Relationship between blood pressure and depression in the elderly.: The Three-City Study

Objective To examine the relationship between blood pressure and depression in a large sample of noninstitutionalized elderly people. Methods Cross-sectional community-based study in 9294 participants aged 65 years and over, living at home, in three French cities ( Bordeaux, Dijon and Montpellier). Participants were categorized as depressive, based on three different markers of depression. Multiple linear regression analyses of the relation between depression and mean systolic and diastolic blood pressure values were conducted, taking into account potential confounders like age, sex, education, smoking, alcohol consumption, body mass index and history of cardiovascular events. Results Our working sample had a mean age (SD) of 73.7 (5.0) years, and included 60.7% of women. Overall, 31% of participants met the criteria for depression, 77.5% had hypertension, and 49.5% were on antihypertensive drugs. Analyses showed lower systolic and diastolic blood pressure values in depressive individuals compared with nondepressive ones, in both men ( systolic blood pressure 148.2 versus 151.8mmHg, P < 0.002; diastolic blood pressure 83.0 versus 84.7mmHg, P=0.003) and women ( systolic blood pressure 141.7 versus 144.7mmHg, P < 0.0001; diastolic blood pressure 80.7 versus 81.4mmHg, P < 0.02). These associations were independent of age and of use of antihypertensive or psychotropic agents. Conclusion In a large sample of elderly individuals from the general population, depressive individuals had lower blood pressure values than nondepressive ones, independent of medications and of history of cardiovascular events.