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Watch for Depression in Hypertensive Patients


 

MONTREAL — Hypertensive patients who have depression are less likely to stick to their therapy regimen than are those who are not depressed or are in remission from depression, according to a study presented at the annual meeting of the Society of Behavioral Medicine.

Sara Gallagher of New York (N.Y.) University, studied 161 hypertensive African Americans who were followed in primary care practice. The patients had a mean age of 54 years, and 87% of them were women. Depressive symptomatology was assessed using the Center for Epidemiologic Studies-Depression (CES-D) scale.

A total of 44% of patients were classified as nondepressed, with a CES-D score of less than 16 at all time points, while 19% were considered depressed, with a score of 16 or above at all time points. A total of 37% of patients were classified as remittent, meaning that they progressed from depressed to nondepressed over the course of the study, said Ms. Gallagher.

Medication adherence was assessed at baseline and at 12 months using the self-reported Morisky scale. At baseline, 64% of the study population reported nonadherence to their medication, and this dropped to 48% at the end of the study.

A multivariate analysis revealed that depressive symptoms were tied to drug nonadherence, Ms. Gallagher reported. Among the depressed patients, only 34% reported adherence at 12 months, compared with 66% in the nondepressed group and 47% in the remittent group.

The finding that a remittence of depressive symptoms can result in improved adherence suggests a benefit to addressing patient depression, she said.

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