 0.05). After 12 months of follow-up, the body mass index (BMI) was reduced in the educational group (23.6 +/- 2.6 vs 21.4 +/- 2.2 kg/m2, p < 0.01), but it remained unchanged in the control group. The average systolic and diastolic blood pressure were reduced in both groups, but the amplitude of systolic blood pressure reduction in the educational group was greater than that of the control group (7.9 +/- 2.3 vs 4.2 +/- 2.0 mmHg, p < 0.01). The incidence of depression (10.9% vs 10.4%) and the average SDS scores (32.4 +/- 6.7 vs 33.2 +/- 6.9) were similar between the two groups (p > 0.05). However, in the depressed patients who received hypertension education, the average systolic (160.2 +/- 12.4 mmHg) and diastolic (89.8 +/- 7.3 mmHg) blood pressure was significantly lower than that of the control group (169.1 +/- 16.8 and 96.8 +/- 13.0 mmHg, respectively, p < 0.01). We conclude that hypertension education does not reduce the incidence or symptoms of depression, but it may facilitate blood pressure management in patients with clinical depression.