Relationship of depressive disorders with hypertension, its control and other metabolic risk factors in the Tyumen Oblast population of men and women. Data from the study “Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation” (ESSE-RF)

Aim. To study the association between depression and metabolic cardiovascular risk factors, hypertension (HTN) and its control in a random sample of Tyumen Oblast population of men and women aged 25-64 years.

Material and methods. The study object was a random sample of the population of the Tyumen and the Tyumen Oblast aged 25-64 years, examined as part of the ESSE-RF epidemiological study. The study included 1658 participants. Among them, 30,3% (n=503) were men, while 69,7% (n=1155) — women. Mean age was 48,9±11,4 years. The prevalence of metabolic risk factors (hyperlipidemia, carbohydrate metabolism disorder, obesity), hypertension and the likelihood of its control in men and women with different levels of depressive disorders diagnosed using the HADS scale were assessed.

Results. Compared with participants without depression, persons with psychological disorders were significantly more likely to have HTN (55,5% vs 47,6%, p<0,01), elevated levels of total cholesterol (TC) (63,9% vs 54,0%, p<0,01) and low-density lipoproteins (LDL) (66,7% vs 60,3%, p<0,05), carbohydrate metabolism disorders (8,3% vs 5,2% p<0,05), obesity (49,2% vs 37,7%, p<0,01). Significantly more often hypertensive subjects without depression took antihypertensive drugs effectively (odds ratio (OR) — 1,747, 95% confidence interval (CI), 1,001-3,053) and controlled blood pressure (OR — 1,533, 95% CI, 1,05-2,36). There was no association between the use of antihypertensives and the level of depressive disorders. Among women with depression (HADS>7), dyslipidemia (65,5% vs 57,4% for TC, p<0,05; 71,0% vs 62,9% for LDL, p<0,05), carbohydrate metabolism disorders (10,1% vs 5,2%, p<0,01), obesity (53,3% vs 43,2%, p<0,01), HTN (60,6% vs 45,6%, p<0,01) were more common. Men with clinical depression were more likely to have HTN (69,0% vs 47,7%, p<0,05), with a high level of depression — hyperlipidemia (58,9% vs 46,7% for TC, p<0,05; 67,1% vs 53,9% for LDL, p<0,05). Women with elevated depression levels were less likely to take antihypertensive drugs (30% vs 49,4%, p<0,01) and control hypertension (13,8% vs 21,2%, p<0,05).

Conclusion. The data obtained confirm the association of depressive disorders with metabolic risk factors and the likelihood of HTN control, which is especially significant among women.

1. Meier SM, Mattheisen M, Mors O, et al. Increased mortality among people with anxiety disorders: total population study. Br J Psychiatry. 2016;209(3):216-21. doi:10.1192/bjp.bp.115.171975.

2. Laursen TM, Musliner KL, Benros ME, et al. Mortality and life expectancy in persons with severe unipolar depression. J Affect Disord. 2016;193:203-7. doi:10.1016/j.jad.2015.12.067.

3. Rotella F, Mannucci E. Depression as a risk factor for diabetes: a meta-analysis of longitudinal studies. J. Clin. Psychiatry. 2013;74(1):31-7.

4. Shalnova SA, Evstifeeva SE, Deev AD, et al. The prevalence of anxiety and depression in different regions of the Russian Federation and its association with sociodemographic factors (according to the data of the ESSE-RF study). Terapevticheskii Arkhiv. 2014;86(12):53-60. (In Russ.) doi:10.17116/terarkh2014861253-60.

5. Efanov AY, Medvedeva IV, Panteleev SM, et al. Anxiety and depression prevalence in patients with arterial hypertension in Tyumen region. Medical science and education of Ural. 2017;4:134-9. (In Russ.)

6. Nauchno-organizatsionnyĭ komitet proekta ÉSSE-RF. Epidemiology of cardiovascular diseases in different regions of Russia (esse-rf). The rationale for and design of the study. Profilakticheskaya Meditsina. 2013;16(6):25-34. (In Russ.)

7. Shalnova SA, Konradi AO, Karpov YuA, et al. Cardiovascular mortality in 12 Russian Federation regions — participants of the “Cardiovascular disease epidemiology in Russian regions” study. Russian Journal of Cardiology. 2012;(5):6-11. (In Russ.)

8. Pogosova NV, Boytsov SA, Oganov RG, et al. Clinical-Epidemiological Program of Studying Psychosocial Risk Factors in Cardiological Practice in Patients With Arterial Hypertension and Ischemic Heart Disease: First Results of a Multicenter Study in Russia. Kardiologiia. 2018;58(9):47-58. (In Russ.) doi:10.18087/cardio.2018.9.10171.

9. Mazgo GE, Shmaneva TM. Correlation between depression and obesity: illusion or reality (literature review). Psichicheskie rasstroystva v obshey medicine. 2012;1:42-6. (In Russ.)

10. Navmenova YaL, Mohart TV. Correlation of depression and diabetes mellitus. Lechebnoye delo. 2014;1(35):50-3.

11. Katon W, et al. Behavioral and Clinical Factors Associated With Depression among Individuals With Diabetes. Diabetes Care. 2004;27(4):914-20. doi:10.2337/diacare.27.4.914.