Older adults who exhibit significant changes in blood pressure over a year may have a higher risk of depressive symptoms than those whose blood pressure remains consistent, according to a study in the American Journal of Geriatric Psychiatry. In particular, diastolic blood pressure variability (changes in the pressure when the heart relaxes and fills with blood) was associated with greater symptoms of dysphoria, or a general state of unease.
“Importantly, these findings were in a study sample without history of dementia or recent depression, indicating BPV [blood pressure variability] may be related to subthreshold levels of depression in the absence of major neurocognitive dysfunction,” wrote Isabel J. Sible M.A., of the University of Southern California, Jung Y. Jang, Ph.D., of the University of California Irvine, and colleagues.
The researchers analyzed data from 505 older adults aged 55 to 91 who participated in the Alzheimer’s Disease Neuroimaging Initiative (ADNI). As part of the ADNI study, participants underwent three to four blood pressure measurements over 12 months and completed the 15-item Geriatric Depression Scale (GDS-15) at enrollment and follow-up 24 months later. The researchers focused their analysis on the participants who had low depressive symptoms (GDS-15 score of < 6), no history of neurological disease, low risk of cardiovascular disease, and no dementia at the start of the study.
Sible, Jang, and colleagues found that adults with greater variability in diastolic blood pressure readings over 12 months were more likely to have elevated GDS-15 scores at the 24-month follow-up. The association between diastolic blood pressure variability and depression symptoms was similar regardless of whether blood pressure levels were low or high on average.
The researchers also looked at the three subcomponents of the GDS-15 (dysphoria, withdrawal, and life satisfaction) and found that greater diastolic blood pressure variability was specifically linked with increased risk of dysphoria symptoms. There was no association between systolic blood pressure variability and dysphoria, nor did there appear to be any relationship between blood pressure variability and symptoms of withdrawal and life satisfaction.
These “[f]indings add to the limited number of studies investigating visit-to-visit [blood pressure variability] and depression in older adults and improve our understanding of associations with subthreshold levels of depressive symptoms,” Sible, Jang, and colleagues wrote.
To read more on this topic, see the Psychiatric News article “Some Hypertension Medications May Protect Against Depression.”
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