The association between depressive symptoms and masked hypertension in participants with normotension measured at research center

Sayuri Tokioka; Naoki Nakaya; Kumi Nakaya; Mana Kogure; Rieko Hatanaka; Ippei Chiba; Ikumi Kanno; Kotaro Nochioka; Hirohito Metoki; Takahisa Murakami; Michihiro Satoh; Tomohiro Nakamura; Mami Ishikuro; Taku Obara; Yohei Hamanaka; Masatsugu Orui; Tomoko Kobayashi; Akira Uruno; Eiichi N Kodama; Satoshi Nagaie; Soichi Ogishima; Yoko Izumi; Nobuo Fuse; Shinichi Kuriyama; Atsushi Hozawa

doi:10.1038/s41440-023-01484-8

The association between depressive symptoms and masked hypertension in participants with normotension measured at research center

Hypertens Res. 2024 Mar;47(3):586-597. doi: 10.1038/s41440-023-01484-8. Epub 2023 Oct 31.

Authors

Sayuri Tokioka^{1

2}, Naoki Nakaya^{1

2}, Kumi Nakaya^{1

2}, Mana Kogure^{1

2}, Rieko Hatanaka^{1

2}, Ippei Chiba^{1

2}, Ikumi Kanno^{1

2}, Kotaro Nochioka^{1

2

3}, Hirohito Metoki^{2

4}, Takahisa Murakami^{2

4}, Michihiro Satoh^{2

4}, Tomohiro Nakamura^{1

2

5}, Mami Ishikuro^{1

2}, Taku Obara^{1

2

3}, Yohei Hamanaka^{1

2}, Masatsugu Orui^{1

2}, Tomoko Kobayashi^{1

2

3}, Akira Uruno^{1

2}, Eiichi N Kodama^{1

2

3}, Satoshi Nagaie^{1

2}, Soichi Ogishima^{1

2}, Yoko Izumi^{1

2}, Nobuo Fuse^{1

2

3}, Shinichi Kuriyama^{1

2

6}, Atsushi Hozawa^{7

8}

Affiliations

¹ Tohoku University Graduate School of Medicine, Sendai, Japan.
² Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
³ Tohoku University Hospital, Tohoku University, Sendai, Japan.
⁴ Tohoku Medical and Pharmaceutical University, Sendai, Japan.
⁵ Kyoto Women's University, Kyoto, Japan.
⁶ International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.
⁷ Tohoku University Graduate School of Medicine, Sendai, Japan. hozawa@megabank.tohoku.ac.jp.
⁸ Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan. hozawa@megabank.tohoku.ac.jp.

Abstract

Masked hypertension is a risk factor for cardiovascular diseases. However, masked hypertension is sometimes overlooked owing to the requirement for home blood pressure measurements for diagnosing. Mental status influences blood pressure. To reduce undiagnosed masked hypertension, this study assessed the association between depressive symptoms and masked hypertension. This cross-sectional study used data from the Tohoku Medical Megabank Project Community-Based Cohort Study (conducted in Miyagi Prefecture, Japan, from 2013) and included participants with normotension measured at the research center (systolic blood pressure<140 mmHg and diastolic blood pressure <90 mmHg). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (Japanese version). Masked hypertension was defined as normotension measured at the research center and home hypertension (home systolic blood pressure ≥135 mmHg or home diastolic blood pressure ≥85 mmHg). The study comprised 6705 participants (mean age: 55.7 ± 13.7 years). Of these participants, 1106 (22.1%) without depressive symptoms and 393 (23.2%) with depressive symptoms were categorized to have masked hypertension. Sex-specific and age-adjusted least mean squares for home blood pressure, not for research blood pressure were significantly higher in the group with depressive symptoms in both sex categories. The multivariate odds ratio for masked hypertension in the patients with depressive symptoms was 1.72 (95% confidence interval: 1.26-2.34) in male participants and 1.30 (95% confidence interval: 1.06-1.59) in female ones. Depressive symptoms were associated with masked hypertension in individuals with normotension measured at the research center. Depressive symptoms may be one of the risk factors for masked hypertension. Depressive symptoms were associated with masked hypertension in individuals with normotension measured at research center.

Keywords: depression; home blood pressure; hypertension; masked hypertension; office blood pressure.

MeSH terms

Adult
Aged
Blood Pressure / physiology
Blood Pressure Monitoring, Ambulatory
Cohort Studies
Cross-Sectional Studies
Depression / complications
Female
Humans
Hypertension* / complications
Hypertension* / diagnosis
Hypertension* / epidemiology
Male
Masked Hypertension*
Middle Aged